Global prevalence and distribution of coinfection of malaria, dengue and chikungunya: a systematic review

Abstract

BackgroundMalaria, Dengue and Chikungunya are vector borne diseases with shared endemic profiles and symptoms. Coinfections with any of these diseases could have fatal outcomes if left undiagnosed. Understanding the prevalence and distribution of coinfections is necessary to improve diagnosis and designing therapeutic interventions.MethodsWe have carried out a systematic search of the published literature based on PRISMA guidelines to identify cases of Malaria, Dengue and Chikungunya coinfections. We systematically reviewed the literature to identify eligible studies and extracted data regarding cases of coinfection from cross sectional studies, case reports, retrospective studies, prospective observational studies and surveillance reports.ResultsCare full screening resulted in 104 publications that met the eligibility criteria and reported Malaria/Dengue, Dengue/Chikungunya, Malaria/Chikungunya and Malaria/Dengue/Chikungunya coinfections. These coinfections were spread over six geographical locations and 42 different countries and are reported more frequently in the last 15 years possibly due to expanding epidemiology of Dengue and Chikungunya. Few of these reports have also analysed distinguishing features of coinfections. Malaria/Dengue coinfections were the most common coinfection followed by Dengue/Chikungunya, Malaria/Chikungunya and Malaria/Dengue/Chikungunya coinfections. P. falciparum and P. vivax were the commonest species found in cases of malaria coinfections and Dengue serotype-4 commonest serotype in cases of dengue coinfections. Most studies were reported from India. Nigeria and India were the only two countries from where all possible combinations of coinfections were reported.ConclusionWe have comprehensively reviewed the literature associated with cases of coinfections of three important vector borne diseases to present a clear picture of their prevalence and distribution across the globe. The frequency of coinfections presented in the study suggests proper diagnosis, surveillance and management of cases of coinfection to avoid poor prognosis of the underlying etiology.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5626-z) contains supplementary material, which is available to authorized users.

The Use of Antimalarial Drugs against Viral Infection

“…For these reasons, antimalarial drugs have been studied, proposed, and sometimes used for the treatment of other pathologies, such as cancer, autoimmune diseases, and nonmalaria infectious diseases [2][3][4]. Moreover, the geographical overlaps between malaria and viral-related diseases [5][6][7] have led to the consideration of possible use of antimalarial drugs as new antiviral drugs. Finally, the lack of new effective antiviral drugs and vaccines against many viral infections has strengthened interest in the potential antiviral activity of antimalarial drugs.…”

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

“…Such high attack rates help explain the occurrence of human coinfections with CHIKV, DENV, and/or ZIKV, which have been reported from the Americas and Asia (7,(28)(29)(30)(31)(32)(33), and individuals with these coinfections may present with more severe manifestations (7,30). A meta-analysis of available publications on CHIKV coinfections revealed that CHIKV-DENV coinfections were most common (44/109 studies), but CHIKV-malaria coinfections were reported in several studies (5/109) (28,29,34). During interepidemic periods, CHIKV may be maintained by other mechanisms, leading to persistence in a region and the potential for sporadic outbreaks (35)(36)(37)(38).…”

“…Attack rates have been relatively low in temperate regions (24), but rates as high as 50 to 75% have been reported during outbreaks in the tropics (25)(26)(27). Such high attack rates help explain the occurrence of human coinfections with CHIKV, DENV, and/or ZIKV, which have been reported from the Americas and Asia (7,(28)(29)(30)(31)(32)(33), and individuals with these coinfections may present with more severe manifestations (7,30). A meta-analysis of available publications on CHIKV coinfections revealed that CHIKV-DENV coinfections were most common (44/109 studies), but CHIKV-malaria coinfections were reported in several studies (5/109) (28,29,34).…”

Pathogenic Th1 responses in CHIKV‐induced inflammation and their modulation upon Plasmodium parasites co‐infection

“…Importantly, the expansion of CHIKV distribution and the establishment of local transmission hotspots in newly colonized areas pose a high risk of co-infections with other highly prevalent tropical diseases. A number of epidemiological studies have reported co-infections of CHIKV with pathogens such as Zika virus (ZIKV), dengue virus (DENV), and malaria parasites in humans[76][77][78][79][80][81][82][83][84][85] although the F I G U R E 1 Malaria co-infection impairs CHIKV-specific CD4 + T cell responses in the pLN-footpad axis. In CHIKV-infected mice, virusspecific CD4 + T cells multiply in the popliteal lymph node (pLN) and acquire a Th1 phenotype.…”