1
|
Kajeguka DC, Mponela FM, Mkumbo E, Kaaya AN, Lasway D, Kaaya RD, Alifrangis M, Elanga-Ndille E, Mmbaga BT, Kavishe R. Prevalence and Associated Factors of Dengue Virus Circulation in the Rural Community, Handeni District in Tanga, Tanzania. J Trop Med 2023; 2023:5576300. [PMID: 38028027 PMCID: PMC10651340 DOI: 10.1155/2023/5576300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Dengue virus is among the most important re-emerging arbovirus that causes global public health attention. Dengue has historically been thought of as an urban disease that frequently occurs in rapidly urbanized settings. However, dengue has become more widespread in rural regions in recent years. Understanding the changing dengue epidemiology in different geographical settings is important for targeted intervention. In Tanzania, dengue fever is not frequently reported because of the poor surveillance infrastructure, underestimation, and a lack of consideration of dengue as a priority. Therefore, the true burden as well as the risk factors for increased transmission has not been fully ascertained, particularly in rural areas. A cross-sectional community-based study was conducted in June 2021, involving a total of 362 participants of all age groups. We investigated the prevalence of acute dengue infection, seroprevalence, and associated factors among the community in three villages of the rural Handeni district. The prevalence of acute dengue infection (based on PCR) was 2.2% (8/362). Dengue-specific IgM and IgG antibodies were detected in 3.3% (12/362) and 5.2% (19/362) of the participants, respectively. Adult participants who were having vegetation around their houses were more likely to be DENV seropositive (AOR = 2.4, CI = 1.88-4.18, p value = 0.05). Children living in houses with garbage pit around their households were less likely to be DENV seropositive (AOR = 0.13, CI = 0.03-0.56, p value <0.01). DENV continues to circulate in rural Tanzania, causes an alarming situation, and necessitates prompt public health action to enhance vector surveillance and control in rural communities.
Collapse
Affiliation(s)
| | | | - Emmanuel Mkumbo
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Anna N. Kaaya
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Daniel Lasway
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Robert D. Kaaya
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Pan-African Malaria Vector Control Consortium, Moshi, Tanzania
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | | | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Reginald Kavishe
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| |
Collapse
|
2
|
Epidemiology of dengue fever in Gabon: Results from a health facility-based fever surveillance in Lambaréné and its surroundings. PLoS Negl Trop Dis 2021; 15:e0008861. [PMID: 33566822 PMCID: PMC7875424 DOI: 10.1371/journal.pntd.0008861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022] Open
Abstract
Background In Africa, information on dengue is limited to outbreak reports and focused on some countries with continuing transmission in West and East Africa. To estimate the proportion of dengue-positive cases among febrile patients and identify clinical indicators of dengue cases, we conducted passive facility-based fever surveillance in a catchment area population of 70,000 residents of Lambaréné and its surroundings in Gabon. Methods Non-malarial febrile patients with current fever or history of fever (≤7 days) between 1 and 55 years of age, were enrolled at Albert Schweitzer Hospital (ASH). Acute (visit 1, day of enrollment) and convalescent blood samples were collected between 10 and 21 days after enrollment. Acute/convalescent samples were tested with IgM/IgG ELISA, and a selected subset of acute samples with RT-PCR. Results Among 682 non-malarial febrile patients enrolled, 119 (17.4%) were identified as dengue-positive (94 dengue-confirmed and 25 dengue-probable cases). Of these dengue-positive cases, 14 were confirmed with PCR, and based on serotyping, two infections were identified to be DENV-2 and two were DENV-3. The majority of our enrolled patients were <25 years of age and close to 80% of our dengue-positive cases were <15 years of age. In adjusted analyses, retro-orbital pain and abdominal pain were 2.7 and 1.6 times more frequently found among dengue-positive cases, compared to non-dengue cases. Conclusion Lambaréné is not considered dengue-endemic. However, one in six non-malarial febrile episodes was found to be dengue-positive in the study period. Dengue should be considered more frequently in clinicians’ diagnosis among non-malarial febrile patients in Lambaréné. Given the lack of data on dengue in Gabon, additional prospective and longitudinal studies would help to further define the burden and patterns of dengue for improved case detection. In Africa, information on dengue is limited to outbreak reports focused on some countries in West and East Africa. To estimate the proportion of dengue-positive cases among febrile patients and identify clinical indicators of dengue cases, we conducted passive health facility-based fever surveillance in a catchment area population of 70,000 residents of Lambaréné and its surroundings, Gabon. Among the patients with negative malaria RDT results, those with current fever or history of fever (≤7 days) between 1 and 55 years of age were enrolled at Albert Schweitzer Hospital (ASH). Two samples were collected with an interval of 10 to 21 days after enrollment. Samples underwent different testing for dengue confirmation. Among 682 febrile patients enrolled, 17.4% were identified as dengue-positive. Of these dengue-positive cases, we found DENV-2 and DENV-3 serotypes. Close to 80% of our dengue-positive cases were < 15 years old. Retro-orbital pain and abdominal pain were more commonly found among dengue-positive cases, compared to non-dengue cases. Lambaréné is not considered dengue-endemic. However, one in six non-malarial febrile episodes was found to be dengue-positive in the study period. Clinicians should consider dengue more frequently among non-malarial febrile patients. Given the lack of data on dengue in Gabon, more data should be generated to understand the burden and patterns of dengue for improved case detection.
