Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria
Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria
复制标题
DOI：
10.3855/jidc.2411
复制
发表时间：
2013-01-01
影响因子：
1.9
通讯作者：
D'Agaro, Pierlanfranco
中科院分区：
文献类型：
--
作者：
Baba, Marycelin;Logue, Christopher H.;D'Agaro, Pierlanfranco
简介：疟疾和伤寒感染的临床症状与许多虫媒病毒感染最初出现的症状几乎无法区分。本文描述了从尼日利亚博尔诺州发热、临床疑似疟疾/伤寒患者采集的310份血清样本中检测到虫媒病毒的情况。方法：最初通过显微镜检测恶性疟原虫，肥达试验检测伤寒沙门氏菌，随后通过空斑减少中和试验检测基孔肯雅(CHIKV)、黄热病(YFV)、登革热(DENV)和西尼罗河病毒(WNV)。结果：92%的患者检测出疟疾、伤寒、虫媒病毒感染或这些类型中的一种或多种感染的组合，只有不到1%的患者单独对疟疾检测呈阳性，只有3.9%的患者单独对伤寒检测呈阳性。无论是否存在疟疾或伤寒，约有一半患者的单一虫媒病毒感染检测呈阳性(48%)。病毒中和90%~95%者中，DENV中和抗体阳性率为67.7%，CHIKV中和抗体阳性率为50%，WNV中和抗体阳性率为25%，YFV中和抗体阳性率为8.7%。8%的人对所有六种病原体的检测结果均为阴性，这表明本研究中未检测到的其他虫媒病毒可能也在尼日利亚传播。结论：结果表明，将虫媒病毒合并感染误诊为疟疾感染，加上缺乏病毒监测和对虫媒病毒感染的漏报，增加了重要媒介传播的虫媒病毒未被发现和失控传播成为尼日利亚严重公共卫生问题的可能性。
Introduction: Clinical symptoms of malaria and typhoid infections are virtually indistinguishable from those initially seen in many arbovirus infections. Here we describe arbovirus co-infection detected in 310 sera samples collected from febrile, clinically suspected malaria/typhoid patients in Borno State, Nigeria.Methodology: Tested initially for Plasmodium falciparum by microscopy and for Salmonella Typhi by Widal test, samples were subsequently tested for chikungunya (CHIKV), yellow fever (YFV), dengue (DENV) and West Nile viruses (WNV) by plaque reduction neutralization test.Results: While 92% of patients tested positive for malaria, typhoid, an arbovirus infection, or a combination of one or more of these types of infections, less than 1% of the patients tested positive for malaria alone and only 3.9% tested positive for typhoid alone. Approximately half of the patients tested positive for infection with a single arbovirus (48%) regardless of the presence or absence of malaria or typhoid. Of those who showed 90% to 95% virus neutralization, 67.7% had neutralizing antibodies against DENV, 50% against CHIKV, 25% against WNV and 8.7% against YFV. Eight per cent tested negative against all six pathogens, suggesting that other arboviruses not tested for in this study may also be circulating in Nigeria.Conclusions: The results suggest that misdiagnosis of arbovirus co-infections as malaria infections, combined with a lack of virus surveillance and underreporting of arbovirus infections, increases the potential for undetected and uncontrolled spread of important vector-borne arboviruses becoming serious underlying public health concerns in Nigeria.