Dengue: The Common Infectious Disease In Pakistan Case Study

Slide 1: An introduction to Dengue

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• Dengue is a global risk, especially in tropical and subtropical regions.
• The WHO expects millions of severe dengue illnesses and thousands of deaths yearly (Murugesan & Manoharan, 2020).
• Dengue can induce flu-like or life-threatening symptoms.
• Dengue has no antiviral treatment, thus prevention and care are key.
• Dengue or shock syndrome can cause severe haemorrhagic fever, organ damage, and death.
• Dengue has no drug therapy, thus early detection and treatment are crucial.
• Dengue vaccines have helped, but vector control and vaccination are still needed.

SN: Many worldwide contract dengue from mosquitoes. In particular, the Aedes aegypti mosquito spreads dengue. Dengue is a global risk, especially in tropical and subtropical regions. The WHO expects thousands of serious dengue illnesses and thousands of fatalities yearly. Dengue can induce flu-like or life-threatening symptoms. High fever, severe headaches, joint and muscle pain, rash, and bleeding are typical. Dengue or dengue shock syndrome can cause extreme haemorrhagic fever, organ damage, and death. Dengue has no antiviral treatment, thus prevention and care are crucial. This includes mosquito breeding site reduction, repellent usage, and vaccine research. Dengue vaccinations have helped, but vector control and immunization are still needed (Girard et al., 2020). The mosquito-borne virus dengue is widespread and severe. It affects millions annually, varied in severity. Prevention and vaccination research are crucial to fighting this public health hazard.

Slide 2: Dengue in Pakistan, Overview

• There were a total of 25,932 confirmed cases of dengue and 62 deaths reported in Pakistan between January and September 2022, with 74% of all occurrences occurring in the month of September itself.
• The last significant epidemic of dengue in Pakistan occurred between September and December of 2019 and resulted in 53,498 cases and 95 deaths (Qureshi et al., 2023).
• Dengue patients can get treatment at no cost because of government programs targeting vectors.
• Preventing mosquito bites is the greatest dengue prevention method.
• Pakistan is handling the dengue outbreak, but more is required.
• WHO is helping the government create and implement a dengue control plan.

SN: Pakistan is considered a native region for dengue, as evidenced by the occurrence of a significant outbreak between September and December 2019, during which 53,498 cases and 95 fatalities were documented. The prevailing dengue situation in Pakistan is a matter of concern. During the period spanning from January to September 2022, the national authorities documented a cumulative count of 25,932 confirmed instances of dengue fever, accompanied by 62 fatalities. Significantly, the month of September accounted for a substantial majority, constituting 74% of the recorded cases. The increase in the number of instances can be attributed to the exceptional floods that commenced in mid-June 2022. The occurrence of floods has resulted in the creation of optimal breeding habitats for mosquitoes, thus leading to the displacement of a significant number of individuals (Abdul-Ghani et al., 2019). This displacement has subsequently heightened their vulnerability to dengue exposure. Pyrexia, cephalalgia, myalgia, arthralgia, emesis, nausea, and skin eruptions are common dengue fever symptoms. When severe, dengue can cause haemorrhaging, hypovolemic shock, and death. Dengue is managed supportively without a focused therapy strategy. Preventing mosquito bites is the greatest dengue prevention method. Insect repellent, long sleeves and mosquito netting help. Eliminating mosquito breeding areas in homes and communities is essential. Pakistan is handling the dengue outbreak, but more is required. Dengue fever patients receive free medical care from the government, which also works to control disease-carrying vectors. The government struggles to satisfy demand due to a shortage of healthcare experts and resources. Pakistan receives dengue help from outside. The WHO is helping the government create and implement a dengue control plan.

Slide 3: Demographics of Dengue in Pakistan

• Although everyone can get dengue, it primarily strikes young individuals. The median age of dengue patients in a Pakistani research was 24 (Ahmad et al., 2020).
• The dengue outbreak in Pakistan is predominantly among 15-45-year-olds.
• Pakistani cities like Lahore, Karachi, and Islamabad have higher dengue.
• Urbanisation and high population density favour Aedes mosquitoes and virus transmission.
• July–September is dengue season in Pakistan.
• More men than women have dengue fever. The dengue patients questioned were 63% male and 36.8% female.

