A STATISTICAL ANALYSIS OF DENGUE

PATIENTS IN DISTRICT PESHAWAR

By

HANIF ULLAH (BSSTAT-192310)

Supervised By

Dr. SAJJAD AHMAD KHAN

DEPARTMENT OF STATISTICS
ISLAMIA COLLEGE PESHAWAR
SESSION: 2019-2023
 A STATISTICAL ANALYSIS OF DENGUE
PATIENTS IN DISTRICTS PESHAWAR

By

HANIF ULLAH (BSSTAT-192310)

Supervised By

Dr. SAJJAD AHMAD KHAN

Submitted to the department of Statistics, Islamia College Peshawar in partial
fulfillment of the requirements for the degree of Bachelor of Science in Statistics.

DEPARTMENT OF STATISTICS
ISLAMIA COLLEGE PESHAWAR
SESSION: 2019-2023
 APPROVAL SHEET
It is certified that this thesis “A STATISTICAL ANALYSIS OF DENGUE VIRUS
INFECTED PATIENTS IN DISTRICT PESHAWAR, PAKISTAN” submitted to
Islamia College Peshawar by Mr. Hanif Ullah Roll No: 192310, in partial fulfillment of
requirements for the degree of Bachelor of Science in Statistics is accepted.

Research Supervisor:

Dr. Sajjad Ahmad Khan

Associate Professor,
Department of Statistics,
Islamia College Peshawar

Examiner:

Dr. Amjad Ali

Associate Professor,
Department of Statistics,
Islamia College Peshawar

Chairman:

Dr. Amjad Ali

Associate Professor,
Department of Statistics,
Islamia College Peshawar

Dated: / /

DEPARTMENT OF STATISTICS
ISLAMIA COLLEGE PESHAWAR
SESSION: 2019-2023
 TABLE OF CONTENTS

DEDICATION………………………………………………………………………i

ACKNOWLEDGEMENT………………………………………………………….ii

CHAPTER-1…………………………………………………………………………1

INTRODUCTION……………………………………………...……………………1

1.1 Definition of Dengue………………………………………….……………....1

1.2 History………………………………………………………………………...1
1.3 Types of Dengue Virus…………………………………………………..……1
1.4 Dengue Fever………………………………………………………………….2
1.5 Role of Hospitals……………………………………………………………...2
1.6 Geographical Overview…………………………………….………………....3
1.7 Dengue Vectors…………………………………………….………….……...3
1.8 World Health Organization………………………………….………………...4
1.9 Objective of the present study……………………………….…………….…..5

CHAPTER-2……………………………………………………………….…………6

LITERATURE REVIEW…………………………………………..…….………….6

CHAPTER-3…………………………………………………………………………11

RESEARCH METHODOLOGY………………………………..…………………11

3.1.1 Location…………………………….……………………….………………..11

3.1.2 Khyber Teaching Hospital (KTH)………………………….………………...11

3.1.3 Population…………………………………………………….………………11

3.1.4 Sample Size……………………………………………….….……………….11

3.1.5 Data Collection…………………………………………….….………………12

3.1.6 Research Tools…………………………………………….….………………12

3.1.7 Chi-Square Test of Independence…………………………….………………12

3.1.8 Odds and Odds Ratio…………………………………………………………12

CHAPTER-4…………………………………………………………………………13

Data Analysis……………………………………………………….………………..13

4.1 Frequency Table…………………………………………….……………….13

4.2 Chi-Square Table……………………………………………………………14

4.3 Odds Ratio…………………………………………………………………...19

CHAPTER-5…………………………………………………………………………20

5.1 Discussion…………………………………………………………………….20

5.2 Conclusion…………………………………………………………………….21

5.3 Recommendations…………………………………………………………….21

REFERENCES………………………………………………………………………22
Dedicated to Loving
Parents, Teachers &
Friends

i
 ACKNOWLEDGEMENT

All praise and glorification be to Almighty Allah the most beneficent and gracious, who
give me the power and courage to complete this task.

I am thankful to my research supervisor, Dr. Sajjad Ahmad Khan for his valuable
guidance and advice. He inspired me greatly to work in this project. His willingness
motivates me to contribute tremendously to this research and also I would like to thank
him for showing me some examples related to the topic of my research.

