Pathogens That Cause Acute Febrile Illness Among Children and Adolescents in Burkina Faso, Madagascar, and Sudan

Marks, Florian; Liu, Jie; Soura, Abdramane; Gasmelseed, Nagla; Operario, Darwin J.; Grundy, Brian S; Wieser, John; Gratz, Jean; Meyer, Christian G.; Im, Justin; Lim, Jacqueline Kyungah; Kalckreuth, Vera von; Espinoza, Ligia María Cruz; Konings, Frank; Jeon, Hyon Jin; Rakotozandrindrainy, Raphäel; Zhang, Jixian; Panzner, Ursula; Houpt, Eric R.

doi:10.1093/cid/ciab289

Cited by 15 publications

(14 citation statements)

References 32 publications

(30 reference statements)

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“…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).…”

Section: Resultsmentioning

confidence: 99%

“…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],…”

Section: The Interaction Of Plasmodium and Dengue Virusesmentioning

confidence: 87%

“…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, crosssectional 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).…”

Section: The Interaction Of Plasmodium and Dengue Virusesmentioning

confidence: 92%

“…, Tanzania25 , Sierra Leone 31 , Democratic Republic of Congo (DRC)42 , Cameroon 39 , Sudan48,50 , and Senegal29 …”

mentioning

confidence: 99%

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

Gebremariam

Schallig

Mekonnen

et al. 2022

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Introduction Malaria and dengue fever are leading causes of acute undifferentiated febrile illness. In Africa, misdiagnoses of dengue fever as malaria is a common scenario. This systematic review was aimed to determine the prevalence of concurrent malaria and dengue fever, aetiologies, and the association between the two infections in Africa. Methods We assessed evidence from previous studies in Africa that were available in MEDLINE and EMBASE databases between January 01, 2005, and March 30, 2022. Results A total of 3942 studies were identified from the databases of which 30 studies from 13 African countries, including 25,241 febrile patients, were included in the meta-analysis. The result of the meta‐analysis showed a 4.0% pooled prevalence of concurrent malaria and dengue fever in (sub-Saharan) Africa, and the highest rate was recorded in Central Africa (5.8%) followed by East Africa (4.7%) and West Africa (2.8%). Children <18 years old (57%) and females (52.8%) were more affected by the co-infection than adults and females, respectively. The dengue virus serotypes identified were DENV-2, DENV-3, DENV-1, and DENV-4 in descending order with a proportion of 39%, 31%, 27%, and 3%, respectively. Moreover, Plasmodium falciparum was the only specified malaria parasite in the co-infection among the included studies. Significantly higher odds of malaria infection were documented due to dengue fever when compared with malaria mono-infection. However, no significant odds of acute dengue co-infection were recorded due to malaria in contrast to dengue mono-infection. Conclusion This study showed a high prevalence of concurrent malaria and dengue fever in Africa. Healthcare workers should bear in mind the possibility of dengue infection as differential diagnoses for acute febrile illness as well as the possibility of co-existent malaria and dengue in endemic areas. Also, high-quality multi-centre studies are required to verify the above conclusions. Protocol registration number: CRD42022311301. Keywords Prevalence, Co-infection, Malaria, Dengue fever, Dengue virus, DENV, Plasmodium falciparum.

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Section: Resultsmentioning

confidence: 99%

Section: The Interaction Of Plasmodium and Dengue Virusesmentioning

confidence: 87%

Section: The Interaction Of Plasmodium and Dengue Virusesmentioning

confidence: 92%

“…, Tanzania25 , Sierra Leone 31 , Democratic Republic of Congo (DRC)42 , Cameroon 39 , Sudan48,50 , and Senegal29 …”

mentioning

confidence: 99%

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

Gebremariam

Schallig

Mekonnen

et al. 2022

Preprint

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“…As a result, many of these AFI patients are treated according to clinical presentation [8]. The reliance on clinical presentation alone can lead to the misuse of antimicrobials [9] as well as poor patient outcomes. This is particularly the case for Zika virus, which like many other causes of AFI, is difficult to diagnose [10] and may clinically mimic other infections such as Salmonella enterica, Listeria spp., and Brucella spp.…”

Section: Introductionmentioning

confidence: 99%

Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019

et al. 2022

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Background Southern China is at risk for arborvirus disease transmission, including Zika virus and dengue. Patients often present to clinical care with non-specific acute febrile illnesses (AFI). To better describe the etiology of AFI, we implemented a two-year AFI surveillance project at five sentinel hospitals in Yunnan and Guangdong Provinces. Methods Between June 2017 and August 2019, we enrolled patients between 2 and 65 years of age presenting at one sentinel hospital in Mengla County, Yunnan, and four in Jiangmen City, Guangdong, with symptoms of AFI (acute onset of fever ≥ 37.5°C within the past 7 days) without respiratory symptoms or diarrhea. Demographic, epidemiologic, and clinical information was obtained and entered into a web-based AFI surveillance database. A custom TaqMan Array card (TAC) was used to test patients’ whole blood specimens for 27 different pathogens using real-time polymerase chain reaction assays. Results During the two-year project period, 836 patients were enrolled; 443 patients from Mengla County and 393 patients from Jiangmen City. The median age was 33 years [range: 2–65], and most were hospitalized [641, 77%]. Of 796 patients with valid TAC results, 341 (43%) were positive for at least one of the 10 unique pathogens detected. This included 205 (26%) patients positive for dengue virus, 60 (8%) for Orientia tsutsugamushi, and 42 (5%) for Coxiella burnetii. Ten patients (1%) in Jiangmen City tested positive for malaria, 8 of whom reported recent travel outside of China. TAC results were negative for 455 (57%) patients. None of the patients had a positive TAC detection for Zika virus. Conclusions The project detected variability in the etiology of AFI in Southern China and highlighted the importance of differential diagnosis. Dengue, O. tsutsugamushi, and C. burnetii were the most frequently identified pathogens among enrolled AFI patients. As a non-notifiable disease, the frequent detection of C. burnetii is noteworthy and warrants additional investigation. The project provided a framework for routine surveillance for persons presenting with AFI.

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Opportunities and challenges to accurate diagnosis and management of acute febrile illness in adults and adolescents: A review

Grundy

Houpt

2022

Acta Tropica

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Pathogens That Cause Acute Febrile Illness Among Children and Adolescents in Burkina Faso, Madagascar, and Sudan

Cited by 15 publications

References 32 publications

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

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

Etiology of acute febrile illnesses in Southern China: Findings from a two-year sentinel surveillance project, 2017–2019

Opportunities and challenges to accurate diagnosis and management of acute febrile illness in adults and adolescents: A review

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