A major Chattogram study reveals rising dengue and chikungunya burdens, genetic mutations and co-infections, urging integrated, science-based public health strategies beyond dengue-centric control to address long-term health and economic risks.
A large joint study by Chattogram (second-largest city in Bangladesh) City Corporation and Esperia Health Research and Development Foundation has mapped the scale, clinical impact and genetic diversity of dengue, chikungunya and Zika infections in Bangladesh’s port city, urging science-based and integrated public health action.
The findings were presented on Sunday at 11:30 am at the Theatre Institute Chattogram during a presentation and stakeholder exchange meeting attended by city officials, physicians and researchers.
Conducted from June to November this year, the research aimed to assess the real burden of mosquito-borne diseases in Chattogram and to help shape effective strategies to mitigate future public health risks. The study was carried out with support from Esperia Healthcare Limited and under the supervision of researchers from the University of Chittagong’s Department of Genetic Engineering and Biotechnology, Chattogram General Hospital, Chattogram Medical College Hospital, Chattogram Maa O Shishu Hospital, Chattogram Veterinary and Animal Sciences University, USTC, Apollo Imperial Hospital, the Disease Biology and Molecular Epidemiology Research Group and the Next Generation Research Sequencing and Innovation Lab, Chittagong.
The research involved a detailed and multidimensional analysis of clinical, public health, epidemiological and genetic characteristics of patients from Chattogram City Corporation areas and surrounding upazilas.
On chikungunya, researchers said the disease has rapidly emerged as a serious public health challenge in Bangladesh, particularly in Chattogram. The findings show chikungunya is no longer limited to short-term fever but is causing prolonged joint pain, reduced work capacity and significant economic losses. Co-infections were also detected, with dengue present in 10 percent of chikungunya cases and Zika in 1.1 percent, complicating disease management.
Within the city, infection rates were comparatively higher in Kotwali, Baklia, Double Mooring, Agrabad, Chawkbazar, Halishahar and Panchlaish. At the upazila level, Sitakunda, Boalkhali and Anwara showed notable infection levels. About 60 percent of patients experienced severe and persistent joint pain lasting more than three months. Researchers said misdiagnosis and inadequate reporting mean the true disease burden remains largely unknown, while limited public awareness and treatment costs ranging from 10,000 to 15,000 taka are adding to the challenge.
In the country’s largest chikungunya-focused study to date, involving 1,100 patients in Chattogram, the most commonly affected joints were the ankles, knees, wrists and hands. Many patients reported morning stiffness and swelling. Genetic analysis revealed significant viral diversity, with variants showing similarities to strains previously identified in Pakistan, India and Thailand. However, the Chattogram samples contained more than 50 genetic changes or mutations, prompting further in-depth research.
Researchers stressed that chikungunya should now be considered a long-term public health and economic crisis and that dengue-focused control strategies alone are insufficient.
The dengue component of the study analysed clinical and biological data from 1,797 patients in Chattogram. Nearly half were infected with dengue, showing warning signs, while a significant number suffered from severe dengue. Almost all patients had fever, with high rates of nausea, headache, muscle pain, pain behind the eyes, abdominal pain and diarrhoea. Demographic analysis showed the highest infection rates among people aged 18 to 35, with men more affected than women. Urban residents were found to be at higher risk than rural populations. Hypertension and diabetes were relatively common comorbidities, and some patients developed complications such as bleeding and fluid accumulation. Overall, dengue infections in Chattogram were found to be more prevalent among young urban men and while most cases remained manageable, vigilance was deemed essential.
The research was led by Dr HM Hamidullah Mehedi of the Department of Medicine at Chattogram General Hospital, Dr Abul Faisal Mohammad Nuruddin of Railway General Hospital and Professor Dr Adnan Mannan of the University of Chittagong’s Department of Genetic Engineering and Biotechnology. The research team included several prominent physicians and scientists from across the country. Support for the project came from Beximco Pharmaceuticals, Chattogram District Council and Chattogram City Corporation.
Chattogram City Corporation Mayor Dr Shahadat Hossain attended the event as the chief guest. Special guests included Professor Dr Jasim Uddin, principal of Chattogram Medical College and Hospital, Professor Dr MA Sattar of the Department of Medicine, Associate Professor Dr Mohammad Ibrahim Chowdhury of the Department of Cardiology and Associate Professor Dr Md Ekram Hossain of the Department of Cardiology at Chattogram General Hospital. Esperia Healthcare Limited Chairman Golam Baki Masud and senior officials, doctors and researchers from various institutions were also present.
In his address, Mayor Dr Shahadat Hossain said the study reflects the real situation in Chattogram and highlighted the need for science-based and coordinated decisions to tackle dengue and chikungunya. Project team leader Professor Dr Adnan Mannan said multiple new and important mutations identified through genetic analysis could influence the spread and severity of disease in the region, making the data crucial for future treatment and control strategies. Esperia Healthcare Limited Chairman Golam Baki Masud said dengue and chikungunya are no longer solely medical issues but represent a broader public health and development challenge that cannot be addressed without research-based evidence.
Lead physicians and researchers said the current situation cannot be managed through dengue-centric approaches alone and called for integrated disease control and awareness programmes that recognise chikungunya as a long-term public health problem. Special guests and participating experts described the research as timely for Chattogram and the country and urged policymakers to incorporate the findings into national public health planning.
