Detection of IgM and IgG Dengue antibodies in febrile patients suspected of malaria attending health center in Jos, Nigeria

Abstract

Background: Despite the public health importance of dengue infections, it is less investigated by clinicians and rarely considered in the differential diagnosis of febrile illnesses in Nigeria. The objective was to detect the presence of Dengue IgG/IgM antibodies and Plasmodium species in the blood of febrile patients. Methods: This is a cross sectional study conducted among ninety-four (94) consenting febrile patients suspected of malaria in Jos. Duo detection of dengue antibodies (IgG/IgM) were determined by ELISA technique. Total DNA was extracted from patient serum and quantified to determine concentration and quality of the extraction process. Malaria was detected by Real Time Polymerase Chain Reaction. Results: Dengue antibodies were detected in 55.3% (52/94) of the febrile patients. The mean age was 29.9±1.2. Highest dengue prevalence of 75% (39/52), 50% (26/52) and 59.6% (31/52) were recorded among females, students and non-users of mosquito nets, respectively. In all. 11.7% (11/94) of the samples tested positive for malaria. Age group 11-20 years recorded the highest prevalence of malaria, 63.6% (7/11). Dengue and Malaria co-infection was documented in 5.3% (5/94). There was a significant difference in the prevalence of dengue and malaria among febrile subjects. Conclusion: No association of dengue infection with gender and use of Insecticide Treated Nets was found. The lower malaria prevalence compared to dengue suggests that febrile illness in this population is shown to be associated more with dengue infection. We recommend a continuous surveillance of dengue infection in this population and consideration of dengue in the differential diagnosis of febrile illnesses.

Concurrent malaria and dengue fever in (sub-Saharan) Africa: a systematic review and meta-analysis

“…Cross-sectional studies in Kenya [22, 39] and Cameroon [30, 45] reported significantly low odds of acute dengue in the presence of malaria than in its absence (OR = 0.57, 95% CI, 0.40 – 0.82). Similar studies Nigeria [18, 20, 25, 32, 33, 35], Tanzania [17], Sierra Leone [23], DRC [34], Cameroon [31], Sudan [40, 42], and Senegal [21] ; however, showed no notable odds of acute dengue infection in the presence of malaria when compared to the absence of malaria (OR = 1.07, 95% CI, 0.58 –1.94). On the contrary, cross-sectional studies in Ethiopia [44], Nigeria [16, 29], Tanzania [36], and Cameroon [43] indicated higher odds of acute dengue infection in the presence of malaria than in its absence (OR = 6.98, 95% CI, 2.89 – 16.85).…”

“…Cross-sectional studies in Kenya [22,39] and Cameroon [30,45] reported significantly low odds of acute dengue in the presence of malaria than in its absence (OR = 0.57, 95% CI, 0.40 -0.82). Similar studies Nigeria [18,20,25,32,33,35],…”

“…In our meta-analysis (Figure 5), cross-sectional studies in Cameroon [30, 45], and Kenya [22] revealed significantly lower odds of co-infection in contrast with the absence of acute dengue infections (OR: 0.60; 95% CI, 0.42 – 0.87). Cross-sectional studies in Nigeria [16, 18, 20, 25, 32, 33, 35], Tanzania [17], Sierra Leone [23], Democratic Republic of Congo (DRC) [34], Cameroon [31], Sudan [40, 42], and Senegal [21] indicated no significant odds of co-infection in comparison with acute dengue negatives (OR = 1.07; 95% CI = 0.58, 1.94). Studies in Ethiopia [44], Nigeria [29], Tanzania [36], Cameroon [43], and Kenya [39], on the other hand, indicated significantly higher odds of concurrent infection to acute dengue negatives (OR = 4.56; 95% CI = 3.29, 6.33).…”

“…The strengths of this study are its large sample size, the good-quality score of studies included in the analysis, and no evidence of publication bias among the included studies. Some of the study limitations include: (1) Our search was restricted to those published in English only, so language bias could have flawed our findings, (2) The analysis was dependent on single-centred studies, which may not accurately reflect the true prevalence of the concurrent infection on the African continent, (3) The sample sizes for six studies 21, 26, 31, 33, 43, 46 were relatively small, so the sampling error could lead to substantial bias in the meta-analysis, (4) Our analysis showed significant heterogeneity among the studies due to too many outcomes, and (5) Subgroup analysis was not performed which could affect the accuracy of the results presented.…”

“…In our metaanalysis (Figure 5), cross-sectional studies in Cameroon [30,45], and Kenya [22] revealed significantly lower odds of co-infection in contrast with the absence of acute dengue infections (OR: 0.60; 95% CI, 0.42 -0.87). Cross-sectional studies in Nigeria [16,18,20,25,32,33,35],…”