Malaria and Dengue Co-infection: A Comprehensive Study in Peshawar, Pakistan

Malaria and dengue are significant mosquito-borne diseases prevalent in tropical and subtropical climates, with increasing reports of co-infections. This study aimed to determine the frequency, patterns, and risk factors of these co-infections in Peshawar.

A cross-sectional study was conducted from June to December 2023 in three tertiary care hospitals in Peshawar. We evaluated 322 febrile patients (temperature >38 °C) using dengue serological tests (NS1, IgM, IgG), malarial parasite microscopy (thick and thin films with double-reading quality control), and immunochromatography. Clinical and demographic data were collected using structured questionnaires. Statistical analysis was performed using SPSS Version 26 (IBM Corp., Armonk, NY).

Of 322 patients (mean age 35.7 ± 14.2 years; 187 male, 58.1%), 72 (22.4%) had malaria-dengue co-infection. Co-infected patients showed NS1 positivity in 30/72 (41.7%), with higher rates in urban areas (60/231 [26.0%] vs. 12/91 [13.2%]; odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.18-4.52, P < 0.01). Age (r = 0.15, P = 0.007) and education (OR = 1.84, 95% CI: 1.09-3.12, P = 0.02) were significant risk factors. Co-infected patients had longer hospital stays (5.8 ± 2.3 vs. 3.9 ± 1.8 days, P < 0.001) and higher mortality (2.8% vs. 1.2%, P = 0.04).

Co-infection of malaria and dengue is common in Peshawar, particularly in urban areas and during monsoon seasons. Age and educational status are significant risk factors. These findings necessitate routine screening for both diseases in febrile patients from endemic areas, especially during peak seasons. Targeted surveillance and vector control strategies in urban areas are recommended.