A Cross-Sectional Study of Malaria and Dengue Co-Infection in a Tertiary Care Hospital in Balochistan

Nimra Anwar; Nabeel Khan Afridi; Sania Khan; Muhammad  Zubair

doi:10.37185/

Authors

Nimra Anwar Combined Military Hospital (CMH), Quetta, Pakistan
Nabeel Khan Afridi Combined Military Hospital (CMH), Quetta, Pakistan
Sania Khan Combined Military Hospital (CMH), Quetta, Pakistan
Muhammad Zubair Combined Military Hospital (CMH), Quetta, Pakistan

DOI:

https://doi.org/10.37185/

Keywords:

Co-Infection, Dengue, Malaria, Pakistan, Thrombocytopenia

Abstract

Objective: To determine the frequency and clinical profile of malaria–dengue co-infection among febrile patients in Quetta, Pakistan.
Study Design: A cross-sectional observational study.
Place and Duration of Study: The study was conducted at the Department of Hematology, Combined Military Hospital, Quetta (Balochistan), Pakistan, from May 2025 to October 2025.
Methods: A total of 355 patients aged ≥12 years presenting with acute febrile illness were evaluated. Malaria was diagnosed using thick and thin smears on microscopy. Serological tests (IgM and NS1) for dengue were performed for confirmation. Hematological parameters were analyzed on a Sysmex XN-350 hematology analyzer. Data was analyzed by using Statistical Package for Social Sciences (SPSS) 26.00, where the Chi-Square test was used for categorical variables, while the Mann–Whitney U test and the Kruskal–Wallis test were applied for comparison of non-normally distributed quantitative variables, with P ≤ 0.05 considered statistically
significant.
Results: Malaria was confirmed in 282 (79.4%) cases, dengue in 27 (7.6%), and dual infection in 15 (4.2%), predominantly Plasmodium vivax (73%). The highest proportion of affected individuals (55.6%) fell in the 26–50-year age group. Fever and myalgia (87.5%) were the most frequent symptoms in co-infected cases.
Platelet counts were lowest in co-infection [100.00 (108.50 – 80.00) × 10⁹/L, P < 0.001, while hemoglobin was significantly reduced in malaria patients (P = 0.271). Dengue + P. falciparum co-infection showed greater bleeding tendency and one fatal outcome due to dengue hemorrhagic fever.
Conclusion: Dengue–malaria co-infection, although relatively uncommon, presents with overlapping clinical manifestations. This can even result in severe thrombocytopenia. Routine dual testing for malaria and dengue in febrile illnesses can facilitate early diagnosis and improve patient outcomes in endemic areas.

How to cite this: Anwar N, Afridi NK, khan S, Zubair M. A Cross-Sectional Study of Malaria and Dengue Co-Infection in a Tertiary Care
Hospital in Balochistan. Life and Science. 2026; 7(2): 231-237. doi: http://doi.org/10.37185/LnS.1.1.1125