Prevalence of dengue, chikungunya, falciparum malaria and their co-infection among febrile individuals in areas of different malaria transmission intensities of Uganda

Abstract

Mosquito-borne infections including Dengue (DEN), Chikungunya (CHIK) and falciparum malaria pose significant global public health threats due to their overlapping geographical distribution and nonspecific symptoms. Co-infections of these diseases, if not properly identified and managed can result in fatal outcomes. The aim of this laboratory-based study was to (i) assess the prevalence of DEN, CHIK and falciparum malaria among febrile individuals,(ii) determine the prevalence of their co-infection among febrile individuals and (iii) determine the prevalence variations of these infections in three districts of different malaria transmission intensities using archived blood samples collected during the PRISM (Programme for Resistance , Immunology, Surveillance and modelling of Malaria) study. These samples were from Tororo district- characterised by high malaria transmission intensity, Kanungu district- characterised by medium malaria transmission intensity and Jinja district- characterised by low malaria transmission intensity. Antibodies to DEN (IgM and IgG) and to CHIK (IgM) were detected using tests from the SD BIOLINE. Falciparum malaria was detected using a nested Polymerase Chain Reaction assay. Mean ± SD body temperature of the participants was 37.4oC ± 0.9and median age 6 years (0.5-64 years). A total of 919-paired plasma- and dry- blood samples were analysed. Out of which, 346 (37.6%) were from Kanungu, 358 (39.0%) were from Tororo and 215 (23.4%) were from Jinja. Overall prevalence of DEN, CHIK and falciparum malaria were 2.1 %(n=19), 13.9 %(n=128) and 32.9% (n=302) respectively. Although the prevalences of DEN [3.3% (1.75.8); 12/358] and CHIK [27.1% (22.5-32.0); 97/358] were highest in Tororo, that of the falciparum malaria was [41.9% (36.7-47.3); 145/346] in Kanungu. Whereas the prevalences of DEN [0.3% (0.01-1.6); 1/346] and CHIK [2.9% (1.3-5.2); 10/346] were lowest in Kanungu, the prevalence of falciparum malaria16.3% (11.6-21.9); 35/215] was lowest in Jinja.