Dengue Awareness Research Articles

Airway breathing circulation dengue: a case of multifactorial shock due to major trauma and severe dengue infection

BackgroundDengue is the most common arboviral illness reported globally, endemic to most tropical and sub-tropical regions of the world. Dengue Shock Syndrome is a rare complication of severe Dengue infection resulting in haemorrhagic complications and refractory hypotension. We report on a case of severe dengue diagnosed in a patient with major trauma and illustrate some of the potential challenges and considerations in the clinical management of such cases.Case PresentationA 49-year-old female presented following a road trauma incident with multiple abdominal injuries requiring urgent laparotomy. Her recovery in Intensive Care Unit was complicated by the development of Dengue Shock Syndrome characterised by a falling haemoglobin and platelet count, multiorgan dysfunction and prolonged hospital stay.ConclusionsDengue Shock Syndrome may complicate fluid management and bleeding control in major trauma cases. Awareness of Dengue, particularly in endemic areas and returned travellers may help facilitate early diagnosis and management of complications.

Awareness and Practice on Prevention and Control of Dengue among Community People of Lalitpur Metropolitan City

Background: Dengue is a mosquito-borne viral disease that has rapidly spread in many countries worldwide in recent years. Dengue is a major public health problem in many countries. Dengue is a rapidly emerging disease in Nepal that is endemic across most provinces. The incidence of dengue has increased in recent years due to the expansion of the Aedes aegypti vector. The increasing outbreak of dengue in Nepal is becoming a major concern for the public health. Objective: The objective of the study was to assess awareness level and practice on prevention and control of dengue among community people in Lalitpur metropolitan city. Method: A community-based cross-sectional study was conducted from January to June 2023 at ten different wards in Lalitpur metropolitan city. Sample populations of 368 residents of Lalitpur metropolitan city above the age of 18 years were selected for the study. Simple random probability sampling technique used for the sample selection. Statistical Package for the Social Sciences (SPSS) 16 version used to analyze the data. Result: Majority (98.1%) of respondents knew about dengue fever. Most of the respondents (47.1%) answered that dengue is caused by aedes mosquito. Majority (71.4%) of respondents stated that dirty water was breeding sites of dengue mosquito. Primary preventive measures used were cleanliness 34.1 percent followed by use of mosquito net/coil 31.4 percent. The community people had good awareness (79.3%) of dengue, but poor practice (56.79%) in prevention and control of dengue. According to this study, socio-demographic factors such as age, sex, and education level were significantly linked to the knowledge level of the participants. Conclusion: According to this study, the community people had a good awareness level of dengue (79.3%). However, their practice of prevention and control of dengue was found to be poor (56.79%).

Perceptions of dengue risk and acceptability of a dengue vaccine in residents of Puerto Rico

ABSTRACT Dengvaxia is the first dengue vaccine recommended in the United States (U.S.). It is recommended for children aged 9–16 y with laboratory-confirmed previous dengue infection and living in areas where dengue is endemic. We conducted focus groups with parents and in-depth interviews with key informants (i.e. practicing pediatricians, physicians from immunization clinics, university researchers, and school officials) in Puerto Rico (P.R.) to examine acceptability, barriers, and motivators to vaccinate with Dengvaxia. We also carried out informal meetings and semi-structured interviews to evaluate key messages and educational materials with pediatricians and parents. Barriers to vaccination included lack of information, distrust toward new vaccines, vaccine side effects and risks, and high cost of/lack of insurance coverage for laboratory tests and vaccines. Motivators included clear information about the vaccine, a desire to prevent future dengue infections, the experience of a previous dengue infection or awareness of dengue fatality, vaccine and laboratory tests covered by health insurance, availability of rapid test results and vaccine appointments. School officials and parents agreed parents would pay a deductible of $5–20 for Dengvaxia. For vaccine information dissemination, parents preferred an educational campaign through traditional media and social media, and one-on-one counseling of parents by healthcare providers. Education about this vaccine to healthcare providers will help them answer parents’ questions. Dengvaxia acceptability in P.R. will increase by addressing motivators and barriers to vaccination and by disseminating vaccine information in plain language through spokespersons from health institutions in P.R.

Sustainable Dengue Prevention and Management: Integrating Dengue Vaccination Strategies with Population Perspectives.

