Manifestations Of Dengue Research Articles

Central and Peripheral Nervous System Manifestations Associated with Dengue Illness.

Dengue illness, caused by the dengue viruses, continues to be a major global health concern, with increasing incidence and the emergence of severe manifestations such as neurological complications. An overview of the current understanding of dengue epidemiology, clinical manifestations, and research priorities is presented here. Dengue transmission has escalated in recent years, exacerbated by factors such as vector expansion, climate change, and socioeconomic challenges. The clinical spectrum of dengue ranges from mild febrile illness to severe manifestations, including hemorrhagic fever and neurological complications. Neurological manifestations of dengue, once considered rare, are now increasingly reported, encompassing encephalitis, myelitis, and Guillain-Barré Syndrome, among others. Diagnosis primarily relies on laboratory methods such as RT/PCR, NS1 antigen detection, and serological assays. Despite advancements in understanding the dengue pathogenesis, there remains a critical need for effective vaccines, antiviral drugs, improved surveillance methods, predictive models for disease severity, and long-term studies on post-Dengue sequelae. Integrated programs and holistic approaches to dengue control are essential for mitigating its impact. Addressing these research priorities will be pivotal in combating dengue and reducing its global burden.

A review of dengue transmission and dengue therapy among people

Dengue fever is a significant threat to global health, caused by the dengue virus and transmitted mainly by Aedes mosquitoes. It is crucial to understand the transmission dynamics of the virus to develop effective control and prevention strategies. Epidemiological studies have provided valuable insights into outbreaks' spread patterns, risk factors, and nature. These are essential for targeted interventions such as vector control, reducing human-mosquito contact, and community-based preventive measures. At the same time, there is a pressing need to develop effective therapies to alleviate the disease burden and reduce mortality associated with dengue outbreaks. Current therapeutic research focuses on antiviral treatments, supportive care strategies, and vaccine development to combat the diverse clinical manifestations of dengue. To address the multifaceted challenges of dengue, there must be a concerted effort toward developing robust preventive measures, innovative therapies, and enhanced diagnostic tools. A comprehensive understanding of its transmission dynamics coupled with effective therapeutic interventions is pivotal in pursuing dengue control and mitigation, as it poses a formidable global health challenge.

Prescribing antibiotics for children with dengue infection in Taiwan: who are at risk and who are high prescribers?

Inappropriate antibiotic use contributes to antimicrobial resistance, a global public health threat. The non-specific manifestations of dengue, itself a growing public health threat, lead to avoidable empiric antibiotic prescription, particularly in children. In this national pooled population-based cross-sectional study, we evaluated child and physician characteristics associated with antibiotics prescription in confirmed dengue cases in Taiwan. Linking national health care insurance claims and reports of confirmed dengue cases from 2008 to 2015, there were 7086 children with confirmed dengue with 21 744 outpatient visits and 2520 inpatient admissions. We assessed the presence of antibiotic prescription in outpatient and inpatient settings separately a week before or after the confirmation date. Logistic regression models with generalized estimating equations were applied to identify patient, practitioner, and other factors associated with antibiotic prescription. A total of 29.4% of children <18 years old with dengue who did not have a concomitant bacterial infection were prescribed antibiotics during the 14-day assessment period. Antibiotics prescription was reduced from 13.5% to 6.3% and from 43.2% to 19.3% in outpatient and inpatient settings, respectively, after dengue was confirmed. Young children were more likely to receive antibiotics. Significant variations in antibiotic prescribing across physicians were observed only in outpatient settings: physicians ≥60 years old and physicians practicing at clinics and in non-urban facilities were more likely to prescribe antibiotics. Antibiotics were less likely to be prescribed during an exceptional 2-year epidemic than in other years. Antibiotic prescribing for dengue, an arboviral infection affecting half of the global population, was shown to occur in 29% of paediatric cases in Taiwan. That potentially avoidable antibiotic consumption could be reduced by improving antibiotic stewardship, informed by understanding the conditions under which antibiotics are prescribed and the availability of prevention strategies for viral diseases, including dengue. We identified a number of such factors in this national population-based study.