Secondly I would to thank and acknowledge my teachers, Dr. Amjad Ali, Dr. Sadaf
Manzoor, Dr. Hassan Zeb, Dr. Shumaila Ehtisham and Dr. Adnan Khan, for their time
and support. I am also thankful to the authority of Islamia College Peshawar for
providing me a good environment to complete this research.

Finally I appreciate the support and encouragement of my family and friends.

Hanif Ullah.

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ii
i
 CHAPTER-1

INTRODUCTION

1.1 Definition of dengue

Dengue virus is a mosquito-borne virus that causes dengue fever, a significant public
health concern in many parts of the world. There are four distinct types of dengue virus,
referred to as serotypes, Dengue virus type 1 (DENV-1), Dengue virus type 2 (DENV-2),
Dengue virus type 3 (DENV-3), Dengue virus type 4 (DENV-4). Here is a brief overview
of the history and types of dengue virus (Gubler, 1998).

1.2 History

Dengue virus has been documented for centuries, with the first recorded outbreak dating
back to the 18th century in Asia. The term “dengue” is believed to have originated from
the Swahili phrase “Ka-dinga pepo” which means “cramp-like seizure caused by an evil
spirit”. The virus was first isolated in 1943 during an outbreak in Japan. (Kyle, Harris,
2008).

1.3 Types of Dengue Virus

1.3.1 Dengue Virus Type 1 (DENV-1)

• First identified in 1940.

• It is associated with mild to severe dengue symptoms.

1.3.2 Dengue Virus Type 2 (DENV-2)

• Also identified in 1940.

• Can lead to severe hemorrhagic fever or dengue shock syndrome in some cases.

1.3.3 Dengue Virus Type 3 (DENV-3)

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 • First isolated in 1953.
• Responsible for outbreaks of dengue worldwide

1.3.4 Dengue Virus Type 4 (DENV-4)

• Isolated in 1956.
• Can cause a range of dengue symptoms, including severe forms. (WHO, 2019).

1.4 Dengue fever

Dengue fever is a mosquito-borne viral disease that is transmitted by female Aedes-

aegypti. This disease has spread rapidly in recent decades, both in terms of geographical
distribution as well as in relation to increase in the number of cases worldwide (WHO,
Sommerfeld J, Kroeger A 2016). The dengue virus is a member of Flavivirus genus and
Flaviviridae family and is responsible for dengue infections in humans. Currently, there
are four serotypes of dengue virus 1-4 identified globally. While the distribution of these
four serotypes was uneven in 1970, confirmed dengue virus 1-4 were found spread across
the entire globe by 2004 (Scitable 2014). Dengue virus is transmitted to humans by
Aedes mosquitoes when they feed. These mosquitoes dwell in tropical and subtropical
countries because they need warm weather to accelerate their growth (Martyn-Simmons
C, et al 2007).

Aedes mosquitoes are mostly found in urban and suburban areas that are associated with
high population densities and the availability of containers and stagnant water locations
in which these mosquitoes to breed (WHO, Sommerfeld J, Kroeger A, Li Y, et al 2014).
Globally, the World Health Organization (WHO) estimates that 3.9 billion people are at
risk of being infected with the dengue virus in more than 100 countries (Brady OJ, et al
2012). Annually, around 500,000 people are hospitalized as a result of severe dengue
infection, leading to 12,500 (1). However, dengue is an underreported disease and many
cases are misclassified (WHO, Silva MM, et al 2016).

1.5 Role of Hospitals

Hospitals, both primary and referral, play a significant role in reducing dengue
transmission because hospitals are responsible providing accurate diagnosis and reporting

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positive cases for early warming purposes (Ang KT, Rohani I, Look CH 2010). Hospitals
must ensure detection of early and severe cases, increase in health services and building
of capacities, provision of dengue prevention courses and preparation of vaccines (WHO
2012). According to the WHO surveillance guidelines, standard case investigation should
be performing within 24 hours of the initial case notification (WHO, 2012).