The GEMKAP study (2023) unveiled consistent knowledge, attitude, and practice (KAP) levels across Asia-Pacific (APAC) and Latin America (LATAM) countries regarding dengue, with variations in the willingness to vaccinate. Despite an overall KAP parity, the disparities within and between the countries indicated the need for both overarching and tailored strategies. Population-wide gaps in dengue awareness result in suboptimal vaccination priorities and preventive measures. This commentary delves into identifying the drivers and barriers for implementing a multi-pronged dengue prevention and management program, emphasizing the pivotal role of vaccination alongside education and vector control. Drawing on expert interviews in APAC and LATAM, informed by the Consolidated Framework for Implementation Research (CFIR), four key themes emerged: prioritizing and continuously advocating for dengue on national health agendas, fostering stakeholder collaboration, incorporating population perspectives for behavioral change, and designing sustainable dengue prevention and management programs. Successful implementation requires evidence-based decision making and a comprehensive understanding of population dynamics to design adaptive education tailored to diverse population views. This commentary provides actionable strategies for enhancing dengue prevention and management, with a pronounced emphasis on dengue vaccination, advocating for a holistic, population-centric approach for sustained effectiveness.

Knowledge, Attitude, and Perception regarding Dengue Prevention and Control in Puducherry – A Community-based Cross-sectional Study

Abstract Context: Dengue is one of the most dreadful viral diseases of humans, with over half of the world’s population living in the areas of risk. Aims: The aim of this study was to determine the level of knowledge, awareness, and practice of preventive measures regarding dengue fever among people living in Puducherry. Settings and Design: A community-based cross-sectional study was carried out among the individuals residing in Puducherry in the field practice areas of our tertiary care hospital. Subjects and Methods: The study was conducted for a period of 3 months from August to October 2023. The study population included residents of Puducherry in the field practice area of our tertiary care hospital based on the inclusion and exclusion criteria. A simple random sampling method was used with an estimated sample size of 285. Statistical Analysis Used: Continuous variables were presented in the form of frequency and proportion. Chi-square test was used for determining the association. Results: Out of 285 participants, 252 had good knowledge, and 33 had poor knowledge. 94.4% had good attitude and 5.6% had poor attitude. 62.1% (177) had good perception and 108 (37.9) had poor perception. The study showed a significant association between age and knowledge (P = 0.003) regarding dengue awareness. Socioeconomic status of the participants had a significant association with the attitude (P < 0.001). Conclusions: Appropriate use of information education and communication by involving mass media and social network and inclusion of environmental sanitation to the primary school curriculum can go a long way in creating awareness and decreasing the dengue burden in the community.

Awareness of Dengue Disease among Female Community Health Volunteers of Sainamina Municipality, Nepal

Dengue is a mosquito-borne viral infection that is a major public health problem in Nepal. Female community health volunteers play a vital role in dengue prevention and control by providing health education and services to the community. This study aimed to provide a comprehensive understanding of the level of dengue awareness among female community health volunteers in Sainamina Municipality, Nepal. This study involved a cross-sectional survey of 50 female community health volunteers aged 20 and above, actively engaged in health-related activities in Sainamina Municipality. A structured questionnaire was used to gather information on their knowledge of dengue transmission, symptoms, preventive measures, and available treatments. The findings revealed that 98 percentage of the female community health volunteers had a general knowledge of dengue, but there was some confusion regarding the specific mode of transmission. Their knowledge about the signs and symptoms, transmission routes, and preventive measures was inadequate. Only 74 percentage identified that dengue is transmitted through the bite of an infected Aedes mosquito. Additionally, 48 percentage of respondents were able to identify the Aedes mosquito, and 36 percentage knew that there was no specific medicine for dengue patients. Targeted efforts are needed to address the areas of confusion among the female community health volunteers and enhance awareness of comprehensive prevention strategies. It is recommended to conduct training, provide educational materials, and encourage them to share their knowledge with their communities to improve dengue awareness and prevention efforts.

The Effect of Community-Based Intervention on Dengue Awareness and Prevention Among Poor Urban Communities in Delhi, India.