Ocular Manifestations of Dengue: A Comprehensive Review of Pathophysiology and Clinical Outcomes

Ocular Manifestations of Dengue: A Comprehensive Review of Pathophysiology and Clinical Outcomes

Hematological Manifestations of Dengue, Malaria and Enteric Fever in Children Presenting To a Tertiary Care Hospital, Pakistan

Hematological Manifestations of Dengue, Malaria and Enteric Fever in Children Presenting To a Tertiary Care Hospital, Pakistan

Clinical Manifestations of Dengue in Children and Adults in a Hyperendemic Region of Colombia.

Dengue is the most common arboviral disease in the world. Traditionally, it has affected more adults, but the incidence in children has increased in recent years. Colombia is no stranger to this change; therefore, we aimed to find the differences in signs, symptoms, and clinical, hematological, and hemogram characteristics between children under 12 years old and individuals aged 12 years and older in an endemic region of Colombia in 2020-2022. The analyses were conducted with baseline data, corresponding to a cross-sectional design. Multiple correspondence analysis was used for general, dermatological, and clinical symptom profiles. Discriminant analysis was used for laboratory profiles. Multiple correspondence analysis was applied to nominal categorical data, employing Euclidean distances to analyze age groups. Discriminant analysis was applied to a training sample and validated on a test sample. The overall agreement of the model's discrimination, sensitivity, specificity, and fit indicators was calculated. The results indicated that individuals under 12 years exhibited distinct dermatological and clinical features, including rash, pruritus, hypotension, lymphocyte count, and platelet count, compared with those aged 12 years and older. In contrast, those 12 years and older were profiled for general and clinical symptoms such as pain (back pain, retro-orbital pain, headache), dizziness, chills, hematuria, tachypnea, and elevated/high hematocrit, hemoglobin, and basophil values. These findings are crucial to understanding the high incidence in children; they also facilitate rapid understanding of the disease in clinical care settings and differentiate it from other febrile outbreaks. This will affect disease control, particularly in severe cases, and reduce mortality.

Evidence supporting correlation between aging and dengue severity: A retrospective analysis on the 2010 dengue outbreak in Brazil

Objective: The aim of this study is to explore the role of aging and non-communicable diseases (NCDs) as potential risk factors for severe clinical manifestations of dengue. This investigation was conducted within a cohort of patients from the 2010 epidemic in Belo Horizonte, Brazil. Methods: A total of 144 subjects diagnosed with dengue were categorized into two groups, representing the early and late (critical) stages of the disease. Further stratification was performed based on age, distinguishing between young and aged subjects. NCD subjects were also divided into young and aged groups. The symptomatology, previous clinical history, age, and presence of NCDs were inquired. Blood samples were collected for the analysis of platelet, soluble tumor necrosis factor receptor 1 (sTNFR1), and aspartate aminotransferase (AST) levels. The Mann-Whitney test was explored for the comparison of two groups, whereas the Kruskal-Wallis test was used for the analysis of differences among the multiple groups. Categorical variables were examined by Chi-square test. Correlation assessments were conducted using binary logic regression analysis with a 95% confidence interval. P&lt;0.05 was considered statistically significant. Results: Compared to the younger subjects with NCDs, aged subjects exhibited a more severe form of dengue during the critical phase. The presence of NCDs was not associated with a worse dengue outcome in younger individuals, suggesting that aging itself maybe an important contributor to the severity of dengue. Conclusions: In the studied cohort, we emphasize that aging is a significant factor associated with severe manifestations of dengue. While we do not discard the potential role of NCDs in exacerbating disease progression, it may be more prominently impact the aged groups.