This notification is used to perform surveillance activity through epidemiological

investigation, which needs to be conducted within a 100 meter radius from the home of
the confirmed dengue case in order to seek the presence of other people with a suspected
dengue infection. Furthermore, this activity also investigates the search for larvae
existence in potential breeding places (Ministry of Health Republic of Indonesia, 2017).
The WHO encourages sustainable dengue control, considering it to be low cost
intervention with long term effects on both health and environment (WHO, 2019). Their
recommendations include using integrated and sustainable vector control to reduce
human vector contact, which can be performed through environmental management and
chemical and biological control (WHO, 2017).

1.6 Geographical overview

In recent years, the transmission has increased, predominantly in the urban and sub-urban
areas (Bowman C, et al 2005). With approximate 25,000 deaths (WHO, Hossain M.S,
&Varatharaj A. 2018). The disease has been well known for 200 years, but the etiology
of the disease was not discovered until 1944 (Esteva L, Chowell, G 2003). It was
recognized in the Philippines in 1953 and in the Thailand in 1955 (Jelinek T, et al 2000).
The threat of the outbreak is now exist in Europe, with its first local transmission reported
in France and Croatia in 2010, other cases have occurred in Florida (USA) and Yunnan
(province of China) in 2013 (Bowman C, Bakach, I 2000). The dengue is causes a
spectrum of illness in humans, ranging from clinically unapparent, to severe and fatal
hemorrhagic disease (Esteva L, et al 2003). The incubation period, time between
infection and appearance of symptoms is from 3-14 days, but often, it is 4-7 days (WHO,
Hossain M.S, Esteva L, 1999).

1.7 Dengue vectors

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Dengue is also known as break bone fever is a serious and sometimes fatal infection. It
transmits through mosquitoes most commonly by Aedes aegypti and Aedes albopictus
types of mosquitoes, and its effects all ages of population. The disease may be
characterized from mild symptoms to life threating condition. The symptoms may range
from moderate headache, nausea, vomiting, muscular pain, and high grade fever to severe
abdominal pain, persisting vomiting, bleeding gums, low pulse, and narrow pulse
pressure. Neurological symptoms may include confusion, unconsciousness and shock
(Guzmán MG, Kouri G 2002).

Since the 19th century, when dengue was a scarcely recognized disease, it arose to be the
most important mosquito borne viral disease in the world. Currently, it is present in 112
countries all over the world. It occurs mainly in tropical and subtropical areas with
incidence primarily located in urban and sub-urban locations. Around 2.5 to 3 billion
people worldwide are estimated to be at risk (Malavige, G. N 2004).

It occurs most in Asian countries and is locally a leading cause of hospitalization and
deaths (Cossio, M. L. T 2014). The vector is responsible for majority of dengue
infections and its transmission is the Aedes aegypti mosquitos (Malavige, G. N 2004).
Dengue represents a health issue in most of Southeast Asian countries, Cambodia,
Malaysia, Vietnam and the Philippines account for over 90% of the total cases registered
within the region. In the Philippines, dengue is the vectors borne viral disease (Rajiah, K
2014).

1.8 World Health Organization

Dengue has a wide spectrum of clinical presentations and its clinical course can be
unpredictable (World Health Organization). The WHO 1997 guidelines classified dengue
into undifferentiated fever, dengue fever and dengue hemorrhagic fever (DHF). DHF was
further classified into four severity grades with grade 3 and 4 defined as dengue shock
syndrome (DSS) (World Health Organization). However, difficulties in applying the
criteria in clinical practice have led to a revision of the classification with the disease
classified as severe and non-severe dengue with or without warning signs (World Health
Organization).

4
According to the report of the World Health Organization (WHO), there is a tremendous
increase in the incidence rate of the dengue infection and pose a global health catastrophe
(Nebehay S, 2013). The infection can be the outcome of the transmission of any of the
four dengue serotypes. The infection can be asymptotic or can also give rise to an
indistinguishable fever which can be associated with other health abnormalities including
dengue hemorrhagic fever (DHF), dengue fever (DF) or dengue shock syndrome (DSS)
(WHO, 2009).

