Clinical and epidemiologic characteristics associated with dengue during and outside the 2016 outbreak identified in health facility-based surveillance in Ouagadougou, Burkina Faso

Abstract

BackgroundIn Africa, the magnitude of dengue virus (DENV) transmission is largely unknown. In Burkina Faso, several outbreaks have been reported and data are often based on findings from outbreak investigations.MethodsTo better understand dengue epidemiology and clinical characteristics in Burkina Faso, a fever surveillance study was conducted among patients aged 1–55 years, who presented with non-malarial febrile illness at five primary healthcare facilities in Ouagadougou, Burkina Faso from December 2014 to February 2017, encompassing a 3-month dengue outbreak in September-November 2016. Acute and convalescent blood samples were collected within an interval of 10–21 days between visits. Acute samples were tested with dengue rapid diagnostic tests (RDT) and a selected subset with RT-PCR, and all acute/convalescent samples with IgM/IgG ELISA.ResultsAmong 2929 non-malarial febrile patients, 740 (25%) were dengue–positive based on RT-PCR and/or IgM/IgG ELISA; 428 out of 777 patients (55%) and 312 out of 2152 (14%) were dengue-positive during outbreak and non-outbreak periods, respectively. There were 11% (316/2929) and 4% (129/2929) patients showing positive for NS1 and IgM, on the RDT, respectively. DENV 2 predominated during the outbreak, whereas DENV 3 predominated before the outbreak. Only 25% of dengue-positive cases were clinically diagnosed with suspected dengue. The odds of requiring observation for ≤3 days (versus routine outpatient care) were 11 times higher among dengue-positive cases than non-dengue cases. In adjusted analyses, dengue-positivity was associated with rash and retro-orbital pain (OR = 2.6 and 7.4, respectively) during the outbreak and with rash and nausea/vomiting (OR = 1.5 and 1.4, respectively) during the non-outbreak period.ConclusionDengue virus is an important pathogen in Burkina Faso, accounting for a substantial proportion of non-malarial fevers both during and outside outbreak, but is only infrequently suspected by clinicians. Additional longitudinal data would help to further define characteristics of dengue for improved case detection and surveillance.

Video as a public health knowledge transfer tool in Burkina Faso: A mixed evaluation comparing three narrative genres

“…According to the World Health Organization, 1266 suspected cases, 1061 positive cases by dengue rapid diagnostic test (RDT: TDR in French) and 15 deaths were reported in 2016 [26]. In 2017, 9 029 suspected cases, 5773 dengue RDT-positive cases and 18 deaths (case fatality rate = 0.2%) were reported throughout the country [26,27]. The number of deaths due to dengue would likely have been lower if health workers had been better trained.…”

The epidemiology of dengue outbreaks in 2016 and 2017 in Ouagadougou, Burkina Faso

“…At the same time, a surveillance study conducted by Lim et al. in adjacent areas in Ouagadougou from December 2014 to February 2017 encompassing the WHO reported outbreak of August–November 2016 reported 2,929 fever cases during both outbreak and non-outbreak periods; 25.3% (740/2,929) were dengue-positive [ 11 ]. Seventy-three percent (540/740) of the dengue-positive cases were laboratory-confirmed and 27.0% (200/740) were classified as probable dengue; among these 42.8% (317/740) were confirmed by RT-PCR and the remainder by paired ELISA [ 11 ].…”

Effect of a free healthcare policy on health services utilisation for non‐malarial febrile illness by children under five years in Burkina Faso: an interrupted time series analysis

“…In Africa, and specifically in Burkina Faso, several studies have shown that a significant proportion of febrile illnesses are non-malarial [24][25][26] and thus becoming a major public health concern because the possibility of misdiagnosis and mistreatment of NMFI as malaria cases, specifically in the infant population [27]. Among these NMFI, we can cite dengue, typhoid fever, salmonellosis, Zika infection and recently COVID-19 which have become endemic in Burkina Faso [28][29][30]. To the best of our knowledge, the effects of free healthcare interventions on NMFI consultations have not been studied yet.…”