Tanreqing injection inhibits dengue virus encephalitis by suppressing the activation of NLRP3 inflammasome

BackgroundEncephalitis caused by dengue virus (DENV) is considered a manifestation of severe dengue. Tanreqing injection (TRQ) is a well-known Chinese patented medicine, which has been used to treat brain-related disorders by inhibiting inflammation. Nevertheless, the effects of TRQ on DENV encephalitis have not been studied. The aim of this study was to evaluate the effects of TRQ on DENV encephalitis and to explore its potential mechanisms.MethodsThe cytotoxicity of TRQ was examined by MTT assay, and the anti-DENV activities of TRQ in BHK-21 baby hamster kidney fibroblast were evaluated through CCK-8 and plaque assays. The expression levels of NO, IL1B/IL-1β, TNFα and IL6 were measured by qRT‒PCR and ELISA in the BV2 murine microglial cell line. The inhibitory effects of TRQ on NLRP3 inflammasome activation in BV2 cells were examined by Western blotting, qRT‒PCR and ELISA. The effects of TRQ on HT22 mouse hippocampal neuronal cells were examined by CCK-8 assay, morphology observation and flow cytometry. Moreover, a DENV-infected ICR suckling mouse model was developed to investigate the protective role of TRQ in vivo.ResultsTRQ decreased the release of NO, IL6, TNFα and IL1B from BV2 cells and inhibited the activation of NLRP3. The presence of the NLRP3 agonist nigericin reversed the anti-inflammatory activities of TRQ. Furthermore, TRQ inhibited the death of HT22 cells by decreasing IL1B in DENV-infected BV2 cells. In addition, TRQ significantly attenuated weight loss, reduced clinical scores and extended the survival in DENV-infected ICR suckling mice. Critically, TRQ ameliorated pathological changes in ICR suckling mice brain by inhibiting microglia and NLRP3 activation and decreasing the production of inflammatory factors and the number of dead neurons.ConclusionTRQ exerts potent inhibitory effects on dengue encephalitis in vitro and in vivo by reducing DENV-2-induced microglial activation and subsequently decreasing the inflammatory response, thereby protecting neurons. These findings demonstrate the potential of TRQ in the treatment of dengue encephalitis.

Clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands: A systematic review and meta-analysis.

Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.

A Case of Dengue Meningitis Manifested as a Part of Expanded Dengue Syndrome

Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retro orbital pain, myalgia, and arthralgia; and a severe form of the disease denominated dengue hemorrhagic fever/dengue shock syndrome, characterized by hemoconcentration, thrombocytopenia, and bleeding tendency. However, atypical manifestations, such as liver, central nervous system, and cardiac involvement, have been increasingly reported called expanded dengue syndrome. We report a 35 years old lady with atypical and rare presentation of dengue disease marked by meningitis. Condition improved after conservative treatment. Neurological complications in dengue are now increasingly observed with the most common case is aseptic meningitis. Dengue meningitis is self-limiting in almost all cases. Hepatic failure rarely dominates the clinical picture in adults. The main mechanism of dengue meningitis is still unknown though both direct viral infection and immune mediated damage have been suggested to be the cause. To avoid otherwise preventable morbidity and mortality, physicians should have a high index of suspicion for neurological complications in patients with dengue illness and should manage this accordingly

Variable presentations of dengue fever with diagnostic dilemma: A case series

Dengue is a viral fever in humans which is caused by 4 serotypes of the flavivirus. It is spread by the bite of the infected Aedes mosquitoes. The acute febrile illness is often associated with multisystem involvement with complications. The case series presented here depicts atypical manifestations of dengue which may present with hypoplastic anemia, hepatitis, pancreatitis, and encephalopathy. The cases were diagnosed based on history of dengue with subsequent persistence of pancytopenia, presence of hepatitis, pancreatitis, and encephalopathy with serological evidence of dengue and after ruling out other possible etiologies supported by laboratory evidence of investigations. The bone marrow revealed pancytopenia with hypocellular marrow causing hypoplastic anemia, transaminitis and rise of lipase and amylase with symptoms diagnosed hepatitis, pancreatitis, and finally impairment of consciousness with electroencephalogram proved encephalopathy. The importance of the case series lies in the fact that atypical manifestations may occur in dengue patients challenging the physicians and early detection may avoid unnecessary treatment and complications.