This study aimed to assess the efficacy of a dengue intervention program in economically deprived urban regions of India, with a particular emphasis on housing conditions and community involvement. Given the global significance of dengue fever as a vector-borne disease, successful vector management requires effective community engagement. Study Design: A quasi-experimental study. This study was conducted with 314 participants from Delhi's Sanjay Colony, divided into control and intervention groups. The study spanned 14 months (August 2020 to September 2021). The intervention program comprised two educational sessions held one month apart, covering dengue awareness, health self-care, and environmental maintenance. Data were collected at baseline, after each intervention session, and during a final follow-up assessment three months later. The primary outcome, the house index (HI), revealed statistically significant differences (P<0.001) favoring the intervention group. The total score (TS) for mosquito-borne disease, TS of knowledge, TS of attitude, and TS of practices all exhibited significant improvements in the intervention group. Participants showed an enhanced understanding of dengue causes, symptoms, and mosquito behavior related to breeding and biting. The HI in the intervention group decreased significantly from 21.65% to 4.45% (P<0.05). This study, grounded in the health belief model (HBM), demonstrated the effectiveness of the intervention program in reducing HI and improving knowledge and preventive practices regarding dengue fever in impoverished urban neighborhoods of Delhi. The intervention program may be beneficial in such a poor urban community.

Public knowledge, belief, and preventive practices regarding dengue: Findings from a community-based survey in rural Bangladesh.

Dengue fever, the most prevalent mosquito-borne viral infection, is a recurrent public health threat in Bangladesh. Despite the government's efforts, dengue outbreaks are on the upswing, and people's knowledge, belief, and preventive practices regarding the disease at the rural community level are unclear. The objective of this study was to assess the level of knowledge, belief and preventive practices regarding dengue and associated factors among community people from rural Bangladesh. A cross-sectional survey was conducted involving 401 people using a convenient sampling technique from three unions of Savar from August to September 2021. Participants' responses were collected through face-to-face interviews using a pre-tested structured questionnaire that included information related to socio-demographics, dengue-related knowledge, preventive practices, and the health belief model (HBM) constructs. Multiple linear regression analysis was performed to determine the factors associated with the knowledge and preventive practices of dengue. Overall, participants (mean age = 33.47 ± 12.96 years; age range = 18-75 years) correctly answered 66.15% of the knowledge questions regarding dengue. Higher education, travel to dengue-risk regions, and self-efficacy under the HBM construct were all shown to be strongly associated with dengue knowledge. Regarding HBM constructs, about 80% of the participants perceived dengue as dangerous, but less than half (41.4%) believed themselves susceptible to dengue. Considering perceived barriers, 73.07% of the participants believed their residential area was not suitable for Aedes mosquito breeding. Nearly all (93.52%) believed they always kept their surrounding area clean as part of self-efficacy. Moreover, on average participants engaged in 53.69% of all dengue preventive practices. Being older, female, having a higher education, being a service holder, having a good quality of house structure, and perceived susceptibility as well as self-efficacy under the HBM construct were all factors in participants' dengue prevention activities. Participants' dengue preventative practices were shown to be significantly influenced by their knowledge. The findings of this study found a moderate level of knowledge regarding dengue among the participants. Regarding dengue prevention, although participants scored highly in several indicators, the overall preventive practices were not satisfactory. This suggests that there is a pressing need for expanded education outreach aimed at increasing public awareness of dengue and encourage preventive practices within rural communities in Bangladesh.

Knowledge, Attitude and Practice Regarding Dengue Fever among the Population of Lahore, Pakistan

Dengue fever is an acute febrile disease caused by one of a number of viruses that are carried by mosquitoes. This prospective cross sectional study was designed to assess knowledge, practice and attitude regarding dengue fever among the population of Lahore, Pakistan. Data was collected from 450 respondents (45.3%) were males and (54.7%) were females. Majority of respondents were employed and (56.0%) respondents were aware about all symptoms of dengue fever, (93.3%) knew that Dengue virus is transmitted through mosquito bites. Radio and TV was the major source of information and (74.4%) respondents were aware of the severity of the DF. Moreover, (74.4%) individuals thought that both Government and people are responsible for mosquito control. Majority considered that DF can be reduced by taking acetaminophen. It was concluded that only knowledge or attitude does not necessarily lead to dengue fever control. Dengue awareness activity must be carried out at the school, college and university level. Radio and television must also play an important role in conveying health information to the public. Both Government and people should play their role in mosquito control that leads to DF prevention. Latest treatment facilities should be provided at hospitals.

