Dengue diagnosis system fails patients

With no policy regulating prices for diagnostic tests, patients are forced to rely on labs using unreliable kits

KARACHI:

As the spread of dengue and malaria once again bedevils people in the port city, diagnostic tests and platelet treatments have become unaffordable for the public. As a result, small laboratories are now conducting tests using low-quality kits that while being light on the pocket produce unreliable results.

Hundreds of labs continue operating without registration with inadequately trained staff, which often creates difficulties for patients. Despite the fact that doctors rely heavily on medical test reports when prescribing treatment for vector-borne diseases, the Health Department has remained silent regarding the use of substandard kits and the overcharging of patients, allowing the medical sector to exploit poor families without fear of action.

Currently, almost every lab in Karachi is charging its own rates for dengue, malaria, and other blood tests, far beyond the reach of poor patients. Many labs use low-cost rapid kits for screening. A 2019 study conducted in Pakistan revealed that these rapid devices provide only about 70 per cent accurate results, with a 30 per cent chance of error. Despite this, many labs continue using cheap and unreliable kits, leading to questionable reports that doctors then use for treatment decisions, sometimes putting patients' lives at risk.

A dengue patient, Saqib, revealed that he had his dengue and malaria tests done at two different laboratories, with one charging Rs2,000 and the other Rs1,400. Lab workers told him his tests were performed using rapid kits. "My CBC reports from the two labs differed significantly, and the doctor explained that these variations were due to differences in diagnostic kits. Dengue patients often also need platelet transfusions, costing between Rs6,000 and Rs35,000," said Saqib, while urging the government to ensure platelet availability for dengue patients.

Similarly, Shazia, a resident of Jamshed Road, shared that her two sons developed high fever, and the doctor instructed her to get the dengue, malaria, and CBC tests done. "I had to pay Rs7,000 in total. When I questioned the cost, the lab claimed it used high-quality kits whose results doctors trusted, unlike the cheaper kits used by small labs whose reports may not be reliable," said Shazia.

According to the Vector-Borne Disease Department of the Director General Health Services Sindh, 22 people have died from dengue across Sindh from January to November 2025, including deaths reported in several districts of Karachi as well as Hyderabad, Jamshoro, Tando Muhammad Khan, and Tando Muhammad Aliyar. During the same period, the number of dengue cases across Karachi and Sindh rose to 18,728.

At Dow Laboratory, the dengue antigen test costs Rs1,100, the IgG/IgM dengue test Rs1,500, the PCR dengue test Rs4,600, and the ELISA dengue test Rs1,180, while the CBC test with ESR costs Rs680. The same tests at larger private hospitals are often twice as expensive, while smaller laboratories have no fixed pricing. PCR and ELISA techniques are considered more reliable, which is why they are more expensive at certified labs.

According to Sindh Healthcare Commission Chairman Dr Khalid Shaikh, new reduced prices for dengue-related tests have been set until 31 December 2025. The ICT malaria test, previously costing Rs3,050, is now offered at Rs600; the dengue ELISA test, previously Rs4,550, at Rs1,100; the dengue IgM/Combo test, earlier Rs4,150, at Rs1,500; and CBC with smear, formerly priced at Rs1,250 is now available for Rs500. Some larger labs have implemented the new rates, but many small labs continue charging as they please.