Clinical description of dengue and chikungunya virus infections amongst acute febrile patients in a malaria endemic area of Mfou, the Centre region of Cameroon

This study aims to determine the frequency and clinical manifestations of dengue and chikungunya viral infections in the district hospital of Mfou, Centre region of Cameroon where malaria is endemic. Blood samples were collected from suspected cases and tested for Plasmodium parasites and for the molecular detection of viral RNAs (dengue, zika and chikungunya viruses) using TRIOPLEX qPCR. A total of 108 patients were clinically suspected among which 25 % were male and 50 % were less than 15.5 years old. Of these 14.8 % (16/108) and 2.8 % (3/108) had acute dengue and chikungunya fevers respectively. Co-infection with malaria was reported in 56.3 % (9/16) of Dengue cases and 33.3 % (1/3) of chikungunya cases. Clinical profiling further revealed that nausea and vomiting show a significant difference in dengue infected individuals to those of non-infected individuals (P = 0.027). The presence of dengue fever and chikungunya fever and the absence of specific clinical manifestations highlight the need to strengthen surveillance of acute febrile infections for a better estimation of the burden of arboviruses.

Clinical Profile of Paediatric Patients Admitted with Dengue Fever in a Tertiary Care Hospital of North India

Background: Dengue, a viral disease transmitted by mosquitoes, is the fastest spreading mosquito-borne illnessin human history, with its global incidence increasing 30-times over the past fifty years. This is a prospectivestudy with the aim to study clinical manifestation of dengue in children diagnosed admitted in a medical collegeHospital in Jammu, India.Methods: The study was conducted on 300 children admitted as dengue fever in a tertiary care hospital from October2022 to December 2022. Paediatric patients who were admitted with symptoms like fever, headache, myalgia,vomiting etc. were evaluated with other clinical features (warning signs of dengue fever, signs of haemorrhage,signs of plasma leakage and signs of shock) and the other causes of fever other than Dengue were rule out.Results: Sixty three percent (63.3%) of patients were adolescents (age &gt;10 Years) and most common symptom wasfever (83%) while as bleeding manifestations was seen in 9.3% and Dengue Shock Syndrome 7.7% patients.Conclusion: Study emphasizes that being the disease with panic, can be well managed to go beyond just a feverinto haemorrhage and shock by timely identification clinically and laboratory methods and followed by appropriateintervention.

Case Report of Foveolitis with Optic Neuritis: A Barely encountered Ophthalmic Manifestation of Dengue

Dengue fever is a tropical disease which is endemic in tropical/subtropical nations like Nepal. Bilateral optic neuritis with unilateral foveolitis is an unusual dengue-related ophthalmic complication. We here present to you a case of bilateral optic neuritis with right eye foveolitis who initially presented with complaints of sudden diminution of vision in one eye following dengue fever. This report deals with prolonged treatment of rare ocular presentation of dengue infection. Patient had persistent myodesopsia and scotoma in the right eye even after 5 months of treatment with oral steroids. Dengue-related ophthalmic findings although rare, can have significant and long-lasting visual impairment if not treated timely and appropriately.

Flood and Dengue: Increased risk of Gestational Pestilences.

Madam Editor, Dengue fever is an acute viral disease caused by an RNA (Ribonucleic Acid) virus transmitted by Aedes mosquitoes. Symptoms can range from asymptomatic fever to life-threatening complications such as haemorrhagic fever and shock (1). Dengue fever is recognized by the (WHO (World Health Organization)) World Health Organization as a serious global public health threat in tropical and subtropical countries. Dengue-endemic regions are home to 2.5 billion people, and 400 million infections occur each year, with mortality rates exceeding 20% in some areas (2). Extremely heavy rains have lately devastated Pakistan, with its most populous metropolis of Karachi witnessing the worst floods in a century. Flooding and inadequate water sanitation have increased the risk of dengue, malaria, and other water-borne disease outbreaks. Determining whether dengue infection during pregnancy is associated with adverse effects on the fetus is important, given that women of reproductive age in dengue-endemic areas are at risk of contracting the disease. Studies have suggested an association between maternal infection during pregnancy and preterm birth, low birth weight, small gestational age births, stillbirth, and miscarriage (3, 4). According to Pouliot SH, et al., high rates of cesarean deliveries (44%) and pre-eclampsia (12%) occurred in women who had dengue infection during pregnancy (5). Even though there are several variants of dengue infection, the study found that the proportion of DENV-4 in pregnant women was higher than in non-pregnant women (6), the reason for which is still unclear. The gestational period involves various anatomical and physiological changes in the female body, such as increased capillary permeability, hemodilution, leukocytosis, thrombocytopenia, etc., which may complicate the assessment of the clinical manifestation of dengue due to opposing effects on the body, such as the contradicting leucocyte concentration, as pregnancy causes leukocytosis, whereas dengue causes leukopenia (6). Though the exact mechanism of the effect of maternal dengue on the fetus is yet to be determined, recent studies have put forward two mechanisms for fetal and neonatal morbidity caused by maternal dengue infection. The first theory is that dengue infection causes hemodynamic changes during pregnancy that could affect the placenta and cause fetal hypoxia, In contrast, the second theory states that dengue infection affects the fetus directly (7). ---Continue