SN: In 2019, the Pakistan Journal of Medical Sciences reported that dengue patients in Pakistan averaged 32.5 years old. Males were more dengue-prone than females, according to the study. The median age of Pakistani dengue patients was 24, according to a 2012 PLOS ONE study. The study also found that 90.9% of Pakistani dengue patients lived in Karachi, the country's most populated city. The evolving expansion of dengue in Pakistan and the concurrent population growth are expected to contribute to the dynamic nature of the disease's demography in the country. Pakistan's dengue outbreak is mostly among 15 to 45 years old. This demographic trend is mostly attributable to increasing outdoor activity and Aedes mosquitoes, the virus's main carriers. The youth spend more time outside, making them more susceptible to mosquito bites. Pakistani cities like Lahore, Karachi, and Islamabad have higher dengue. Urbanisation and high population density favour Aedes mosquitoes and virus transmission. The urban-rural dengue case gap highlights the need for focused vector control and public health in cities. Understanding dengue demography in Pakistan is crucial for public health planning and resource allocation (Naqvi et al., 2021). Authorities can target the most susceptible individuals and regions with preventative and control initiatives by concentrating on the age categories and geographic areas most impacted.

Slide 4: Distribution of Dengue in Pakistan

• Dengue is more common in Punjab, especially in Lahore and Rawalpindi (Ullah et al., 2023).
• In Pakistan, dengue incidences vary throughout the year. Seasonally, they peak in July–September during the monsoon.
• Higher population density, inadequate sanitation, and human-mosquito interaction cause greater dengue cases in Karachi, Lahore, and Islamabad.

SN: Dengue is frequent in Punjab, notably Lahore and Rawalpindi. This concentration is caused by urbanisation, population density, and Aedes mosquito breeding conditions. In Pakistan, dengue incidences vary throughout the year. They fluctuate seasonally, peaking during the rainy season. Aedes mosquitoes reproduce and move more during the wet months, driving this dispersion (Lamy et al., 2023). Higher population density, inadequate sanitation, and human-mosquito interaction cause greater dengue cases in Karachi, Lahore, and Islamabad. Urbanisation and transportation help spread the virus between cities. For public health planning and resource allocation, Pakistani dengue case distribution must be acknowledged. Health authorities can reduce dengue in high-risk areas by targeting mosquito control, information campaigns, and budget allocation by determining where and when the illness is most likely to occur.

Slide 5: Epidemiological triad of Dengue

• Vaccines against the dengue virus can be used to bring this infectious pathogen under control.
• The host can be managed by spreading information about dengue and the need of avoiding mosquito bites. Wearing long pants and sleeves and employing a mosquito net fall under this category.
• Eliminating mosquito breeding sites surrounding residential areas is one method of environmental control (Da et al., 2021). Water containers should be emptied of any standing water and covered.

SN: Infected mosquitoes propagate the flavivirus genus' dengue virus. Infection with one of the four dengue virus serotypes does not protect against the others. Dengue has no natural hosts other than humans. When an Aedes mosquito feeds on an infected human, it gets the virus. The infection may then spread through mosquito bites. The main dengue carriers are Aedes mosquitoes. Swimming pools, tiny standing water, and other clean water sources are where these mosquitoes reproduce. Most Aedes mosquitoes are active throughout the day. However, they can bite at night. For the transmission of dengue to occur, it is essential that all three components of the epidemiological triangle are concurrently present (Yasri & Wiwanitkit, 2023). Dengue fever transmission requires the presence of the virus, a susceptible human host, and a vector, the Aedes mosquito.

Slide 6: Dengue chain of transmission

• Dengue is carried by Aedes mosquitoes.
• Infected mosquitoes carry the infection.
• The mosquito can attack humans after 8–12 days of infection (Li et al., 2023).
• Infected people get dengue fever.
• The virus can transmit between mosquitoes if an infected person is bitten.

SN: The dengue chain of transmission helps spread the infection. Transmission begins when an infected Aedes mosquito bites a person. Mosquitoes spread the virus by biting infected humans. The virus enters the bloodstream and travels to the liver after a mosquito bite. The viral replication process begins in hepatic cells and spreads to the spleen, bone marrow, and lymph nodes. Following the dissemination of the virus within the human body, the individual subsequently acquires a dengue infection. Subsequently, the infected individual serves as a reservoir of infection for other Aedes mosquitoes. When an Aedes mosquito feeds on a human host who is infected with the virus, the mosquito acquires the viral infection, initiating the transmission cycle anew (Visser et al., 2023). The dengue transmission chain must be interrupted at any point to avoid disease spread. Vaccination can prevent illness and reduce its severity.

Slide 7: Inequalities Of Dengue in Pakistan

• Variables that increase dengue fever risk affect a person's vulnerability.
• Dengue-carrying mosquitoes thrive in standing water, therefore those with poor sanitation are more likely to get bitten (Jing & Wang, 2019).
• Overcrowding increases the risk of dengue because mosquitoes are more likely to locate hosts.

SN: Pakistan's most populated city, Karachi, has the highest dengue cases. A 2019 study published in "PLOS Neglected Tropical Diseases" found that dengue fever was more common in Karachi's poorest neighbourhoods. The study also found that living in socioeconomically deprived Karachi neighbourhoods increased the risk of severe dengue illness and its fatality rate. The study's findings suggest that dengue is a major public health issue in Karachi, Pakistan (Haroon, 2019). Also, poor people endure a disproportionate burden of this illness. This emphasises the need for targeted dengue prevention in these groups. Improved sanitation and hygiene in disadvantaged regions will reduce mosquito breeding sites and dengue risk. Improving healthcare systems can help people get high-quality dengue care, reducing complications and deaths. Dengue fever infections might be reduced by spreading knowledge and preventing mosquito bites.

Slide 8: Socioeconomic Burden of Dengue in Pakistan

• Dengue affects Pakistan's labour and healthcare system, causing economical hardship (Khurram et al., 2022).
• Infected people need time off work to recuperate, losing productivity and revenue.
• Dengue patients and their families may incur significant costs.
• Many people in Pakistan are responsible for these costs, which can put families in poverty.
• Pakistan may lose visitors and investment due to dengue epidemics.
• Dengue outbreaks' poor image might hurt tourism and the economy.

SN: Due to its impacts on the workforce and healthcare facilities, dengue has a major economic impact on Pakistan. Infected workers often require time off work to recover, reducing output and costing money. Dengue demand puts strain on the healthcare system, diverting resources from other goals. The acquisition of dengue fever can lead to significant financial burdens for people and their families, necessitating hefty out-of-pocket expenditures. Potential expenses might encompass hospitalisation, diagnostic procedures, and pharmaceutical interventions. A significant number of individuals in Pakistan are compelled to personally shoulder these expenditures, resulting in financial difficulties and, in certain instances, precipitating families' descent into poverty. The occurrence of dengue epidemics in Pakistan has the potential to discourage both tourists and international investors from coming or making investments in the country (Sarkar et al., 2020). Dengue outbreaks might hurt tourism and the economy. Thus, policymakers and public health experts must understand dengue's socio economic impact in Pakistan. This emphasises the need for comprehensive dengue prevention and control to reduce its consequences on the economy, healthcare system, and public welfare. Governments may justify expenditure on preventive measures, healthcare infrastructure, and public awareness by evaluating these costs.

Slide 9: WHO Current strategy for Dengue Elimination.

• To lower Pakistan's Aedes mosquito population, utilise insecticide-treated bed nets, residual spraying in the home, and community engagement.
• Improve disease surveillance to detect and contain dengue pandemics. This requires frequent dengue surveillance and early case reporting using contemporary technologies.
• Considering receiving a WHO-recommended dengue vaccination as part of a comprehensive dengue control plan (Coudeville et al., 2020). Dengue vaccination reduces incidence and severity.
• Inform people about dengue control and prevention methods. Community education and engagement can reduce mosquito breeding places and dengue transmission.
• Enhance medical facilities and their ability to treat dengue patients early, medically, and supportively.

SN: The Aedes mosquito is the main vector for dengue virus transmission, hence this procedure must be successful. Implementing effective mosquito management and mitigation methods can significantly reduce dengue fever transmission. Integrated Vector Management is a holistic strategy that integrates many strategies and techniques to effectively reduce mosquito populations at different life phases (Mafra-Neto & Dekker, 2019). By combining diverse methodologies, IVM offers a comprehensive solution for vector control. For the most recent information about the World Health Organization's strategy for eliminating dengue in Pakistan, it is advisable to consult the official website of the WHO or reach out to the relevant local health authorities.

Slide 10 WHO Recommended strategy plan on ( Upstream, Midstream and Downstream levels).

• The work with government officials to create and implement public health and wellness initiatives.
• These policies may address nutrition, healthcare, and the environment.
• Health promotion and education campaigns can improve awareness of health concerns, preventative measures, and behaviours that are beneficial (Van Asbroeck et al., 2021).
• Health education in schools and community outreach.
• Provide excellent diagnosis, treatment, and therapy.
• Medication, surgery, and specialised treatment are available.

SN: The reasoning for each tier underscores its significance within the overarching healthcare plan. The implementation of upstream strategies is essential in establishing a foundation for a health-promoting environment (Pineda et al., 2022). These strategies aim to address the underlying determinants of health and create conditions that assist individuals in making healthier choices. In contrast, midstream strategies are designed to empower both individuals and communities, enabling them to make informed decisions that promote better health outcomes. Lastly, downstream strategies concentrate on clinical treatment and monitoring, with the objective of addressing health concerns at both the individual and community levels. These levels operate in a collaborative manner to attain the most favourable health results.

Slide 11: WHO Recommended strategy plan on (Upstream, Midstream and Downstream levels).

• Upstream policies support health programmes in Pakistan.
• Midstream interventions educate people and communities to make healthy choices. Behaviour modification and illness prevention need education and awareness.
• Downstream actions are essential for individual health. They guarantee patients receive proper treatment and have the best chance of recovery, especially those with health issues in Pakistan (Rehman et al., 2023).

SN: The government of Pakistan has the potential to enhance population health via the strategic prioritisation of health activities.The provision of healthcare services at the midstream stage is crucial in facilitating prompt diagnosis and treatment. The promotion of health equity serves to reduce disparities in health outcomes.The evaluation of the effectiveness of health interventions is facilitated by downstream health monitoring and surveillance (Andrianou et al., 2021). This enables prompt response to developing health issues and facilitates the adjustment of strategies to achieve improved outcomes.

Slide 12:WHO recommended strategies 2023 plan

• Promote Dengue prevention, symptoms, and early identification through comprehensive public awareness programmes.
• Domestic residual spraying and Aedes mosquito breeding site eradication are efficient vector control techniques (Ogunah et al., 2020).
• Increase Dengue case management capacity by providing diagnostic instruments, hospital beds, and qualified medical personnel.
• Improve lab capacity for precise diagnosis and fast treatment.
• Increase mosquito monitoring to track Dengue vectors.

SN: The most important approach involves the facilitation of community education and the cultivation of awareness. This approach requires the implementation of comprehensive public awareness programmes aimed at educating communities on the prevention, symptoms, and early identification of Dengue. The basis for implementing this approach stems from the recognition that increasing public consciousness is of utmost importance in a nation such as Pakistan, where Dengue fever is prevalent. These programmes aim to empower individuals by encouraging them to engage in proactive preventative actions, such as the elimination of breeding grounds for Aedes mosquitoes and the adoption of personal protective practices. Additionally, these efforts emphasise the importance of seeking early medical attention when symptoms of The dengue virus manifest. Through the dissemination of knowledge to the general population, health authorities have the ability to not only diminish the occurrence of Dengue, but also mitigate its impact on healthcare systems (Aguiar et al., 2022). This is due to the fact that early identification and suitable treatment may effectively avert severe instances of the disease and the subsequent difficulties that may arise. Furthermore, it facilitates the cultivation of a shared duty, supporting a community-oriented strategy towards the prevention and management of Dengue fever, a crucial factor for achieving sustained efficacy in the fight against this illness.

Slide 13 Proposed Dengue intervention strategies

• Indoor persistent spraying, breeding site elimination, and bed net and mosquito repellent promotion should be part of a complete vector control programme.
• Increase national surveillance and monitoring to detect and react to Dengue outbreaks quickly.
• Publicise dengue, its symptoms, and preventative methods through broad community awareness programmes (Wang et al., 2020).
• Empowering people to act in their neighbourhoods and neighbourhoods can greatly minimise Dengue transmission.

SN: The implementation of these recommended intervention measures is crucial for Pakistan in order to successfully address the issue of dengue. The implementation of improved vector control measures plays a crucial role in mitigating the mosquito population, given that the Aedes mosquito serves as the principal vector accountable for the transmission of dengue. The utilisation of surveillance and early warning systems facilitates a prompt and timely reaction to outbreaks, hence aiding in the prevention of disease dissemination. Community participation and education play a significant role in enabling individuals to adopt proactive measures, a critical aspect in a nation characterised by a high prevalence of dengue (Righi et al., 2021). The process of healthcare capacity building is essential in ensuring the provision of adequate treatment to patients, hence contributing to the reduction of death rates. Finally, it is significant to emphasise the significance of research and innovation in the pursuit of discovering innovative and more efficient strategies for the prevention and management of dengue, so eventually mitigating its adverse effects on public health. By employing these measures, Pakistan can enhance its ability to control and manage the outbreak of dengue inside its borders.

Slide 14: Proposed dengue intervention strategies

• Improve healthcare facilities' dengue diagnosis and management.
• For immediate dengue care, provide an adequate supply of diagnostic instruments, hospital beds, and qualified healthcare staff (Javaid & Khan, 2021).
• Pakistan needs to emphasise strengthening its efforts to manage vectors.
• An efficient vector management campaign that promotes the use of bed nets and insect repellents is crucial.
• The dengue vaccine, prevention of vectors, and diagnostic studies should be funded.

SN: Pakistan has to prioritise stepping up its vector control initiatives. The majority of cases of Dengue are spread by Aedes mosquitoes. As a result, it is essential to implement an effective vector control programme that encourages the use of bed nets and bug repellents in addition to spraying indoor areas with residual chemicals and removing mosquito breeding grounds. Eliminating mosquito breeding grounds is an important step in preventing the propagation of dengue (Bravo et al., 2021). It is critical to improve the nation's monitoring and early warning systems in addition to vector control. Dengue outbreaks may be quickly identified and controlled with better surveillance. Techniques include better exchange of information between hospitals and government organisations, as well as improved reporting of cases of dengue and the use of weather data to anticipate outbreaks. When it comes to medical treatment, a system for early warning may be invaluable in terms of helping authorities distribute resources and prepare solutions.

Slide 15: Proposed Dengue interventions strategies

• Community engagement and education are key to dengue prevention.
• Insufficient diagnostic resources, capacity for hospitals, and competent medical staff can make dengue a dangerous illness (Atif et al., 2020).
• Collaboration with local and worldwide research groups can accelerate dengue prevention and treatment.
• Pakistan needs a comprehensive dengue management plan that includes vector control, monitoring, community engagement, healthcare capacity building, and innovation and study.

SN: Community engagement and education are key to dengue prevention. Comprehensive awareness programmes are needed to educate the public about dengue disease, its symptoms, and prevention. The need of fostering individual agency in both domestic and communal settings is paramount in mitigating the transmission of dengue fever. It is recommended that these campaigns have a multi-faceted approach by targeting diverse demographic groups and placing particular emphasis on the importance of community-based initiatives in addressing the condition.