Effectiveness of Dengue Awareness Calendar on Indigenous Population: Impact on Knowledge, Belief and Practice

Dengue is prevalent among the indigenous community due to impoverished living conditions near the forest fringe areas and lack of health awareness. The study aims to determine the effect of a dengue awareness calendar on knowledge, belief, and practices (KBP) among the indigenous population. A cross-sectional study was conducted in nine selected indigenous villages in Selangor, Malaysia. A dengue awareness calendar was distributed to the indigenous communities after pre-intervention. The KBP scores were compared between the pre-and post-intervention. A total of 609 paired responses were obtained. Knowledge, perceived severity, cues to action, self-efficacy, and prevention practices were significantly improved after the intervention (p > 0.00). Participants with primary (Odds Ratio (OR) 2.627; 95% CI 1.338-5.160) and secondary level education (OR 2.263; 95% Cl 1.126-4.550) reported a high increment in practices score. High increments in dengue knowledge scores (OR 2.190; 95% CI 1.521-3.757, p < 0.00) were significantly more likely to report a high increment in practices score. Housewives (OR 0.535; 95% Cl 0.289-0.950), perceived severity (OR 0.349; 95% CI 0.184-0.662), and perceived susceptibility (OR 0.474; 95% CI 0.286-0.785) were significantly less likely to report an increment in prevention practices score. Findings inferred that the dengue awareness calendar significantly improved knowledge and practices. Our findings revealed the effectiveness of the dengue awareness calendar in dengue prevention among indigenous communities.

Economic status as the predictor of dengue awareness among local residents of Sabah, Malaysia

Abstract We investigated the knowledge, attitudes, and practices (KAPs) regarding dengue and its prevention among local residents in all five divisions of Sabah, Malaysia. A cross-sectional questionnaire survey was conducted with 1,000 residents aged 18 years and above. The results revealed that less than one-tenth of the respondents scored high in knowledge (9.6%), while more than half scored high in attitude (64.6%), and less than one-fifth (15.6%) scored high in dengue prevention practices. Economic factors (monthly salary and occupation) were the final independent predictors in all KAP domains. KAP parameters were correlated with each other, but wide gaps between the scores implied that a positive attitude was not translated into either high knowledge or practice scores. Therefore, it is imperative for the authorities to employ multifaceted approaches in future dengue awareness campaigns to increase all KAP domains, especially among those with lower economic status.

Limited Awareness of Melioidosis in High-risk Populations Despite an Increasing Incidence of the Disease in Far North Queensland, Australia.

The incidence of melioidosis, an opportunistic infection caused by Burkholderia pseudomallei, has recently doubled in Far North Queensland (FNQ), Australia. This contrasts with the local burden of dengue, which is nearing elimination, and the stable incidence of leptospirosis. This questionnaire-based study assessed the awareness of melioidosis among people in FNQ with risk factors for the disease, using awareness of leptospirosis and dengue as comparators. There were 427 respondents; 361 (85%) reported one or more risk factors for melioidosis. Only 69 of 361 (19%) had heard of melioidosis compared with 301 of 361 (83%) who had heard of dengue (P < 0.001) and 137 of 361 (38%) who had heard of leptospirosis (P < 0.001). In FNQ, Australia, there is an increasing local incidence of melioidosis, but there is limited awareness of the disease among high-risk individuals. Greater community awareness of melioidosis is necessary to implement strategies to prevent disease and expedite the presentation of patients with this life-threatening infection.

Dengue awareness among faculty members of government college university, Faisalabad

Background: As Pakistan is a developing country with limited sources and overpopulation, facing problems like earthquakes, water shortages and floods has affected the health conditions of people of Pakistan. Dengue has been a grave problem in Pakistan due to the availability of no vaccine, insufficient sanitation system, presence of polluted water for drinking and overpopulation for a very long time but still each year there are dengue cases reported along with deaths caused by it. Even for being present for a very long time and being prevalent, there is lack of sufficient awareness in the people of Pakistan. Aims: There are awareness studies conducted on various aspects of the population and in different areas but neither there are any studies conducted on faculty members nor consequently there are awareness programs based for the faculty members that are the source of knowledge for the society and specifically the newer generations. Thus, this study focused on determining the level of awareness in faculty members which might help in designing awareness programs for them later on. Method: The sampling technique used in this study was convenient sampling and the sample included 50 faculty members (men = 28, women = 21) from different departments of Government College University, Faisalabad. A self-constructed structured dengue awareness questionnaire was administered onto the participants i.e., the faculty members. Later on, the data obtained through these questionnaires were quantitatively analyzed and interpreted through the Statistical Package for Social Sciences SPSS version 26. Later on, the results were reported.

Retraction: Awareness and perception of malaria and dengue at school and college level in the district of Multan.

Retraction: Awareness and perception of malaria and dengue at school and college level in the district of Multan.

