Burden of Dengue Virus Infection in Chitwan and Peripheral Districts: An Emerging Disease in Terai Region of Nepal

Abstract

Background: Dengue has become endemic and subject of concern in Terai regions of Nepal especially Chitwan and its peripheral districts. The evidence of all four serotypes of dengue virus could be a consequence of a sudden resurgence of more severe dengue disease in Nepal. Study Design: The present study was designed to determine the incidence of Dengue virus infection in clinically suspected patients visiting Chitwan Medical College Teaching Hospital (CMCTH) in a Central part of Nepal. Methods: A prospective study was conducted from July 2015 to June 2016 at CMCTH, Bharatpur, the fifth largest city of Nepal. Blood specimens from 357 patients from inpatient and outpatient departments, was collected and processed for anti-dengue immunoglobulin IgM by antibody isotype-capture enzyme-linked immunosorbent assay (IgM ELISA). Results: Among 357 samples processed, 45 (12.60%) were positive for anti-dengue IgM antibodies. The highest number of dengue positive cases was observed in the age group of 21-30 years with greater predilection in males. The gender bias, was statistically significant (p value=0.0004). The dengue positivity was highest in the month of November (51.11%) and majority of dengue infection was recorded in the winter season (86.67%). Dengue was highly prevalent in urban society compared to rural society and the difference is statistically significant (p value<0.0001). Conclusion: Incidence of dengue infection is increasing and current outbreak in Chitwan and peripheral districts is a serious matter of concern. The higher prevalence of dengue in this study underscore the need for comprehensive surveillance of the disease in order to identify the high risk areas and current disease burden for immediate implementation of preventive measures.