title: Concurrent malaria and arbovirus infections in Kedougou, southeastern Senegal.
abstract: BACKGROUND
  Malaria is one of the leading causes of acute febrile illness (AFI) in Africa. With the advent of malaria rapid diagnostic tests, misdiagnosis and co-morbidity with other diseases has been highlighted by an increasing number of studies. Although arboviral infections and malaria are both vector-borne diseases and often have an overlapping geographic distribution in sub-Saharan Africa, information about their incidence rates and concurrent infections is scarce.
  
  
  METHODS
  From July 2009 to March 2013 patients from seven healthcare facilities of the Kedougou region presenting with AFI were enrolled and tested for malaria and arboviral infections, i.e., yellow fever (YFV), West Nile (WNV), dengue (DENV), chikungunya (CHIKV), Crimean Congo haemorrhagic fever (CCHFV), Zika (ZIKV), and Rift Valley fever viruses (RVFV). Malaria parasite infections were investigated using thick blood smear (TBS) and rapid diagnostics tests (RDT) while arbovirus infections were tested by IgM antibody detection (ELISA) and RT-PCR assays. Data analysis of single or concurrent malaria and arbovirus was performed using R software.
  
  
  RESULTS
  A total of 13,845 patients, including 7387 with malaria and 41 with acute arbovirus infections (12 YFV, nine ZIKV, 16 CHIKV, three DENV, and one RVFV) were enrolled. Among the arbovirus-infected patients, 48.7% (20/41) were co-infected with malaria parasites at the following frequencies: CHIKV 18.7% (3/16), YFV 58.3% (7/12), ZIKV 88.9% (8/9), DENV 33.3% (1/3), and RVF 100% (1/1). Fever ≥40 °C was the only sign or symptom significantly associated with dual malaria parasite/arbovirus infection.
  
  
  CONCLUSIONS
  Concurrent malaria parasite and arbovirus infections were detected in the Kedougou region from 2009 to 2013 and need to be further documented, including among asymptomatic individuals, to assess its epidemiological and clinical impact.
authors.affiliation: Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. asow@pasteur.sn.|Institut Santé et développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal. asow@pasteur.sn.|Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre de recherche INSERM U897 Epidémiologie-Biostatistique, Université de Bordeaux, Bordeaux, France. asow@pasteur.sn.
authors.forename: Abdourahmane
authors.initials: A
authors.lastname: Sow
authors.affiliation: Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. cloucoubar@pasteur.sn.
authors.forename: Cheikh
authors.initials: C
authors.lastname: Loucoubar
authors.affiliation: Medical Entomology Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. diawod@yahoo.fr.
authors.forename: Diawo
authors.initials: D
authors.lastname: Diallo
authors.affiliation: Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. oumarfaye@pasteur.sn.
authors.forename: Oumar
authors.initials: O
authors.lastname: Faye
authors.affiliation: Saraya Health District, Saraya, Senegal. youndiaye@hotmail.com.
authors.forename: Youssoupha
authors.initials: Y
authors.lastname: Ndiaye
authors.affiliation: Kedougou Health District, Kedougou, Senegal. doczenghos@yahoo.fr.
authors.forename: Cheikh Saadibou
authors.initials: CS
authors.lastname: Senghor
authors.affiliation: Institut Santé et développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal. adia@ised.sn.
authors.forename: Anta Tal
authors.initials: AT
authors.lastname: Dia
authors.affiliation: Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. ofaye@pasteur.sn.
authors.forename: Ousmane
authors.initials: O
authors.lastname: Faye
authors.affiliation: Department of Pathology, Institute for Human Infections and Immunity, Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, USA. sweaver@utmb.edu.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Weaver
authors.affiliation: Medical Entomology Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. diallo@pasteur.sn.
authors.forename: Mawlouth
authors.initials: M
authors.lastname: Diallo
authors.affiliation: Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre de recherche INSERM U897 Epidémiologie-Biostatistique, Université de Bordeaux, Bordeaux, France. denis.malvy@chu-bordeaux.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
authors.affiliation: Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, BP 220, Dakar, Senegal. asall@pasteur.sn.
authors.forename: Amadou Alpha
authors.initials: AA
authors.lastname: Sall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001102:Arbovirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012675:Senegal / Q000453:epidemiology; D055815:Young Adult; D000071243:Zika Virus Infection / Q000175:diagnosis / Q000453:epidemiology
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