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Abstract
Dengue constitutes an alarmingly increasing Pakistani public-health issue. Longitudinal studies of case severity, serotype mechanisms and outcomes are limited. Objectives were to analyze 12 years (2013-2024) data of confirmed Dengue patients who were managed at Rawalpindi Medical University attached hospitals for; 1) trends in yearly cases, age, gender, disease severity (DF, DHF, DSS), mortality, and serotypes of circulating dengue, and 2) to determine predictors of severe disease. This cross-sectional study was conducted at RMU from January to March 2025. Data of confirmed Dengue infected patients managed at RMU-affiliated hospitals between January 2013 and December 2024 were retrieved, keeping in mind the objectives of the study. Chi2 and t-tests or ANOVA were used to compare categorical and continuous variables where relevant. Independent predictors of severe dengue (DHF/DSS) were identified using multivariable logistic regression. Of the 41196 patients (mean age 34±12.7 years; 51.4 % males), total annual cases significantly differed, with the highest number of 11942 occurring in 2019. The number of outpatient visits and hospitalization admissions varied (p < 0.001), as well. The percentage of DHF increased to 51.0% in 2024 compared to 27.7% in 2013 (p = 0.003). DSS percentage increased to 4.15% in 2024 as compared to 2.03 % in 2013 (p < 0.05). 122 dengue-related deaths were noted (case-fatality rate 0.29 %), with the peak in 2019 (0.34 %). DENV-II was most common during high-incidence years and occurred independently with severe dengue (adjusted OR 1.62; 95 % CI 1.282.05; p < 0.01). It has been concluded that dengue cases increased in frequency and severity over the last 12 years in Rawalpindi. DENV-II infection remained common. Mortality, however, remained at a low level.
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