title: Dengue fever in malaria endemic areas.
abstract: OBJECTIVE
  To determine the clinical presentation and frequency of dengue fever in patients presenting with acute febrile illness.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Combined Military Hospital, Attock in collaboration with Armed Forces Institute of Pathology, Rawalpindi from November 2003 to October 2004.
  
  
  METHODS
  Patients presenting with acute febrile illness were screened for clinical features of dengue fever (DF). Dengue specific IgM was performed in clinically suspected cases. In addition, peripheral smear for malarial parasites and complete blood counts were performed.
  
  
  RESULTS
  Eight hundred patients with fever of less than 2 weeks duration were encountered. Twenty-two (2.75%) presented with the characteristic features of DF. Dengue specific IgM was detected in 11 patients (50%). Nine out of 11 (81.8%) dengue specific IgM positive patients were also positive for malarial parasites on peripheral smear. Out of 11 DF patients, 8 patients (78%) were cured and 3 (28%) died.
  
  
  CONCLUSIONS
  Dengue fever should be suspected if patient presents with bleeding manifestations, retrobulbar headache, severe myalgias and/or thrombocytopenia. Malaria and dengue may co-exist; dengue should be excluded in clinically suspected cases by laboratory investigations. Furthermore, surveillance strategies, preventive measures and healthcare workers' education is critical for curtailing this problem.
authors.affiliation: Department of Pathology, Combined Military Hospital, Attock, Karachi, Pakistan. nmjrm@hotmail.com
authors.forename: Nadir
authors.initials: N
authors.lastname: Ali
authors.forename: Asif
authors.initials: A
authors.lastname: Nadeem
authors.forename: Masood
authors.initials: M
authors.lastname: Anwar
authors.forename: Waheed Uz Zaman
authors.initials: WU
authors.lastname: Tariq
authors.forename: Rashid A
authors.initials: RA
authors.lastname: Chotani
mesh_terms: D003715:Dengue / Q000150:complications*; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology