Aetiologies of acute undifferentiated febrile illness at the emergency ward of the University of Gondar Hospital, Ethiopia

Akelew, Yibeltal; Pareyn, Myrthe; Lemma, Mulualem; Negash, Markos; Bewket, Gezahegn; Derbew, Agegnehu; Belay, Gizeaddis; Pollmann, Julia; Adriaensen, Wim; Peeters, Marjan; Ombelet, Sien; Adane, Aynishet; Mohammed, Rezika; Griensven, Johan van; Cnops, Lieselotte

doi:10.1111/tmi.13721

Cited by 11 publications

(23 citation statements)

References 57 publications

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“…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). There was no indication of a potential outlier (studentized residuals >±3.0654) and overlay influence (cook’s distance) among the studies.…”

Section: Resultsmentioning

confidence: 99%

“…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). The overall estimate based on 22 studies showed no significant odds of acute dengue co-infection in contrast to malaria mono-infection (OR = 1.00, 95% CI, 0.87 – 1.16) with significant heterogeneity (I 2 = 86, P <0.0001).…”

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: 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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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: Resultsmentioning

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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“…Subsequently, annual outbreaks have been observed in Godey Town and Dire Dawa [26,27]. Circulating dengue infection has also been identified in Humera, Tigray Region, Metema, Amhara Region, Arba Minch, Southern Nations, Nationalities, and People Region, Gondar, Amhara Region, and Borena Zone, Oromia Region, by the presence of anti-DENV IgG/IgM antibodies in febrile patients [28][29][30][31], indicating that the true distribution of DF in Ethiopia is highly underestimated. More recently, in 2017, DF emerged in Kabridahar Town, Korahey Zone (Eastern Ethiopia), affecting more than 100 individuals [24], and in 2019, for the first time in Gewane District, Afar Region (North-East Ethiopia).…”

Section: Introductionmentioning

confidence: 99%

Epidemiological, Entomological, and Climatological Investigation of the 2019 Dengue Fever Outbreak in Gewane District, Afar Region, North-East Ethiopia

Mekuriaw

Kinde

Kindu

et al. 2022

Insects

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Dengue Fever (DF) is an important arthropod-borne viral infection that has repeatedly occurred as outbreaks in eastern and northeastern Ethiopia since 2013. A cross-sectional epidemiological outbreak investigation was carried out from September to November 2019 on febrile patients (confirmed malaria negative) who presented with suspected and confirmed DF at both public and private health facilities in Gewane District, Afar Region, northeastern Ethiopia. Entomological investigation of containers found in randomly selected houses belonging to DF-positive patients was undertaken to survey for the presence of Aedes larvae/pupae. A total of 1185 DF cases were recorded from six health facilities during the 3-month study period. The mean age of DF cases was 27.2 years, and 42.7% of cases were female. The most affected age group was 15–49 years old (78.98%). The total case proportions differed significantly across age groups when compared to the population distribution; there were approximately 15% and 5% higher case proportions among those aged 15–49 years and 49+ years, respectively. A total of 162 artificial containers were inspected from 62 houses, with 49.4% found positive for Aedes aegypti larva/pupae. Aedes mosquitoes were most commonly observed breeding in plastic tanks, tires, and plastic or metal buckets/bowls. World Health Organization entomological indices classified the study site as high risk for dengue virus outbreaks (House Index = 45.2%, Container Index = 49.4%, and Breteau Index = 129). Time series climate data, specifically rainfall, were found to be significantly predictive of AR (p = 0.035). Study findings highlight the importance of vector control to prevent future DF outbreaks in the region. The scarcity of drinking water and microclimatic conditions may have also contributed to the occurrence of this outbreak.

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“…Subsequently, annual outbreaks have been observed in Godey Town and Dire Dawa [27,28]. Circulating dengue infection has also been identified in Humera, Tigray Region, Metema, Amhara Region, Arba Minch, Southern Nations, Nationalities, and People Region, Gondar, Amhara Region, and Borena Zone, Oromia Region, by the presence of anti-DENV IgG/IgM antibodies in febrile patients [29][30][31][32], indicating that the true distribution of DF in Ethiopia is highly underestimated. More recently, in 2017, DF emerged in Kabridahar Town, Korahey Zone (Eastern Ethiopia), affecting more than 100 individuals [24], and in 2019, for the first time in Gewane District, Afar Region (North-East Ethiopia).…”

Section: Introductionmentioning

confidence: 99%

Entomological, Epidemiological, and Climatological Investigation of the 2019 Dengue Fever Outbreak in Gewane District, Afar Region, North-East Ethiopia

Mekuriaw¹,

Getahun²,

Tilahun³

et al. 2022

Preprint

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Dengue Fever (DF) is an important arthropod-borne viral infection, which has repeatedly oc-curred as outbreaks in eastern and northeastern Ethiopia since 2013. A cross-sectional epidemio-logical outbreak investigation was carried out from September - November 2019 on febrile pa-tients (confirmed malaria negative) who presented with suspected and confirmed DF at both public and private health facilities in Gewane District, Afar Region, northeastern Ethiopia. Ento-mological investigation of containers found in randomly selected houses belonging to DF positive patients was undertaken, to survey for the presence of Aedes larvae or pupae. A total of 1185 DF cases was recorded from six heath facilities during the 3-month study period. The mean age of DF cases was 27.2 years and 42.7% of the cases were female. The most affected age group was 15-49 years (78.98%). However, the attack rate (AR) was highest in the 49+ age group (134.2). A total of 162 artificial containers were inspected from 62 houses, with 49.4% found positive for Aedes larva/pupae. Aedes mosquitoes were mostly found breeding in buckets/bowls, clay jars, plastic tanks, and tires. World Health Organization entomological indices classified the study site as high risk for dengue outbreaks (House Index=45.2%, Container Index=49.4% and Breteau In-dex=129). Study findings highlight the importance of vector control to prevent future dengue out-breaks in the region. The scarcity of drinking water and changing climactic conditions may have also contributed to the occurrence of this outbreak.

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Aetiologies of acute undifferentiated febrile illness at the emergency ward of the University of Gondar Hospital, Ethiopia

Cited by 11 publications

References 57 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

Epidemiological, Entomological, and Climatological Investigation of the 2019 Dengue Fever Outbreak in Gewane District, Afar Region, North-East Ethiopia

Entomological, Epidemiological, and Climatological Investigation of the 2019 Dengue Fever Outbreak in Gewane District, Afar Region, North-East Ethiopia

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