Dengue and Chikungunya Virus Infections among Young Febrile Adults Evaluated for Acute HIV-1 Infection in Coastal Kenya

Abstract

BackgroundFever is common among patients seeking care in sub-Saharan Africa (sSA), but causes other than malaria are rarely diagnosed. We assessed dengue and chikungunya virus infections among young febrile adults evaluated for acute HIV infection (AHI) and malaria in coastal Kenya.MethodsWe tested plasma samples obtained in a cross-sectional study from febrile adult patients aged 18–35 years evaluated for AHI and malaria at urgent care seeking at seven health facilities in coastal Kenya in 2014–2015. Dengue virus (DENV) and chikungunya virus (CHIKV) were amplified using quantitative real-time reverse-transcription polymerase chain reaction. We conducted logistic regression analyses to determine independent predictors of dengue virus infection.Results489 samples that were negative for both AHI and malaria were tested, of which 43 (8.8%, 95% confidence interval [CI]: 6.4–11.7) were positive for DENV infection. No participant was positive for CHIKV infection. DENV infections were associated with clinic visits in the rainy season (adjusted odds ratio (AOR) = 3.0, 95% CI: 1.3–6.5) and evaluation at a private health facility (AOR 5.2, 95% CI: 2.0–13.1) or research health facility (AOR = 25.6, 95% CI: 8.9–73.2) instead of a public health facility.ConclusionA high prevalence of DENV infections was found in febrile young adult patients evaluated for AHI. Our data suggests that DENV, along with AHI and malaria, should be considered in the differential diagnosis of the adult patient seeking care for fever in coastal Kenya.

Investigation of an Outbreak of Dengue Virus Serotype 1 in a Rural Area of Kribi, South Cameroon: A Cross-Sectional Study

“…The results obtained may be due to the fact that the majority of the participants included in the analysis were asymptomatic. This is in accordance with results observed in other studies [16, 20, 21]. During epidemics, all these pathologies are clinically difficult to distinguish from other diseases, and differential diagnosis in case of suspicion remains a major problem to date [22, 23].…”

Unrecognized Dengue Virus Infections in Children, Western Kenya, 2014–2015

“…In 2013, an outbreak of DENV-2 in Mombasa was detected, in part, by RT-PCR ( 7 ). More recently, DENV infections were described in 43 adult patients with fever who resided in Mtwapa, on the coast of Kenya near Mombasa; these cases occurred February 2014–January 2015 ( 8 ), which overlapped with the period in which we observed the DENV cases we report in this study. All of the DENV PCR-positive subjects from the 2016 study were infected with DENV-2, which is consistent with the DENV serotype observed in the 2013 Mombasa outbreak ( 7 ).…”

Metagenomic Virome Analysis of Culex Mosquitoes from Kenya and China

“…The virus causes variable symptoms ranging from mild febrile illness to the more severe dengue hemorrhagic fever, which can progress to a fatal form, dengue shock syndrome (DSS). Aedes aegyptii and Aedes albopictus are the two competent vectors of the virus worldwide [ 59 , 60 , 61 ]; hence, Culex mosquitoes ingested the virus from viremic hosts. The Kenyan coastal towns, which include Kwale, have experienced intermittent outbreaks due to dengue 2 in the past and presence of the virus suggests continuous low-level circulation.…”