Publication date: May 01, 2026
Dengue is a major public health concern in India, showing marked seasonal variation and diverse clinical manifestations. Long-term regional data are essential for improving early diagnosis and guiding public health interventions. This study assessed decade-long epidemiological trends, clinical spectrum, and dengue virus serotype distribution among NS1-confirmed dengue cases in Andhra Pradesh, India. We conducted a retrospective observational study of 30,086 clinically suspected dengue cases tested for dengue NS1 antigen at a tertiary-care center in Andhra Pradesh, India, between January 2015 and December 2024. Demographic characteristics, urban-rural residence, temporal trends, clinical manifestations classified according to the WHO 2009 dengue classification, and dengue virus serotypes were analyzed. Associations were assessed using chi-square tests, and selected comparisons of clinical manifestation categories were performed using proportion-based analyses. Among 30,086 suspected cases, 3,899 (13. 0%) were NS1-positive. Positivity was higher among males (2,142; 13. 6%), children aged ≤18 years (2,235; 20. 7%), and rural residents (1,679; 14. 7%). Dengue transmission showed consistent post-monsoon peaks from August to October, with a marked decline in 2020 during COVID-19-related movement restrictions. Severe dengue with hemorrhagic manifestations was the most common clinical category (1,734; 44. 47%), followed by systemic manifestations (727; 18. 64%), neurological involvement (690; 17. 68%), gastrointestinal warning signs (307; 7. 87%), and hepatic involvement (160; 4. 10%). Neurological manifestations were significantly more frequent than gastrointestinal or hepatic involvement. Serotyping of 300 NS1-positive samples showed predominance of dengue virus serotype 3 (111; 37. 0%), followed by serotype 2 (70; 23. 3%), with mixed serotype infections (28; 9. 3%). This decade-long analysis highlights pronounced seasonality, a substantial pediatric burden, rural predominance, evolving dengue virus serotype circulation, and a notable contribution of neurological manifestations to dengue morbidity in southern India. Strengthened pre-monsoon vector control, early syndromic recognition particularly of neurological involvement, and continued molecular serotype surveillance are essential to reduce dengue-related morbidity in endemic regions.
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| Concepts | Keywords |
|---|---|
| Decade | dengue |
| Hepatic | epidemiology |
| Monsoon | neurological manifestations |
| Rural | ns1 antigen |
| seasonal trends | |
| serotyping | |
| who |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | NS1 |
| disease | MESH | Dengue |
| disease | MESH | COVID-19 |
| disease | MESH | Severe dengue |
| disease | MESH | Neurological manifestations |
| disease | MESH | infections |
| pathway | REACTOME | Reproduction |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | hemorrhage |
| disease | MESH | shock |
| disease | MESH | encephalitis |
| disease | MESH | seizures |
| disease | MESH | included |
| disease | MESH | fever |
| disease | MESH | headache |
| disease | MESH | myalgia |
| disease | MESH | arthralgia |
| disease | MESH | pain |
| disease | MESH | abdominal pain |
| disease | MESH | vomiting |
| disease | MESH | diarrhea |
| disease | MESH | encephalopathy |
| disease | MESH | somnolence |
| disease | MESH | jaundice |
| disease | MESH | liver dysfunction |