In addition, the development of healthcare capability holds significant importance. The dengue has the potential to manifest as a serious ailment, and insufficiencies in diagnostic resources, hospital capacity, and well qualified medical staff can lead to unfavourable consequences. It is imperative to enhance the capabilities of healthcare institutions in order to effectively detect and manage instances of dengue. The provision of sufficient resources and comprehensive staff training will effectively contribute to the timely and proper delivery of treatment to patients, hence leading to a reduction in death rates. Investment in research and innovation has a crucial role in the sustainable management of dengue in the long run. This includes the provision of research assistance for the development of vaccines, the exploration of innovative strategies for vector control, and the enhancement of diagnostic techniques. The acceleration of progress in dengue prevention and treatment can be facilitated via collaboration with local as well as global research organisations. Innovative discoveries and developments can help reduce dengue's negative impact on human health. Pakistan needs a comprehensive dengue management plan that includes vector control, monitoring, community engagement, healthcare capacity building, and research and innovation (Bilal et al., 2022). The simultaneous application of these strategies will reduce Dengue, reduce healthcare pressure, and improve population wellbeing.

Slide 16 Appraisal of proposed strategies

• The dengue intervention techniques in Pakistan are broad and well-rounded, addressing the persistence of the disease.
• For early identification and fast response to dengue outbreaks, monitoring and early warning systems need to be strengthened to optimise the distribution of resources and response planning.
• Dengue prevention relies on community participation and education to enable people to adopt preventative actions in their areas (Suwanbamrung et al., 2021).

SN: Pakistan's dengue intervention measures are extensive and well-rounded. Increasing vector control strategies like residual spraying within the home and breeding site disappearance is key to lowering the dengue-causing Aedes mosquito population. For early identification and fast response to dengue outbreaks, monitoring and early warning systems must be strengthened to optimise allocation of resources and response planning. The dengue prevention relies on community participation and education to enable people to adopt preventative actions in their areas. These projects promote community-based dengue control by emphasising collaborative responsibility. Building healthcare capacity helps dengue patients obtain prompt and adequate care, lowering mortality and facility stress.

Slide 17: Appraisal of proposed strategies

• Forward-thinking and necessary for the long-term management of dengue is the incorporation of research and innovation into the recommended methods (Rosário et al., 2023).
• The recommended dengue intervention techniques provide a thorough, well-considered method of dealing with the dengue problem in Pakistan.

SN: The incorporation of investigation and creativity within the suggested solutions is a forward-thinking and important approach for the sustainable management of dengue. The potential for enhanced preventative and treatment strategies is evident via the provision of research-based support for vaccinations, vector control approaches, and diagnostics. The acceleration of development in these areas can be facilitated via collaboration with research organisations, both domestically and internationally, in Pakistan (Raza et al., 2022). Therefore, the dengue intervention options present a comprehensive and thoughtful strategy to tackling the issue of Dengue in Pakistan. Through the integration of vector control, monitoring, community involvement, healthcare infrastructure building, and technological advancement, Pakistan has enhanced its preparedness to mitigate the occurrence of Dengue, enhance the treatment of patients, and ultimately protect public health in the presence of this enduring menace.

Slide 18: Recommendations

• There has to be a serious and ongoing dedication to public health education and awareness efforts of all kinds.
• It is crucial to improve monitoring and early warning systems.
• Research and development should be promoted, especially in the areas of diagnostics, innovative vector control approaches, and vaccine creation.
• For dengue patients in Pakistan to receive prompt diagnosis and treatment, the country's healthcare system must be improved (Khurram et al., 2022).
• The mosquito management measures, which are crucial in lowering the Aedes mosquito population, need constant attention.

