Arboviruses as an unappreciated cause of non-malarial acute febrile illness in the Dschang Health District of western Cameroon

Abstract

Acute febrile illness is a common problem managed by clinicians and health systems globally, particularly in the Tropics. In many regions, malaria is a leading and potentially deadly cause of fever; however, myriad alternative etiologies exist. Identifying the cause of fever allows optimal management, but this depends on many factors including thorough knowledge of circulating infections. Arboviruses such as dengue (DENV) cause fever and may be underdiagnosed in sub-Saharan Africa where malaria is a major focus. We examined cases of fever in western Cameroon that tested negative for malaria and found 13.5% (13/96) were due to DENV, with 75% (9/12) of these being DENV serotype 2 infections. Two complete DENV2 genomes were obtained and clustered closely to recent isolates from Senegal and Burkina Faso. The seroprevalence of DENV in this region was 24.8% (96/387). Neutralizing antibodies to DENV2 were detected in all (15/15) seropositive samples tested. Chikungunya (CHIKV) is an arthritogenic alphavirus that is transmitted by Aedes mosquitoes, the same principal vector as DENV. The seroprevalence for CHIKV was 15.7% (67/427); however, CHIKV did not cause a single case of fever in the 96 subjects tested. Of note, being seropositive for one arbovirus was associated with being seropositive for the other (Χ2 = 16.8, p<0.001). Taken together, these data indicate that Aedes-transmitted arboviruses are endemic in western Cameroon and are likely a common but underappreciated cause of febrile illness. This work supports the need for additional study of arboviruses in sub-Saharan Africa and efforts to improve diagnostic capacity, surveillance systems, and arbovirus prevention strategies.

Mosquito-Borne Arboviruses Occurrence and Distribution in the Last Three Decades in Central Africa: A Systematic Literature Review

“…The vector competence of Ae. aegypti [ 139 , 189 , 190 , 191 ] and Ae. albopictus [ 190 , 192 ] in the transmission of major arboviruses has been well-documented.…”

“…as potential vectors of important viruses is still unknown. For the Culex mosquitoes already identified in studies of the Central African region, they have been frequently reported to be associated with zoonotic arboviruses such as RVFV and WNV [ 19 , 188 , 191 , 193 ]. Of the Culex spp.…”

“…moucheti ) [ 194 ], and CHIKV ( An. funestus ) [ 191 ]. Moreover, other mosquitoes that are not well-known in the region are associated with arboviruses and include Eretmapodites spp.…”

(Sero)Prevalence of (Re)Emerging Major Arbovirus Infections in Africa: A Systematic Review and Meta-Analysis Protocol

“…First, surveillance of arboviral etiologic pathogens related to common acute febrile illness is challenging, given that most attention has been given to the malaria response [7][8][9]. Second, there is limited availability of routine diagnostic procedures for Arbovirus screening and detection [10].…”

Distribution and Characterization of Culicids (Diptera: Culicidae) in Two Urban Communes of Estuaire Province of Gabon

“…Mosquitoes are extensively studied due to their role in spreading viral and parasitic diseases of medical and zoonotic significance 1 . Over 3000 species of mosquitoes spread diseases like malaria, lymphatic filariasis and arboviruses 2,3 . The capital cities of Africa have been reported to be one of the hotspot areas for the spread of dangerous vector-borne diseases (VBDs) such as malaria 4 and arboviruses (chikungunya, dengue, Zika and yellow fever) 5 .…”