The mortality rate is less than 1% when clinically administered with proper care (WHO,
2009). And usually stands 1-5% without sufficient clinical management (Ranjit S,
Kissoon N, 2011). In certain cases the mortality rates stands at 26% with a severe form of
disease (Wilder-Smith A, et al 2017). The common mosquito vectors for the transmission
of infection are Aedes aegypti and Aedes albopictus (Kyle JL, Harris E 2017). The
disease has penetrated its roots into the foundation of many nations and is now endemic
in more than 100 countries including Africa, America, Western pacific and South-east
Asia (Sharp TM, 2017). The dengue virus has been endemic for many years in Pakistan,
because of the temperate climate of the country (Rasheed S, et al 2013). Multiple dengue
outbreaks have been reported since 2006 every year along with the circulation of the
multiple serotypes (Ali A, et al 2016).

1.9 Objective of the present study

The aim of this study is to determine the current situation of dengue virus
infected patients in district Peshawar.

5
 CHAPTER-2

LITERATURE REVIEW

Dengue is the most common and serious arthropod-borne viral disease. First reported in
1779 by David Bylon during an epidemic in Indonesia, there has a dramatic spread in
disease distribution in the previous 50 years (Hanley KA, Weaver SC, 2010). Before
1970, only nine countries had dengue epidemics. Currently, dengue is endemic in more
than a hundred countries in five out six WHO regions (WHO, 2011). It is estimated that
there are 2.5 billion people living in dengue-endemic countries (WHO, SEARO, 2015).

Worldwide, the incidence of dengue is greater than any other arbo-virus infection
(Nathan MB, et al 2011). According to the World Health Organization (WHO), nearly
100 million new cases are reported every year, and this has a major social and economic
impact, especially in tropical and subtropical regions (Tapia-Conyer R, 2009). The
dengue virus is transmitted by mosquitos, primarily Aedes aegypti, which typically found
around human dwellings (Harrington LC, et al 2001). Infection with any of the four
serotypes can be asymptotic in 65-90% cases (Porter KR, et al 2005). However, when
such infections results in clinically apparent disease, symptoms can range from mild
undifferentiated febrile illness to severe dengue, which can include fatal complications
such as major bleeding and shock caused by abnormal capillary permeability with plasma
leakage(Kyle JL, et al 2008).

Recent reports have shown that the incidence of dengue is increasing in Americas
(Guzman MG, Kouri G, 2003). There has been a dramatic increase in the number of
reported cases in Latin America and the Caribbean, a region in which the number of high
incidence countries with > 100 cases/100,000 population increased from 5 to 15 in the
last three decades (San Martin JL, et al 2010). Likewise, the annual number of dengue

6
related deaths has increased in the region from 242 in 1980s to 2,068 in the 2000s (Pan
American Health Organization (PAHO) 2009).

Dengue fever is a public health problem of global importance about 2.5 billion people are
at risk of dengue infection, of which 50 million get infected every year (Suaya JA, 2009).
Dengue is the most quickly re-emerging arbore-viral disease in the world (Garg P, 2008).
At this time dengue is a major epidemiological peril for over 100 countries. Currently,
40% of the world’s population survives in areas with high risk of dengue infection. The
World Health Organization (WHO) estimates that 50-100 million of dengue infection
occurs every year including 500,000 dengue hemorrhagic fever cases and 22,000 deaths,
often among children (WHO, 2009).

In 2006, ten out of eleven countries in South-East Asia Region the region except Korea
reported dengue cases. In India, dengue is endemic in Delhi, Gujarat, Punjab, Karnataka,
Tamil Nadu, Kerala and Andhra Pradesh (Cited on 2013).

In Asian and American countries wherein dengue is endemic, the effect of dengue is
approximately 1300 disability-adjusted life years per million populations; this effect is
highly similar to the disease burden of related childhood and tropical disease, including
tuberculosis (Gubler, DJ, Meltzer M. 1999).

In Asia, the coverage of epidemic dengue hemorrhagic fever (DHF) has expanded
geographically westward from Southeast Asian countries India, Sri Lanka, the Maldives,
and Pakistan and then eastward to China (Gubler D.J, Meltzer M. 1999). In China, the
first reported DF outbreak due dengue virus type 4 occurred in Foshan City, Guangdong
Province, in 1978; DF then began to spread to southern Chinese provinces from Foshan
City (Wen J, Liang F, 1998).

Since then, the Guangdong Province has exhibited the highest incidence of DF in
mainland China, and more than 65% of all DF cases in the country were reported in this
province (Liu C, et al 2001). In 2014, the number of DF cases increased dramatically to
38,753 in Guangdong Province and accounted for 93.83% of DF fever cases in mainland

7
of China (Zhang, Y, et al 2016) Aedes albopictus, an aggressive mosquito species that is
also on the main vectors of DF, is widely distributed with high density Guangdong
Province (Guo Y, Song, Z, Jia, DS, 2017).

Understanding the risk factors for dengue virus infection is necessary to control this
disease effectively. However, most of the current case-control studies on risk factors for
DF focused on severe dengue infections, such as dengue shock syndrome and DHF, are
variables related to clinical and laboratory indexes (Thein TL, Branco MR, et al 2013).
Environmental, such as heavy rainfall and global warming and factors based on the
awareness and knowledge of dengue prevention measures are also responsible for drastic
reductions in dengue transmission (Van Benthem B.H, Phuanukoonnon S, et al 2010).
Several macroscopic descriptive studies have been performed to explore the risk factors
for dengue virus infection and provide a basis for formulating control strategies in
Guangdong Province. These studies have obtained considerable information on the group
level and climate factors but limited information on personal protective measures (Luo L,
Gu H, et al 2012)

Dengue was reported in 1902 in Penang, Malaysia (Skae, FMT, 1902). The incidence rate
of dengue in Malaysia had quadrupled from 44.3cases/1,0,0000 in 1999 to 181
cases/100,000 in 2007 (Ministry of Health Malaysia, 2010 ). And the number of reported
dengue cases has increased 6.5 fold in the last decade (Mia MS, et al 2000). Since 2001,
the fatality rate has been 2 to 3 in a thousand cases except for 2007 where it increased to
6 in a thousand (Ministry of Health Malaysia, Mia MS, et al 2010).

A study in Singapore of 596 dengue cases found that female gender, lower than normal
hematocrit levels, abdominal distension, vomiting and fever on admission were factors
associated with severe dengue (Carrasco LR, Leo YS, et al 2014). In Vietnam, young age
female genders were found to be associated dengue mortality (Anders KL, Nguyet NM,
et al 2011).

Another study on 560 dengue patients in France found that plasma leakage, severe
thrombocytopenia and acute hepatitis were associated with increased mortality (Thomas

8
L, Brouste Y, et al 2010). Abdominal pain, cough and diarrhea were found to predict
development of severe complications (Thomas L, Brouste Y, et al 2010).

Indonesia has been dengue-endemic for the past five decades, almost since the first cases
were discovered in Jakarta and Surabaya on Java Island in 1968. During the first outbreak
in Indonesia, 58 dengue cases were reported and 24 of them led to patient death
(Sumarmo, 1987). During the initial outbreak period, dengue spread rapidly across the
country, leading to dengue transmission quickly becoming hyper endemic in the country
(Sumarmo, Karyanti MR, Suwandono A, et al 2014). With cases continuing to increase
sharply as time passed. By the 2000s, the number of dengue cases continued to increase
(Setiati TE, e al 2006) and four DEN Viruses, 1–4, came to be identified in Indonesia,
with most cases resulting from DENV-3 infection (Suwandono A, 2006).

Dengue is thought to be expanding in Pakistan. The first dengue case was reported from
Hub, Baluchistan Province in 1960, when the estimated population of Pakistan was 45.9
million. The total number of reported dengue cases for the 1960–1980 periods was only
12 (Chan Y, Rasheed S, et al 2013). The first serologically and virologically confirmed
dengue outbreak was reported from Karachi in 1994 (Chan Y, 2013).

In Pakistan, dengue hemorrhagic fever was recognized as a major public health problem
in 2006 when the first major outbreak caused 4800 positive cases and 50 death tolls. This
was followed by 2008 outbreak that hit the entire country (Fatima Z, et al 2012). A
massive outbreak in 2011 in Punjab province affected more than 21,597 individuals and
claimed 365 precious lives (Rasheed S, 2013). Since then, every year thousands of
positive cases and hundreds of deaths have been reported (Boots M, Moher D, et al
2009).