SN: Several major suggestions should be explored to effectively battle dengue in Pakistan. In the first place, the need to dedicate substantial resources to extensive public health education and awareness initiatives. These campaigns need to reach out to different communities and stress the significance of eradicating breeding grounds, using personal protective measures, and learning to spot the first signs of dengue. Campaigns like this encourage people to take preventative measures against dengue in their own areas (Fongwen et al., 2021). Meanwhile, healthcare infrastructure has to be improved so that patients with dengue receive prompt diagnosis and treatment. This includes things like having access to diagnostic equipment, enough hospital beds, and knowledgeable medical staff. In order to lower death rates from dengue and ease the burden on medical facilities during outbreaks, it is essential to invest in healthcare capacity. Furthermore, viral management measures, which are crucial in lowering the Aedes mosquito population, should be given constant attention. Priorities should include regular interior residual spraying, the elimination of breeding sites, and the promotion of personal protective measures like bed nets and repellents to keep insects away. Moreover, it is crucial to strengthen monitoring and early warning systems. This includes using climatic data to anticipate probable outbreaks, better reporting of Dengue cases, and data exchange among healthcare facilities and authorities. Dengue can be stopped by early detection and intervention. Finally, research and innovation in vaccine development, vector control, and diagnostics are crucial. Accelerating development in these areas through collaboration with local and international research organisations offers promise for more efficient preventative and therapeutic strategies. Thus, addressing the dengue outbreak in Pakistan requires research, innovation, public health education, healthcare system strengthening, vector prevention and control, monitoring, and research. Comprehensive application of these principles might dramatically reduce dengue in Pakistan, improve patient outcomes, and preserve public health.

Slide: 19: Limitations of Review

• Data quality and accessibility are major issues. Dengue case and information reporting errors might lower review accuracy and dependability.
• Historical data may limit the review's capacity to determine long-term Dengue incidence patterns and trends (Seah et al., 2021).
• Funding and staff restrictions may limit review depth and breadth.
• Review's capacity to capture dengue's full impact is limited.

The dengue in Pakistan reviews can inform plans, but they have significant drawbacks. Data quality and accessibility are major issues. The dengue case and information reporting errors might lower review accuracy and dependability. This can underestimate illness burden and make trend analysis difficult. Furthermore, historical data may limit the review's capacity to identify long-term dengue incidence trends. Some Pakistani regions have better surveillance systems, which might affect data accuracy. The evaluation may struggle to give a national summary due to regional data quality differences. The review's capacity to capture Dengue's entire impact is another shortcoming (Khan et al., 2023). It may focus on epidemiological statistics rather than social, environmental, and behavioural elements that cause Dengue and its effects. A multidisciplinary approach is needed to grasp Dengue's complexity beyond a review. Resource restrictions like funds and staff may limit the review's depth and scope. The review may not have the resources to perform extensive fieldwork, acquire primary information, or access all relevant sources. Finally, the methodology and sources may make the review's results subjective and biased. Data sources and analytical criteria might influence the evaluation and undermine its objectivity. A review on Dengue in Pakistan can help explain the disease's dynamics, but these limitations, particularly the quality of the data, availability, regional disparities, impact assessment comprehensiveness, limited resources, and potential subjectivity should be considered when interpreting the results and developing Dengue control strategies.

Slide 20:Conclusion

• The dengue in Pakistan requires strong vector control, enhanced monitoring and early warning systems, community education, healthcare development, and technical and research investment.
• These proposals might reduce dengue, improve patient outcomes, and preserve Pakistan's public health if adopted.

Dengue fever is a serious public health issue in Pakistan. Dengue fever has plagued the country, straining healthcare and the economy. The dengue is difficult to effectively manage despite extensive attempts to stem its spread. This is due to the virus' chronic character as well as several contributing variables. Strong vector control measures, improved monitoring as well as early warning systems, widespread education for the community, healthcare development, and investment in technological advancement and research are all needed to effectively battle dengue in Pakistan. When fully implemented, these suggestions have a chance to lessen the spread of Dengue, boost patient outcomes, and protect Pakistan's public health. However, it is critical to acknowledge the difficulties and restrictions involved in dealing with dengue fever, such as poor data quality, limited resources, and geographical differences. Dengue fever control and research should be prioritised in spite of these obstacles if the illness is to have a lesser impact on the population of Pakistan.

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