KARACHI: A new study led by Aga Khan University (AKU) has found that the dengue burden in Pakistan is substantially higher than previously estimated, with cases rising from around 100,000 in 2012 to an estimated 3.28 million in 2022.
Published in PLOS ONE, the study provides national estimates of dengue incidence between 2012 and 2022 and suggests that official surveillance figures may significantly underestimate the scale of transmission across the country.
The research was conducted by AKU in collaboration with national and international partners. Researchers used statistical modelling and laboratory-confirmed data while accounting for healthcare-seeking behaviour, diagnostic testing practices and laboratory utilization to develop more representative estimates.
Sindh emerges as Pakistan’s highest-burden region
The study found major geographic differences in dengue transmission across Pakistan. Sindh recorded the highest estimated incidence at 45.63 cases per 1,000 people, corresponding to approximately 2.63 million cases.
Adults aged 15 to 49 were particularly affected in the province. At the district level, Karachi East recorded the highest estimated incidence, identifying it as a priority area for targeted public health measures.
Professor Erum Khan, Chair of Pathology and Laboratory Medicine at AKU, said the study’s distinctive feature was its use of routinely collected clinical laboratory data from three nationwide diagnostic laboratory networks to estimate dengue incidence.
Dengue showing signs of year-round transmission
Dr Zarmeen Nasim, the study’s lead author, Assistant Professor and researcher at AKU’s Health Data Science Centre, said dengue should no longer be viewed solely as a seasonal health threat.
Although transmission continues to increase during the post-monsoon period, the study’s estimates and seasonal analysis indicate signs of sustained transmission throughout the year, alongside increasingly large outbreaks.
The findings point to the need for stronger disease surveillance, greater focus on high-risk districts and improved environmental control measures.
Researchers also highlighted the importance of sustainable, multi-pronged prevention strategies, including vector control, vaccination, Wolbachia-based interventions and better awareness and training for healthcare professionals in dengue management.