title: Is dengue and malaria co-infection more severe than single infections? A retrospective matched-pair study in French Guiana.
abstract: BACKGROUND
  Dengue and malaria are two major arthropod-borne infections in tropical areas, but dual infections were only described for the first time in 2005. Reports of these concomitant infections are scarce and there is no evidence of more severe clinical and biological pictures than single infections.
  
  
  METHODS
  To compare co-infections to dengue alone and malaria alone, a retrospective matched-pair study was conducted between 2004 and 2010 among patients admitted in the emergency department of Cayenne hospital, French Guiana.
  
  
  RESULTS
  104 dengue and malaria co-infection cases were identified during the study period and 208 individuals were matched in two comparison groups: dengue alone and malaria alone. In bivariate analysis, co-infection clinical picture was more severe than separated infections, in particular using the severe malaria WHO criteria. In multivariate analysis, independent factors associated with co-infection versus dengue were: masculine gender, CRP level > 50 mg/L, thrombocytopaenia < 50 109/L, and low haematocrit <36% and independent factors significantly associated with co-infections versus malaria were red cells transfusion, low haematocrit < 36%, thrombocytopaenia < 50 109/L and low Plasmodium parasitic load < 0.001%.
  
  
  CONCLUSIONS
  In the present study, dengue and malaria co-infection clinical picture seems to be more severe than single infections in French Guiana, with a greater risk of deep thrombocytopaenia and anaemia.
authors.affiliation: CIC-EC Antilles Guyane CIE 802 Inserm, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana. epelboincrh@hotmail.fr
authors.forename: Loïc
authors.initials: L
authors.lastname: Epelboin
authors.forename: Matthieu
authors.initials: M
authors.lastname: Hanf
authors.forename: Philippe
authors.initials: P
authors.lastname: Dussart
authors.forename: Sihem
authors.initials: S
authors.lastname: Ouar-Epelboin
authors.forename: Félix
authors.initials: F
authors.lastname: Djossou
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.forename: Bernard
authors.initials: B
authors.lastname: Carme
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000473:pathology*; D003715:Dengue / Q000150:complications / Q000473:pathology*; D005260:Female; D005616:French Guiana; D006801:Humans; D007223:Infant; D008288:Malaria / Q000150:complications / Q000473:pathology*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult