Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania.
Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.
Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Julian T
JT
Hertz
O Michael
OM
Munishi
Eng Eong
EE
Ooi
Shiqin
S
Howe
Wen Yan
WY
Lim
Angelia
A
Chow
Anne B
AB
Morrissey
John A
JA
Bartlett
Jecinta J
JJ
Onyango
Venance P
VP
Maro
Grace D
GD
Kinabo
Wilbrod
W
Saganda
Duane J
DJ
Gubler
John A
JA
Crump
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018354:Alphavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D000914:Antibodies, Viral / Q000097:blood; D065632:Chikungunya Fever; D002646:Chikungunya virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D003716:Dengue Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
D000914:Antibodies, Viral; D007075:Immunoglobulin M