Seroepidemiological Study of Dengue Virus Infection in Parsha District of Nepal

Dengue fever (DF) is an emerging mosquito borne viral disease and important public health problem in low land of Terai region which is also expanding to hilly region of Nepal. The study aims to shed light on the clinical, epidemiological and serological aspects associated with dengue virus infections (DVI) and its implications in future diagnosis, management, prevention and control of the disease in Nepal. Two hundred sixty one serum samples were collected from patients suspected of dengue virus infection visiting hospitals of Parsha districts during August- November of 2023 and tested by IgM Capture Enzyme linked immunosorbent assay (Standard Diagnostic INC., Korea) and Dengue IgM/IgG Rapid immunochromatographic test kit(Panbio, Australia).The Anti-Dengue IgM positivity was found to be 18.8% and 15.3% by IgM capture Enzyme linked immunosorbent assay and Rapid immunochromatographic test respectively. Compared to ELISA, sensitivity and specificity of RDT was 73.46% and 98.1% respectively. RDT performed poor (kappa value-0.77) and should not be used as a sole diagnostic method for diagnosis of Dengue virus infection. In 49 Anti-Dengue IgM positive cases, 67.4% were male and 32.6% were females (male to female ratio=2.06:1). The highest numbers (81.6%) cases were observed in age group of 15-50 years. Student was the most commonly affected with the highest number of positive cases (32.7%). Patients with Joint pain, retro-orbital pain and Skin rash as clinical symptoms were more likely to be diagnosed as Anti-Dengue IgM positive. Hemorrhagic manifestation was seen in 12.2% of cases. The highest numbers 199(79.6%) of cases have duration of fever more than 5 days. Anti-Dengue IgM was not found to be detected significantly in cases with duration of fever of 5 days and more (p=0.686). Knowledge of dengue was found in 65.9% of which 11.6% was found to be Anti-Dengue IgM positive. Water logging (10.7%) and Travel to endemic area (37%) were found as the more likely risk factors in Anti-Dengue IgM positive cases. Flower pot was found as the most likely breeding place with the highest number of positive cases 36.55%. Use of net 87.3% and change stored water 85.8% was the most likely used preventive measures respectively.