Dengue Serotype 2 was detected in 1987 and serotype 1 in 1990s (Khan J, 2017). The
first outbreak was recorded in Karachi during 1994 caused by circulating DENV-1 and
2(Paul RE, et al 1998). Another dengue outbreak was documented in Karachi during
2005 in which DENV-1 and 2 were the predominant serotypes, with newly introduced
DENV-3 also detected (Ahmed S, et al 2013). Three dengue virus serotypes (2, 3, and 4)
were observed during 2008 in Lahore (Jamil B, et al 2007). The largest dengue outbreak

9
was reported during 2011 in Lahore with 22,562 dengue cases and 363 fatalities (Khan J,
et al 2018).

The second largest epidemic occurred during 2013 in Swat (KP province) with 8343
dengue cases and 57 deaths. The predominant circulating serotypes reported were
DENV-2, 3 & 4 in Punjab during 2011, and DENV-2 & 3 in Swat, KP during 2013
(Khan E, et al 2008).

The highest numbers of confirmed dengue cases in Pakistan were noted during 2010 and
2011, with 37,512 and 10,416 cases respectively. Even though dengue epidemics varied
across the years, there was an increasing trend of dengue over time in Pakistan,
suggesting a worsening situation since 2005. From 1994 to 2013, nine national epidemics
occurred (Ali A, et al 2013).

The reported dengue cases and fatality rates were very high in Lahore (2011) and Swat
(2013) as compared to other Asian regions. However, the number of dengue cases
reported in Pakistan is lower than other countries in Asia, South East Asia and Americas
(Koo C, et al 2013).

In Khyber Pakhtunkhwa (KP) province of Pakistan, the disease has been there since 2006
with low magnitude (Rasheed SB, et al 2013). However, in 2013 an estimated 9024
positive dengue cases with 70 deaths were reported in Swat (Wasim A, 2014). This was
followed by another outbreak in 2014 claiming the lives of many men, women, and
children. In 2016, 272 dengue cases were reported by a health facility in Batkhela, a
locality of Swat district (DAWN, 2019).

The dengue outbreaks remained confined to specific geographical areas (districts) in

2013–16 (Khan J, et al 2015). In 2017, the outbreak spread to the entire province. Out of
95,000 suspects, 20,000 emerged as confirmed cases and claimed 61 lives. Most of these
cases were reported from Peshawar district, the provincial capital (WHO, 2019).

10
 CHAPTER-3

RESEARCH METHODOLOGY

2.1 Location

3.1.1 Peshawar – The Capital of Khyber Pakhtunkhwa

Peshawar is one of the oldest cities in Asia and is the capital of Khyber Pakhtunkhwa
(KPK). The people of Peshawar are well known for being extremely respectable and
making others feel at home which makes you want to visit again and again. It is famous
for its “Bara and Karkhano” markets and the huge variety of goods one finds at
surprising prices one can’t even imagine otherwise. Moreover, Peshawar is a colorful and
bright city and if you are coming from a city like Islamabad you might even find the
roads emptier and surroundings cleaner. It is a place that gives a feeling of warmth and
nostalgia even to new visitors. There are some historical places like Qisa khuwani bazaar,
Fort Bala Hisar, Peshawar museum, Ganta gharr and Namak Mandi which must not be
missed as well some modern buildings.

3.1.2 Khyber Teaching Hospital

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In a modern and friendly health care organization that prides itself on serving its
community with excellent care and treatment. It provides acute hospital services and
specialist services to people living in KPK, FATA and adjoining areas of Afghanistan.
KTH offers a full range of emergency and high dependency care in Maternity, Pediatrics,
Surgery, Orthopedics and Medicine.

3.1.3 Population

All the dengue virus infected patients of Khyber Teaching Hospital (KTH) in district
Peshawar are considered as population for this study.

3.1.4 Sample size

This is a retrospective study, using G-power software for selecting a sample. The sample
size was calculated with 0.05 level of significance and degrees of freedom 5 in a sample
300 patients.

3.1.5 Data Collection

The data was collected through retrospective method from main laboratory of Khyber
Teaching Hospital (KTH).

3.1.6 Research Tools

After collecting the required data, the data was entered in statistical software SPSS
version 16.0. The data were edited and clean. Chi-Square Goodness of fit Test, and Odds
ratio were used.

3.1.7 Chi-Square Test of Independence

The chi-square test of Independence is a statistical test used to assess the association of
observed data to the expected distribution.

Formula;

3.1.8 Odds and Odds Ratio

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Odds are the probability of an event occurring divided by the probability of the event not
occurring. An odds ratio is the odds of the event in one group.

𝒑
The formula of Odds;
(𝟏−𝒑)

𝒑𝟏(𝟏−𝒑𝟏)
The formula of Odds Ratio OR;
𝒑𝟐(𝟏−𝒑𝟐)

CHAPTER-4

DATA ANALYSIS

4.1 Frequency Tables

Variables Category Frequency Percentage

Gender Male 183 61%

Female 117 39%

Age 6 to 15yrs 127 42.3%
16 to 25yrs 61 20.3%
26 to 35yrs 39 13%
36 to 45yrs 26 8.7%
46 to 55yrs 17 5.7%
>56yrs 30 10%
Area Urban 212 70.7%

13
 Rural 88 29.3%
Test Results Positive 266 88.7%
Negative 34 11.3%

4.2 Chi-Square Table

14
Variables Category Test Results Chi-Square P-value

Positive Negative
Gender Male 1.482 0.223
24 159
Female
10 107
Age
6 to
8 119
15yrs
16 to 7.917 0.161
11 50
25yrs
26 to
6 33
35yrs
36 to
3 23
45yrs
46 to
1 16
55yrs
>56yrs 5 25
Area
Urban 22 190
Rural 12 76 0.657 0.418

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16
17
18
19
 4.2 ODDS RATIO

Gender Results

Odds ratio 1.6151

95 % CI: 0.7423 to 3.5140
z statistic 1.209
Significance P = 0.2268
level

Area Results

Odds ratio 0.7333

95 % CI: 0.3457 to 1.5556
z statistic 0.808
Significance P = 0.4189
level

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 CHAPTER-5

5.1 DISCUSSION

This study was carried out to know the current situation of dengue virus infection in
male, female and children at Peshawar, for this study 300 patients were selected as
sample.

Gender Wise Dengue Patients

Among 300 patients 183 (63%) were male and 117 (39%) were female. The value of Chi-
square is 1.482 having P-value is 0.223 the P-value is >0.05 which shows that there is no
significant association between gender and dengue virus infection.

Area Wise Dengue Patients:

212 (70.7%) patients were belong to urban area and 88 (29.3%) belong to rural area. The
value of Chi-square is 0.657 having P-value is 0.418 the P-value is >0.05 therefore area
status has no significant association with dengue virus infection.

Age Wise Dengue Patients:

The number of those patients whose age were 6 to 15 years are 127 (42.3%), whose age
were 16 to 25 are 61 (20.3%), whose age were 26 to 35 are 39 (13.0%), whose age were
36 to 45 are 26 (8.7%), whose age were 46 to 55 are 17 (5.7%) and above 56 are 30
(10.0%). The Chi-square value is 7.917 having P-value is 0.161 the P-value is >0.05
which shows that there is no significant difference between dengue virus infection and
age of the patients.

Gender and Area Wise Odds Ratio:

The finding showed that the odds ratio regarding dengue is 1.651 times higher for males
as compared to females, and odds ratio of area regarding dengue is 0.73 times higher for
urban as compared to rural area.

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5.2 CONCLUSION:

Dengue has always been an important and major health problem in Pakistan. Dengue is
transmits through mosquitoes most commonly by Aedes aegypti and Aedes albopictus
types of mosquitoes, and its effects all ages of population. The purpose of this study is to
check the current situation of dengue patients in KTH Peshawar. After statistical analysis
we conclude from the results that there is no significant association of gender, area status
and age with dengue virus infection. Further we calculated odds ratio of gender and area
status. The finding showed that the odds ratio regarding dengue is higher for males as
compared to females, and odds ratio of area regarding dengue is higher for urban as
compared to rural area.

5.3 Recommendations:

This study provides some recommendations

• The first recommendation is that the data was collected of dengue patients from
only Khyber Teaching Hospital, further projects should be conducted including
all the hospitals in Peshawar.
• Secondly taking 300 dengue patients as a sample from Khyber Teaching Hospital
Peshawar. Therefore, the study finding is limited to this area.

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 REFERENCES

Gubler DJ, (1998). Dengue and dengue hemorrhagic fever Clin Microbiol Rev 11: 480–
496

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