Collapse
|
3
|
Fritzell C, Rousset D, Adde A, Kazanji M, Van Kerkhove MD, Flamand C. Current challenges and implications for dengue, chikungunya and Zika seroprevalence studies worldwide: A scoping review. PLoS Negl Trop Dis 2018; 12:e0006533. [PMID: 30011271 PMCID: PMC6062120 DOI: 10.1371/journal.pntd.0006533] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/26/2018] [Accepted: 05/16/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Arboviral infections are a public health concern and an escalating problem worldwide. Estimating the burden of these diseases represents a major challenge that is complicated by the large number of unapparent infections, especially those of dengue fever. Serological surveys are thus required to identify the distribution of these diseases and measure their impact. Therefore, we undertook a scoping review of the literature to describe and summarize epidemiological practices, findings and insights related to seroprevalence studies of dengue, chikungunya and Zika virus, which have rapidly expanded across the globe in recent years. METHODOLOGY/PRINCIPAL FINDINGS Relevant studies were retrieved through a literature search of MEDLINE, WHOLIS, Lilacs, SciELO and Scopus (2000 to 2018). In total, 1389 publications were identified. Studies addressing the seroprevalence of dengue, chikungunya and/or Zika written in English or French and meeting the inclusion and exclusion criteria were included. In total, 147 studies were included, from which 185 data points were retrieved, as some studies used several different samples. Most of the studies were exclusively conducted on dengue (66.5%), but 16% were exclusively conducted on chikungunya, and 7 were exclusively conducted on Zika; the remainder were conducted on multiple arboviruses. A wide range of designs were applied, but most studies were conducted in the general population (39%) and in households (41%). Although several assays were used, enzyme-linked immunosorbent assays (ELISAs) were the predominant test used (77%). The temporal distribution of chikungunya studies followed the virus during its rapid expansion since 2004. The results revealed heterogeneity of arboviruses seroprevalence between continents and within a given country for dengue, chikungunya and Zika viruses, ranging from 0 to 100%, 76% and 73% respectively. CONCLUSIONS/SIGNIFICANCE Serological surveys provide the most direct measurement for defining the immunity landscape for infectious diseases, but the methodology remains difficult to implement. Overall, dengue, chikungunya and Zika serosurveys followed the expansion of these arboviruses, but there remain gaps in their geographic distribution. This review addresses the challenges for researchers regarding study design biases. Moreover, the development of reliable, rapid and affordable diagnosis tools represents a significant issue concerning the ability of seroprevalence surveys to differentiate infections when multiple viruses co-circulate.
Collapse
Affiliation(s)
- Camille Fritzell
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Dominique Rousset
- National Reference Laboratory for Arboviruses, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Antoine Adde
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Mirdad Kazanji
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | | | - Claude Flamand
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| |
Collapse
|
4
|
Lim JK, Carabali M, Lee JS, Lee KS, Namkung S, Lim SK, Ridde V, Fernandes J, Lell B, Matendechero SH, Esen M, Andia E, Oyembo N, Barro A, Bonnet E, Njenga SM, Agnandji ST, Yaro S, Alexander N, Yoon IK. Evaluating dengue burden in Africa in passive fever surveillance and seroprevalence studies: protocol of field studies of the Dengue Vaccine Initiative. BMJ Open 2018; 8:e017673. [PMID: 29358421 PMCID: PMC5780679 DOI: 10.1136/bmjopen-2017-017673] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/25/2017] [Accepted: 10/18/2017] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Dengue is an important and well-documented public health problem in the Asia-Pacific and Latin American regions. However, in Africa, information on disease burden is limited to case reports and reports of sporadic outbreaks, thus hindering the implementation of public health actions for disease control. To gather evidence on the undocumented burden of dengue in Africa, epidemiological studies with standardised methods were launched in three locations in Africa. METHODS AND ANALYSIS In 2014-2017, the Dengue Vaccine Initiative initiated field studies at three sites in Ouagadougou, Burkina Faso; Lambaréné, Gabon and Mombasa, Kenya to obtain comparable incidence data on dengue and assess its burden through standardised hospital-based surveillance and community-based serological methods. Multidisciplinary measurements of the burden of dengue were obtained through field studies that included passive facility-based fever surveillance, cost-of-illness surveys, serological surveys and healthcare utilisation surveys. All three sites conducted case detection using standardised procedures with uniform laboratory assays to diagnose dengue. Healthcare utilisation surveys were conducted to adjust population denominators in incidence calculations for differing healthcare seeking patterns. The fever surveillance data will allow calculation of age-specific incidence rates and comparison of symptomatic presentation between patients with dengue and non-dengue using multivariable logistic regression. Serological surveys assessed changes in immune status of cohorts of approximately 3000 randomly selected residents at each site at 6-month intervals. The age-stratified serosurvey data will allow calculation of seroprevalence and force of infection of dengue. Cost-of-illness evaluations were conducted among patients with acute dengue by Rapid Diagnostic Test. ETHICS AND DISSEMINATION By standardising methods to evaluate dengue burden across several sites in Africa, these studies will generate evidence for dengue burden in Africa and data will be disseminated as publication in peer-review journals in 2018.
