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- Title
Dengue and Chikungunya Fever among Viral Diseases in Outpatient Febrile Children in Kilosa District Hospital, Tanzania.
- Authors
Chipwaza, Beatrice; Mugasa, Joseph P.; Selemani, Majige; Amuri, Mbaraka; Mosha, Fausta; Ngatunga, Steve D.; Gwakisa, Paul S.
- Abstract
Introduction: Viral etiologies of fever, including dengue, Chikungunya, influenza, rota and adeno viruses, cause major disease burden in tropical and subtropical countries. The lack of diagnostic facilities in developing countries leads to failure to estimate the true burden of such illnesses, and generally the diseases are underreported. These diseases may have similar symptoms with other causes of acute febrile illnesses including malaria and hence clinical diagnosis without laboratory tests can be difficult. This study aimed to identify viral etiologies as a cause of fever in children and their co-infections with malaria. Methods: A cross sectional study was conducted for 6 months at Kilosa district hospital, Tanzania. The participants were febrile children aged 2–13 years presented at the outpatient department. Diagnostic tests such as IgM and IgG ELISA, and PCR were used. Results: A total of 364 patients were enrolled, of these 83(22.8%) had malaria parasites, 76 (20.9%) had presumptive acute dengue infection and among those, 29(38.2%) were confirmed cases. Dengue was more likely to occur in children ≥ 5 years than in <5 years (OR 2.28, 95% CI: 1.35–3.86). Presumptive acute Chikungunya infection was identified in 17(4.7%) of patients. We observed no presenting symptoms that distinguished patients with Chikungunya infection from those with dengue infection or malaria. Co-infections between malaria and Chikungunya, malaria and dengue fever as well as Chikungunya and dengue were detected. Most patients with Chikungunya and dengue infections were treated with antibacterials. Furthermore, our results revealed that 5(5.2%) of patients had influenza virus while 5(12.8%) had rotavirus and 2(5.1%) had adenovirus. Conclusion: Our results suggest that even though viral diseases are a major public health concern, they are not given due recognition as a cause of fever in febrile patients. Emphasis on laboratory diagnostic tests for proper diagnosis and management of febrile patients is recommended. Author Summary: Viral etiologies of fever, such as dengue, Chikungunya, influenza, rotaviruses, and adenoviruses contribute to substantial morbidity and mortality particularly in children in the tropical and subtropical countries. Despite their importance, the true burden of viral etiologies of fever in Tanzania is not known, and in most cases these diseases are unrecognized and treated as malaria. This study aimed to identify viral etiologies as a cause of fever in children and co-infections among viral diseases and malaria. A total of 364 febrile children were enrolled, of these, 83 (22.8%) had malaria, 76(20.9%) had presumptive acute dengue, among those, 29(38.2%) were confirmed cases. Dengue was more likely to occur in children aged ≥ 5 years than in <5 years (OR 2.28, 95% CI: 1.35–3.86). Presumptive acute Chikungunya infection was found in 17(4.7%) of patients. Co-infections between malaria and Chikungunya, malaria and dengue as well as Chikungunya and dengue were observed. Furthermore, 5(5.2%) of the patients had influenza virus, 5(12.8%) had rotavirus and 2(5.1%) had adenovirus. Knowledge on occurrence of these viral etiologies of febrile illnesses will alert clinicians to be more responsive towards viral infectious agents as potential causes of febrile illnesses in the routine diagnosis and management of febrile patients.
- Subjects
TANZANIA; VIRUS diseases; DENGUE hemorrhagic fever; CHIKUNGUNYA; DENGUE; CLINICAL pathology; PUBLIC health
- Publication
PLoS Neglected Tropical Diseases, 2014, Vol 8, Issue 11, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0003335