A predictive analytics model using machine learning algorithms to estimate the risk of shock development among dengue patients

Dengue is a common viral disease in tropical and subtropical countries. The clinical manifestation of dengue has a wide spectrum, from asymptomatic seroconversion to severe dengue infection. Severe dengue is defined as dengue with the presence of specific symptoms, including severe plasma leakage leading to shock or the accumulation of fluids with respiratory distress, severe bleeding, and severe organ impairment. Examining the progression of shock with the integration of patients’ physiological information and biochemical parameters would help in understanding the progression of the disease and early detection of shock. In this study, physiological patient data diagnosed with dengue are collected from a University Malaya Medical Centre’s electronic record. A prediction model learned from the measurement of a patient’s physiological data is the basis for effective treatment and prevention of shock development in critically ill patients. Hence, this study presents the predictive performance of machine learning algorithms to estimate the risk of shock development among dengue patients. Logistic regression, decision trees, support vector machines and neural networks are evaluated. Lastly, ensemble learnings of bagging and boosting are also applied to the weak learner to optimize performance. The experimental results show that the bagging algorithm outperforms other competing methods with a 14.5% improvement from the individual decision tree. The full blood count (FBC) specifically haemoglobin (Hb) on day 2 is found to be a strong predictor for severe dengue occurrence.

A Review on Epidemiology, Clinical Manifestation and Diagnostic Approach of Dengue in Bangladesh Perspective

Background: Dengue is an arboviral disease caused by dengue virus; single positive stranded RNA virus of the family Flaviviridae. Symptomatic dengue infection causes a wide range of clinical manifestations; from mild dengue fever (DF) to potentially fatal disease, such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Dengue is endemic in Bangladesh with recurrent outbreak and is one of the major public health concerns in current period. Therefore; we conducted a literature review to analyze demography, epidemiology, pathogenesis, clinical feature and diagnosis of dengue virus infection. Methods: According to the PRISMA guidelines, the references were selected from PubMed, Web of Science and Google Scholar database using search strings containing a combination of terms that included ”dengue”, “Bangladesh”, “epidemiology”, “outbreak”,” pathogenesis”, “clinical manifestation”, “demography “and “diagnosis”. Quality of references was evaluated by independent contributors. Results: About 167,700 confirmed dengue cases were reported at 16’september’2023 in Bangladesh. Although dengue is endemic in Bangladesh, the current dengue surge is unusual in terms of seasonality and the early sharp increase in comparison to previous years, where the surge started around –late June. Plasma leakages are the main pathophysiological hallmark that distinguishes DHF from DF. Severe plasma leakage can result in hypovolemic shock. Various factors are thought to impact disease presentation and severity. Virus segregation in cell cultures, nucleic acid demonstration by polymerase chain reaction (PCR), and serological detection of viral antigens (such as NS1) or particular antibodies are the preferred microbiological assays for dengue detection. Currently, no specific drugs and licensed vaccines are available to treat dengue disease in any of its clinical presentations for all age group. Conclusion: Understanding the clinical manifestation of dengue infection, prompt diagnosis, appropriate treatment, active and continuous surveillance of cases and vectors are the essential determinants for dengue prevention, control and reducing fatality rate. J Bangladesh Coll Phys Surg 2023; 41: 69-81

Extracellular vesicles recovered from plasma of severe dengue patients induce CD4+ T cell suppression through PD-L1/PD-1 interaction.