Analyzing &amp; Evaluating the Effects of Public Service Messages about Dengue in Punjab-Pakistan

This research aimed to evaluate the impact of public service messages about Dengue in Punjab, Pakistan. The aim was to measure the perceived effectiveness of public service messages, knowledge, attitudes, and practices in the context of Health Belief Model constructs. The pre-constructed questionnaire was used to collect data from 540 respondents through the survey method. The findings indicated a significant difference in the perceived effectiveness of the PSM between normal and diseased. Among normal people. There was a significant difference in knowledge about Dengue among people belonging to different socioeconomic backgrounds. A positive and significant relationship between knowledge and attitudes toward dengue was discovered, with a linear regression model indicating a 54.7% positive impact on attitudes. In addition, perceived susceptibility to dengue had a significant impact on dengue prevention measures (p-value&gt;0.05). But the impact of perceived severity on the preventive measures was not noteworthy (p-value =.144 &gt; 0.05). Moreover, the perceived benefits of Dengue had a significant impact on the self-efficacy but Perceived barriers were negatively correlated with self-efficacy, although the correlation was very weak (r = -16). Furthermore, exposure to the media and participation in health-related awareness had a significant impact on knowledge. TV, newspapers, and health clinics/hospitals were rated the most effective and leading sources of Dengue awareness.

Assessment of dengue virus threat to blood safety and community health: A single center study in northern Egypt

BackgroundThe risk of transfusion transmitted dengue (DENV) is increasingly recognized and poses a risk to blood safety as well as spreading into non-immune communities. ObjectivesTo determine dengue serological profile, environmental risk, knowledge, and preventive measures among blood donors in a national blood bank in northern Egypt. MethodsA total of 500 blood donors were enrolled into this study between June and September 2018. Socio-demographic and medical data were collected using a predesigned questionnaire. Blood samples were screened for anti-DENV IgM, anti-DENV IgG and non-structural protein 1 antigen (DENV-NS1 antigen). ResultsHistory of past dengue exposure was identified in 10.2% of blood donors. No samples (0.0%) tested positive for anti-DENV IgG, IgM or NS1 antigen. At the time of blood donation, no individuals had any symptoms suggestive of a dengue-related illness. Dengue exposure strongly correlated with travel to the Kingdom of Saudi Arabia (KSA), Sudan and the El-Quseir outbreak area in Egypt. Knowledge of dengue and prevention methods was found to be substantially deficient, and the relatively higher level of knowledge among exposed donors did not translate into appropriate preventative measures. ConclusionsOur risk assessment shows the impact of travel on DENV exposure and highlights its potential threat to disease spread in Egypt. Dengue awareness programs are urgently needed for effective prevention of transmission.

Molecular and genomic investigation of an urban outbreak of dengue virus serotype 2 in Angola, 2017-2019.

BackgroundThe transmission patterns and genetic diversity of dengue virus (DENV) circulating in Africa remain poorly understood. Circulation of the DENV serotype 1 (DENV1) in Angola was detected in 2013, while DENV serotype 2 (DENV2) was detected in 2018. Here, we report results from molecular and genomic investigations conducted at the Ministry of Health national reference laboratory (INIS) in Angola on suspected dengue cases detected between January 2017 and February 2019.MethodsA total of 401 serum samples from dengue suspected cases were collected in 13 of the 18 provinces in Angola. Of those, 351 samples had complete data for demographic and epidemiological analysis, including age, gender, province, type of residence, clinical symptoms, as well as dates of onset of symptoms and sample collection. RNA was extracted from residual samples and tested for DENV-RNA using two distinct real time RT-PCR protocols. On-site whole genome nanopore sequencing was performed on RT-PCR+ samples. Bayesian coalescent models were used to estimate date and origin of outbreak emergence, as well as population growth rates.ResultsMolecular screening showed that 66 out of 351 (19%) suspected cases were DENV-RNA positive across 5 provinces in Angola. DENV RT-PCR+ cases were detected more frequently in urban sites compared to rural sites. Of the DENV RT-PCR+ cases most were collected within 6 days of symptom onset. 93% of infections were confirmed by serotype-specific RT-PCR as DENV2 and 1 case (1.4%) was confirmed as DENV1. Six CHIKV RT-PCR+ cases were also detected during the study period, including 1 co-infection of CHIKV with DENV1. Most cases (87%) were detected in Luanda during the rainy season between April and October. Symptoms associated with severe dengue were observed in 11 patients, including 2 with a fatal outcome. On-site nanopore genome sequencing followed by genetic analysis revealed an introduction of DENV2 Cosmopolitan genotype (also known as DENV2-II genotype) possibly from India in or around October 2015, at least 1 year before its detection in the country. Coalescent models suggest relatively moderately rapid epidemic growth rates and doubling times, and a moderate expansion of DENV2 in Angola during the studied period.ConclusionThis study describes genomic, epidemiological and demographic characteristic of predominately urban transmission of DENV2 in Angola. We also find co-circulation of DENV2 with DENV1 and CHIKV and report several RT-PCR confirmed severe dengue cases in the country. Increasing dengue awareness in healthcare professional, expanding the monitorization of arboviral epidemics across the country, identifying most common mosquito breeding sites in urban settings, implementing innovative vector control interventions and dengue vaccination campaigns could help to reduce vector presence and DENV transmission in Angola.

Spatio-temporal clustering analysis using two different scanning windows: A case study of dengue fever in Peninsular Malaysia

Dengue fever is a mosquito-borne viral infection of humans caused by a virus of the Flaviviridae family. In Malaysia the annual incidence risk of dengue fever for the period 2000 to 2019 ranged from 30 to 390 cases per 100,000. The aim of this paper was to identify spatial, temporal and spatio-temporal clusters of dengue fever in Peninsular Malaysia for the period 2015 to 2017.Counts of confirmed incident cases of dengue fever for each of the 86 districts of Peninsular Malaysia for the period 1 January 2015 to 31 December 2017 (inclusive) and district-level census data allowed us to calculate the incidence rate of dengue fever, defined as the number of confirmed cases of dengue fever per 100,000 person-years at risk. We applied Kulldorff’s cylindrical space–time scan statistic and Takahashi et al.’s prismatic space–time scan statistic to the data.We identified no major differences in the number and location of spatial clusters of dengue incidence for 2015, 2016 and 2017 using Kulldorff’s and Takahashi et al.’s method. Spatio-temporal clusters of dengue occurred at several times throughout each year in various high population dense areas. These clusters not only included high population density districts but also their adjacent district neighbours. The temporal clustering of dengue cases during the monsoon season (mid September to late December each year) implies that there is a biologically plausible causal association between rainfall and the incidence of dengue.Identification of locations and time periods when the frequency of dengue is high allows Malaysian public health authorities to be more objective in their decision making around vector control and dengue public awareness campaigns. Future research will quantify the association between population density and rainfall on dengue incidence. This will allow health authorities to take a more proactive approach for dengue control.

Awareness and perception of malaria and dengue at school and college level in the district of Multan.

The purpose of this study is to examine the awareness and perception of malaria and dengue fever in Multan Punjab, Pakistan while taking into account the important role of government policies and other variables. The goal of this study is to examine the awareness of students in Multan, Pakistan on malaria and dengue. This study is based on a quantitative approach of secondary evidence from scientific journals and questionnaire surveys. It is also based on observational evidence gathered in Multan Punjab Pakistan, in a field study. The survey with school children, teachers and healthcare professionals were both formal and semi-structuralize. Studies have found that malaria and dengue mainly affect children's schooling through their absence, but can also induce brain loss and cognitive disability. In questionnaires, students were seen to have different understanding of the illness, but also to be able to serve as agents of health reform only through teachers. A sample size of 500 respondents has been selected from different colleges of district Multan Punjab, Pakistan. Correlation technique is used for the data analysis. According to our results it is concluded that the students at college level are aware of malaria and dengue diseases, but they are not capable of engaging and serving as agents for health reform. On the basis of results it is recommended that students must teach about epidemics diseases regarding how to handle these diseases.

Dengue Virus Cases Surge Amidst COVID-19 in Pakistan: Challenges, Efforts and Recommendations.

Pakistan is currently facing two outbreaks, dengue and COVID-19; both have strained its healthcare system resulting in multiple concerns including the co-diagnosis of two. Due to poor healthcare capacity, low vaccination rate, increasing COVID-19 variants, socioeconomic disparities, and misinformation, it is inevitable that implications will prove to be damaging to both healthcare workers and civilians. Among these challenges, it is important to note the need for stronger epidemiological surveillance for both COVID-19 and dengue and the implementation of public health measures without endangering sources of livelihood. To sustain this, cooperation between WHO and Pakistan’s government must continue through smart lockdowns, dengue awareness campaigns, and double laboratory procedures.