Little is known about the extent and serotypes of dengue viruses circulating in Africa. We evaluated the presence of dengue viremia during 4 years of surveillance (2014–2017) among children with febrile illness in Kenya. Acutely ill febrile children were recruited from 4 clinical sites in western and coastal Kenya, and 1,022 participant samples were tested by using a highly sensitive real-time reverse transcription PCR. A complete case analysis with genomic sequencing and phylogenetic analyses was conducted to characterize the presence of dengue viremia among participants during 2014–2017. Dengue viremia was detected in 41.9% (361/862) of outpatient children who had undifferentiated febrile illness in Kenya. Of children with confirmed dengue viremia, 51.5% (150/291) had malaria parasitemia. All 4 dengue virus serotypes were detected, and phylogenetic analyses showed several viruses from novel lineages. Our results suggests high levels of dengue virus infection among children with undifferentiated febrile illness in Kenya.
Modelling of emerging vector borne diseases serves as an important complement to clinical studies of modern zoonoses. This article presents an archaeo‐historic epidemiological modelling study of Rift Valley fever (RVF), using data‐driven neural network technology. RVF affects both human and animal populations, can rapidly decimate herds causing catastrophic economic hardship, and is identified as a Category A biodefense pathogen by the US Center for Disease Control. Despite recent origins circa the early 1900s, little is known about the circumstances of its inception nor the relationships between factors that affect transmission. This evidence could be vital as the disease continues to expand from its epicentre in Kenya to other parts of Africa and the Arabian Peninsula. RVF is a relevant case for archaeological/palaeopathological investigations of disease as it intersects between numerous human, animal, spatial, temporal, and sociopolitical dimensions. By integrating landscape archaeology, historical evidence, and climatic data, with evidence of human behaviour gathered through ethnoarchaeological study, this article presents an applied framework for human–animal palaeopathology. This framework aligns with the One Health approach that observes disease to be intrinsically tied to ecological and societal factors. We provide a useable alternative way of thinking about disease modelling in the present and the past, ultimately seeking to support efforts to accurately predict future impacts. Tapping into longitudinal evidence from the last 50–300 years offers a powerful way to respond to the threat zoonoses will pose to human populations around the world as the climate warms.
Objective
To evaluate pregnancy and neonatal outcomes, disease severity, and mother‐to‐child transmission of pregnant women with Chikungunya infection (CHIKV).
Design
Retrospective observational study.
Setting
Grenada.
Population
Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible.
Methods
This descriptive study investigated 731 mother‐infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA.
Main outcome measures
Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity.
Results
Of 416 mother‐infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother‐to‐child transmission occurred in two (1.3%) mother‐infant pairs and two of eight intrapartum infections (25%).
Conclusion
CHIKV infection during pregnancy may be protective against long‐term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother‐to‐child transmission of CHIKV.
Tweetable abstract
Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
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