Vitamin D Deficiency in Dengue Fever Patients' Coinfected with in Pakistan. A Case-control Study

Introduction: Dengue fever is a vector-borne disease with an estimate of 390 million persons getting the infection each year with a significant public health impact. It has been reported DENV patients with vitamin D deficiency led to severe form of dengue infection; while coinfection alters vitamin D receptors leading to vitamin D deficiency. We hypothesize that DENV patient's having low vitamin D along with coinfection could have worsen dengue severity as well as vitamin D deficiency. In this case-control study, we compared (I) the vitamin D deficiency in dengue fever cases with or without coinfection, and (II) negative dengue fever as a control with or without coinfection. We have also assessed the correlation between vitamin D levels and its effect on warning signs of the dengue fever. Further, we have investigated whether coinfection with has any effect on warning signs in the dengue fever patients and the vitamin D deficiency in all serotypes of the dengue virus infected patients.

Methods: In this case control study the association of the vitamin D levels with age, gender and coinfection in dengue fever hospitalized patients was assessed using chi-square and multivariate logistic regression analysis.

Results: Four hundred dengue fever patients with coinfection were compared with 400 dengue negative controls with coinfection. The mean age was 29.96 ± 10.5 and 29.88 ± 10.7 years among cases and controls, respectively. Most dengue fever patients with coinfection were deficient in vitamin D compared with negative dengue controls with coinfection. In multivariate logistic regression, the dengue cases with coinfection were.056 times (95% CI: 0.024, 0.128, = 0.000) more likely to have vitamin D "deficiency', while compared with the cases who did not have coinfection.

Conclusion: The present study proposes that vitamin D deficiency in dengue fever patients coinfected with is much higher than the dengue fever negative controls coinfected with . As hypothesized the DENV patient with coinfection has vitamin D deficiency as well as increased dengue severity.