• Sindh saw highest disease burden in 2022, AKU research finds • Cases grew from 100,000 in 2012 to 3.28m in 2022
• Lead author Dr Zarmeen says dengue is no longer just a seasonal threat

KARACHI: Pakistan saw over 3,000 per cent increase in dengue cases from 2012 to 2022, a new study shows, indicating that the mosquito-borne viral infection poses a greater public health challenge in the country than previously recognised.

Led by the Aga Khan University (AKU), in collaboration with national and international partners, the study is published in the research journal PLOS ONE.

The research provides the most comprehensive national estimates of dengue incidence from 2012 to 2022, showing that the country’s true dengue burden is substantially higher than official surveillance figures suggest.

Using advanced statistical modelling and laboratory-confirmed data estimates, the study accounts for healthcare-seeking behaviour, diagnostic testing practices, and laboratory utilisation to generate more representative national estimates.

Estimates reveal that dengue cases in the country increased dramatically from approximately 100,000 in 2012 to an estimated 3.28 million in 2022, underscoring the rapidly escalating burden of the disease.

“The unique feature of this study is its innovative use of routinely collected clinical laboratory data from three nationwide diagnostic laboratory networks, to estimate the incidence of dengue fever in Pakistan,” said Prof Erum Khan, the chair pathology & laboratory medicine, AKU.

Significant geographic disparities were also observed across the country. Sindh was the highest-burden hotspot for dengue transmission in 2022, with 45.63 cases per 1,000 population, corresponding to an estimated 2.63m cases, mainly affecting adults aged 15-49 years.

The same year, Balochistan had the lowest incidence rates of 0.44 case per 100,000 individuals, corresponding to an estimated 6,785 cases. All age groups experienced increasing incidence, with the 15-49 age-group showing the most pronounced rise.

At the district level, Karachi East reported the highest estimated incidence, highlighting priority areas for targeted public health action.

“Dengue is no longer just a seasonal threat,” explains lead author Dr Zarmeen Nasim, who is assistant professor and AKU Health Data Science Centre researcher.

“Although cases continue to surge during the post-monsoon months, essential estimates along with seasonal data show signs of sustained year-round disease transmission, with progressively larger outbreaks over time,” she said.

The findings underscore the urgent need to strengthen surveillance, target high-risk districts, improve environmental control measures and invest in sustainable multimodal prevention strategies.

This includes vector control, vaccines, introduction of Wolbachia mosquitoes (a modern scientific method that uses natural bacteria to stop mosquitoes from spreading dangerous viruses like dengue) and greater awareness and training of health care professionals in best practices of dengue fever management.

Published in Dawn, September 9th, 2026