title: "Preliminary Seroepidemiological survey of dengue infections in Pakistan, 2009-2014".
abstract: BACKGROUND
  Dengue virus is the causative agent of dengue fever, a vector borne infection which causes self-limiting to life threatening disease in humans. A sero-epidemiological study was conducted to understand the current epidemiology of dengue virus in Pakistan which is now known as a dengue endemic country after its first reported outbreak in 1994.
  
  
  METHODS
  To investigate the prevalence of dengue virus in Pakistan during 2009-2014, a total of 9,493 blood samples were screened for the detection of anti-dengue IgM antibodies using ELISA. Clinical and demographic features available with hospital records were reviewed to ascertain mortalities related to dengue hemorrhagic shock syndrome.
  
  
  RESULTS
  Out of 9,493 samples tested, 37% (3,504) were found positive for anti-dengue IgM antibodies. Of the seropositive cases, 73.6% (2,578/3,504) were male and 26.4% (926/3,504) were female. The highest number (382/929; 41.1%) of sero-positive cases was observed among the individuals of age group 31-40 years. The highest number of symptomatic cases was reported in October (46%; 4,400/9,493), and the highest number of sero-positive cases among symptomatic cases was observed in November (45.7%; 806/1,764). Mean annual patient incidence (MAPI) during 2009-2014 in Pakistan remained 0.30 with the highest annual patient incidence (11.03) found in Islamabad. According to the available medical case record, 472 dengue related deaths were reported during 2009-2014.
  
  
  CONCLUSIONS
  The data from earlier reports in Pakistan described the dengue virus incidence from limited areas of the country. Our findings are important considering the testing of clinical samples at a larger scale covering patients of vast geographical regions and warrants timely implementation of dengue vector surveillance and control programs.
  
  
  BACKGROUND
  It is an epidemiological research study, so trial registration is not required.
authors.affiliation: Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan.|Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Suleman
authors.affiliation: Department of Tropical Medicine and Parasitology, Inha University School of Medicine, Incheon, 22212, Republic of Korea.
authors.forename: Hyeong-Woo
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Syed Sohail Zahoor
authors.initials: SS
authors.lastname: Zaidi
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Muhammad Masroor
authors.initials: MM
authors.lastname: Alam
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Nadia
authors.initials: N
authors.lastname: Nisar
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Uzma Bashir
authors.initials: UB
authors.lastname: Aamir
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Salmaan
authors.initials: S
authors.lastname: Sharif
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Shahzad
authors.initials: S
authors.lastname: Shaukat
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Adnan
authors.initials: A
authors.lastname: Khurshid
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Mehar
authors.initials: M
authors.lastname: Angez
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Massab
authors.initials: M
authors.lastname: Umair
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Mujtaba
authors.affiliation: Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan. ranifaryal@gmail.com.
authors.forename: Rani
authors.initials: R
authors.lastname: Faryal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003716:Dengue Virus / Q000254:growth & development / Q000302:isolation & purification* / Q000472:pathogenicity; D004196:Disease Outbreaks; D005260:Female; D006306:Health Surveys; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012621:Seasons; D016036:Seroepidemiologic Studies; D019595:Severe Dengue / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000401:mortality; D016019:Survival Analysis
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M
keywords: Dengue Virus; IgM ELISA; Pakistan; Vector; epidemiology