Severe dengue manifestations caused by the dengue virus are a global health problem. Studies suggest that severe dengue disease depends on uncontrolled immune cell activation, and excessive inflammation adds to the pathogenesis of severe dengue disease. Therefore, it is important to understand the process that triggers the uncontrolled activation of the immune cells. The change in immune response in mild to severe dengue may be due to direct virus-to-cell interaction or it could be a contact-independent process through the extracellular vesicles (EVs) released from infected cells. The importance of circulating EVs in the context of dengue virus infection and pathogenesis remains unexplored. Therefore, understanding the possible biological function of circulating EVs may help to delineate the role of EVs in the progression of disease. Our present study highlights that EVs from plasma of severe dengue patients can have immunosuppressive properties on CD4+ T cells which may contribute to T cell suppression and may contribute to dengue disease progression.

Obesity as a clinical predictor for severe manifestation of dengue: a systematic review and meta-analysis

BackgroundSevere dengue often leads to poor clinical outcomes and high mortality; as a result, it is of vital importance to find prognostic factors associated with the severe form of dengue. Obesity is known to deteriorate many infectious diseases due to impaired immune responses. Several studies have suggested that obese patients with dengue infection tend to have more severe manifestations with poorer prognosis. However, a firm conclusion could not be drawn due to the varied results of these studies. Here, we aimed to conduct a systematic review and meta-analysis to investigate the association between obesity and dengue severity.MethodsA literature search for relevant studies was conducted in PubMed, Embase, Ovid Medline and Cochrane from inception to September 9, 2022. The two main keywords were “dengue” and “obesity”. Mantel-Haenszel method and random effects model was used to analyze the pooled odds ratio with 95% confidence intervals.ResultsA total of 15 article involving a total of 6,508 patients were included in the meta-analysis. Included patients in most studies were hospitalized pediatric patients. Only one study included adulthood data. Three cohort studies, four case-control studies, and one cross-sectional studies found a significant association between obesity and dengue severity. In contrast, three cohort studies, three case-control studies, and one cross-sectional study reported no significant relationship between obesity and dengue severity. Our analysis results showed that patient with obesity is 50% (OR = 1.50; 95%CI: 1.15–1.97) more likely to develop severe manifestation of dengue.ConclusionThis meta-analysis revealed that overweight could be a clinical predictor for severe disease for pediatric patients with dengue infection.

Dengue seroprevalence study in Bali.

Dengue infection poses significant public health problems in tropical and subtropical regions worldwide. The clinical manifestations of dengue vary from asymptomatic to severe dengue manifestations. This serological survey highlighted the high incidence of asymptomatic cases. This study aimed to determine the prevalence of dengue in healthy and ill adults in Bali. Cross-sectional seroprevalence surveys were performed between July 2020 and June 2021 among healthy and ill adults in Denpasar Bali. Blood samples were collected from 539 randomly selected urban sites in Denpasar. Immunoglobulin G antibodies against the dengue virus were detected in serum using a commercial enzyme-linked immunosorbent assay kit. Overall, the dengue seroprevalence rate among the 539 clinically healthy and ill adults was high (85.5%). The median age was 34.1 (18-86.1). Most of the participants in the study were younger than 40 years (61.2%). Men were the dominant sex (54.5%). The study found a significant association between dengue seropositivity among people aged > 40 years and healthy status (p = 0.005; odds ratio [OR] = 0.459 and p < 0.001; OR = 0.336, respectively). The study reported that as many as 60% of the subjects had a history of previously suspected dengue infection. This study reflected the proportion of asymptomatic dengue patients requiring better assessment with a serological test. The current study highlighted that real cases of dengue infection may be higher than reported, with a high prevalence of dengue seropositivity and a relatively dominant proportion of asymptomatic cases. The study guides physicians to be aware of every dengue infection in tropical countries and prevent the spread of the disease.