COVID-19 Pandemic and Endemic Febrile Illnesses: The Dilemma of Exclusion and Diagnosis with Limited Capacities in Aden, Yemen

Abstract

Background: In the beginning of May 2020, Aden was living a state of catastrophic events with the spread of COVID-19 pandemic with accompanying heavy raining season leading to increase of unexpected fever cases. Despite the limited diagnostic capacity, data on causes and trends of febrile illness can be valuable indicators of the causes and trends of fever problems in Aden at the time of COVID-19 pandemic. Objective: to analyze the available data on febrile illness reported in the "Cuban-Yemeni Hospital" in Aden during May-June 2020. Methods: This is a retrospective review of the available data from the hospital registry. Results: Out of 7385 febrile patients, there were 1208 confirmed Malaria cases (16.4%), 1786 clinically diagnosed Dengue cases (23.3%), 1855 clinically diagnosed Chikungunya (25%), 2023 cases of respiratory tract infections-RTI (26.6%) and only 613 probable COVID-19 cases (8.4%). The total deaths in this period was 63, most of them died due to respiratory problems. Conclusions: Malaria is a problem of serious concern in Aden as 16% of fever in this study were confirmed by laboratory testing while Dengue and Chikungunya were reported frequently but the diagnosis is still based on clinical grounds. As the diagnostic capacity for COVID-19 was limited, the available data underestimated the COVID-19 problem.