TY - BOOK AU - Muhammad Usman Zaheer AU - Prof. Dr. Mansur-ud-Din Ahmad ED - TI - Geographical Distribution Of Dengue Fever Infected Patients And Its Related Risk Factors In And Aroun Lahore U1 - 1444,T PY - 2012/// KW - Department of Epidemiology & Public Health N1 - Dengue fever is the most common mosquito-borne viral infection of humans worldwide and is a major public health concern, especially in tropical and subtropical regions (Mackenzie et al., 2004). This life threatening disease is caused by a specific virus (ARBO-Flavivirus) transmitted by the bite of a female mosquito (Aedes aegyptii and Aedes albopictus) which is identified by the white bands and scale patterns on its legs and thorax. Trans-ovarial transmission of dengue virus has also been reported in different studies. The mosquito may bite at any time but the probability of bites increase at dusk and dawn (WHO 2009). Dengue fever has emerged as a significant public health problem in Pakistan. In Pakistan, the first epidemic of dengue fever was reported in 1994 in Karachi (Anaari et al., 2001). Several years later, in 2006 another epidemic was reported in the southern part of Pakistan, predominantly caused by DENV-2 that led to 58 deaths (khan et al., 2008). In 2007, 22 people died of disease and in 2008 only five people were reported to die from it. Between October 2006 and January 2008, there were 3,242 laboratory confirmed cases of dengue fever in Pakistan. Since January 2009, 224 suspected cases were reported in Sindh province, of which 135 were the confirmed cases. During the epidemic of dengue fever in 2010 more than seven thousand cases were reported in Pakistan, of which 5 thousand cases were from Punjab and resulted in 63 deaths. The mosquito-borne viral hemorrhagic diseases are prevalent throughout the world. Dengue hemorrhagic fever (DHF) is one of the most important diseases widely distributed in the tropics of South East Asia. It is an infectious malady of human beings characterized by fever and non-specific constitutional symptoms. The virus is transmissible to human beings by the bite of female Aedes aegypti and Aedes albopictus. The disease is spreading like a geometric rise of cases in a wide range of geographical regions. The geographical factors and locality of patients may be a contributing factor to the outbreak of Dengue Fever. Climate change is likely to increase the area of land with a climate suitable for dengue fever transmission, and that if no other contributing factors were to change, a large proportion of the human population would then be put at risk. The data on address of patients were collected from all the patients admitted in tertiary care hospital from August 01, 2011 to November 30, 2011. The geographical risk factors studied in this project were presence or absence of parks, trees, ponds, swimming pool, service station, tyre shop, source of stagnant water, pond and municipality garbage tank in vicinity of house of the cases and controls. For the study of risk factors we made 2 groups i.e. cases and controls; each comprising of 300 subjects and then data on presence or absence of various hypothesized risk factors in the vicinity of house (400 meters) and area (800 meters) were collected through a well structured and pre-tested questionnaire (Harrington et al., 2005; HonĂ³rio et al., 2003; Schatzmayr 2000; Muir and Kay 1998; Reiter et al., 1995; McDonald 1977; Hausemann 1971 and Bond et al., 1970). The statistical analysis of data was done by using SPSS 16.0. Qualitative data were presented in form of tables, bar charts, column and pie- charts. Chi-square test was applied to see the association between dengue fever and various hypothesized risk factors. P-value<0.05 was considered as significant. Odds ratio was calculated at 95% level of confidence (CI) for various hypothesized risk factors of dengue fever. The results of present study revealed that the season of dengue fever in Pakistan is from August to November and the period prevalence of dengue fever to be 0.11%. Males (59%) were mainly the victim of dengue fever. The main affected age groups were 16-30 year (37.33%) and 31-45 years (29.67%). As far as the geographical distribution of dengue fever infected patients is concerned, it was concluded that dengue fever cases were reported from all the ten towns of Lahore metropolitan, however, most of the cases were reported from Ravi town followed by Data Ganj Baksh town and Cantt. The results regarding various hypothesized risk factors are as follows: parks/trees/plants in vicinity of house OR=8.81, p-value <0.05; swimming pool in vicinity of house OR=5.O3, p-value <0.05; source of stagnant water in vicinity of house OR=8.25, p-value <0.05; fogging in your area OR=0.50, p-value <0.05; service station in the area OR=5.98, p-value <0.05; tyre shop in the area OR=6.11, p-value <0.05; municipality garbage tank in the area OR=5.88, p-value <0.05; any pond in the area OR=5.69, p-value <0.05. From the results of this project we concluded that dengue fever is most prevalent from August to November and it is a disease of mainly male gender and mostly affects people of age group 16-45 years. Besides this, dengue fever is almost equally distributed in all the towns of Lahore metropolitan. Also we concluded that presence or absence of parks, trees, plants, swimming pool, stagnant water, pond, service station, tyre shop and municipality garbage tanks in vicinity of house are the risk factors of dengue fever. Fogging proved to be a deterrent to dengue fever. On the basis of results of this project there is need to implement a control program in which vector control and minimizing the exposure of people to risk factors should be the key points that need to be addressed ER -