Collapse
Affiliation(s)
- Jacqueline Kyungah Lim
- Global Dengue and Aedes-transmitted Diseases Consortium, International Vaccine Institute, Gwanak-gu, The Republic of Korea
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mabel Carabali
- Global Dengue and Aedes-transmitted Diseases Consortium, International Vaccine Institute, Gwanak-gu, The Republic of Korea
- Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Jung-Seok Lee
- Development and Delivery, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Kang-Sung Lee
- Development and Delivery, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Suk Namkung
- Global Dengue and Aedes-transmitted Diseases Consortium, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Sl-Ki Lim
- Global Dengue and Aedes-transmitted Diseases Consortium, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Valéry Ridde
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Jose Fernandes
- Centre de Recherches Médicales de Lambaréné, Fondation Internationale de l'Hôpital Albert Schweitzer, Lambaréné, Gabon
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Fondation Internationale de l'Hôpital Albert Schweitzer, Lambaréné, Gabon
| | | | - Meral Esen
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Esther Andia
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | - Noah Oyembo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | - Ahmed Barro
- Program Equité, Action-Gouvernance-Integration-Reinforcement, Ouagadougou, Burkina Faso
| | - Emmanuel Bonnet
- UMI Résiliences, Institut de recherche pour le developpement (IRD), Paris, France
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Fondation Internationale de l'Hôpital Albert Schweitzer, Lambaréné, Gabon
| | - Seydou Yaro
- Centre Muraz, Bobo Dioulasso, Hauts Bassins, Burkina Faso
| | - Neal Alexander
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - In-Kyu Yoon
- Global Dengue and Aedes-transmitted Diseases Consortium, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| |
Collapse
|
5
|
L'Azou M, Succo T, Kamagaté M, Ouattara A, Gilbernair E, Adjogoua E, Luxemburger C. Dengue: etiology of acute febrile illness in Abidjan, Côte d'Ivoire, in 2011-2012. Trans R Soc Trop Med Hyg 2015; 109:717-22. [PMID: 26385938 PMCID: PMC4603269 DOI: 10.1093/trstmh/trv076] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 08/20/2015] [Indexed: 01/22/2023] Open
Abstract
Background The burden of dengue in Africa is not well understood. A prospective study was conducted in Abidjan, Côte d'Ivoire from December 2011 to December 2012 to estimate the proportion of dengue and malaria cases among febrile patients during a period when dengue was not known to be circulating in the region, and to describe the clinical and virological characteristics of laboratory-diagnosed dengue cases. Methods Blood samples were taken from febrile patients (body temperature ≥38°C) at two study sites. Patients with fever lasting more than 7 days, with fever of known origin and with jaundice were excluded. Thick blood film tests, ELISA for anti-dengue IgM and reverse transcription-PCR (RT-PCR) were performed. Results A total of 812 patients were enrolled (51.7% male [48.3% female]; 46.4% aged <10 years) of whom 796 (98.0%) provided IgM ELISA and RT-PCR data, and 807 (99.4%) had thick blood film results. Three (0.4%) patients had laboratory-diagnosed dengue (one with DENV-3 serotype), none of whom were diagnosed clinically, and 234 (28.8%) had confirmed malaria. Conclusions This study suggests that dengue virus circulates in Abidjan outside an epidemic and that there should be an increase in awareness of dengue as a possible diagnosis in cases of undifferentiated fever. These results stress the importance of implementing laboratory capacity to assess dengue burden in Africa.
Collapse
Affiliation(s)
- Maïna L'Azou
- Global Epidemiology Department, Sanofi Pasteur, Avenue Pont Pasteur 69367 Lyon cedex 07, France
| | - Tiphanie Succo
- Global Epidemiology Department, Sanofi Pasteur, Avenue Pont Pasteur 69367 Lyon cedex 07, France
| | | | - Abdoulaye Ouattara
- Epidemiology and Clinical Research Department, Pasteur Institute, Abidjan, Côte d'Ivoire
| | | | - Edgar Adjogoua
- Endemic Viruses Department, Pasteur Institute, Abidjan, Côte d'Ivoire
| | - Christine Luxemburger
- Global Epidemiology Department, Sanofi Pasteur, Avenue Pont Pasteur 69367 Lyon cedex 07, France
| |
Collapse
|
6
|
Caron M, Grard G, Paupy C, Mombo IM, Bikie Bi Nso B, Kassa Kassa FR, Nkoghe D, Leroy EM. First evidence of simultaneous circulation of three different dengue virus serotypes in Africa. PLoS One 2013; 8:e78030. [PMID: 24205075 PMCID: PMC3804462 DOI: 10.1371/journal.pone.0078030] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 09/08/2013] [Indexed: 01/10/2023] Open
Abstract
Gabon, in Central Africa, was affected for the first time in 2007 and then in 2010 by simultaneous outbreaks of chikungunya and Dengue serotype 2 (DENV-2) viruses. Through the national surveillance of dengue-like syndromes between 2007 and 2010, we observed continuous circulation of DENV-2 in a southward movement. This rapid spread of DENV-2 was associated with the emergence of DENV-1 in 2007 and DENV-3 in 2010. Interestingly, we detected six DENV-2 infected patients with hemorrhagic signs during the second outbreak in 2010. Although these cases do not meet all standard WHO criteria for severe Dengue with hemorrhage (formerly DHF), this is the first report of several dengue fever cases associated with hemorrhagic signs during a simultaneous circulation of different DENV serotypes in Africa. Together, these findings suggest that DENV is becoming more widely established on this continent and that DHF will likely become a serious public-health problem in the near future.
Collapse
Affiliation(s)
- Melanie Caron
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Institut de recherche pour le développement (IRD), Montpellier, France
- * E-mail:
| | - Gilda Grard
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Christophe Paupy
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Institut de recherche pour le développement (IRD), Montpellier, France
| | - Illich Mamfred Mombo
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Institut de recherche pour le développement (IRD), Montpellier, France
| | - Branly Bikie Bi Nso
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | - Dieudonne Nkoghe
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Ministère de la Santé Publique, Libreville, Gabon
| | - Eric Maurice Leroy
- Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Institut de recherche pour le développement (IRD), Montpellier, France
| |
Collapse
|
7
|
Abstract
BACKGROUND Chikungunya virus (CHIKV) has caused multiple outbreaks in tropical and temperate areas worldwide, but the clinical and biological features of this disease are poorly described, particularly in Africa. We report a prospective study of clinical and biological features during an outbreak that occurred in Franceville, Gabon in 2010. METHODOLOGY/PRINCIPAL FINDINGS We collected, in suspect cases (individuals presenting with at least one of the following symptoms or signs: fever, arthralgias, myalgias, headaches, rash, fatigue, nausea, vomiting, diarrhea, bleeding, or jaundice), blood samples, demographic and clinical characteristics and outcome. Hematological and biochemical tests, blood smears for malaria parasites and quantitative PCR for CHIKV then dengue virus were performed. CHIKV+ patients with concomitant malaria and/or dengue were excluded from the study. From May to July 2010, data on 270 laboratory-confirmed CHIK patients were recorded. Fever and arthralgias were reported by respectively 85% and 90% of patients, while myalgias, rash and hemorrhage were noted in 73%, 42% and 2% of patients. The patients were grouped into 4 clinical categories depending on the existence of fever and/or joint pain. On this basis, mixed forms accounted for 78.5% of cases, arthralgic forms 12.6%, febrile forms 6.7% and unusual forms (without fever and arthralgias) 2.2%. No cases of organ failure or death were reported. Elevated liver enzyme and creatinine levels, anemia and lymphocytopenia were the predominant biological abnormalities, and lymphocytopenia was more severe in patients with high viral loads (p = 0.01). CONCLUSIONS/SIGNIFICANCE During CHIK epidemics, some patients may not have classical symptoms. The existence of unusual forms and the absence of severe forms of CHIK call for surveillance to detect any change in pathogenicity.
Collapse
|