Arboviruses as an unappreciated cause of non-malarial acute febrile illness in the Dschang Health District of western Cameroon

PLoS Negl Trop Dis. 2022 Oct 12;16(10):e0010790. doi: 10.1371/journal.pntd.0010790. eCollection 2022 Oct.

Abstract

Acute febrile illness is a common problem managed by clinicians and health systems globally, particularly in the Tropics. In many regions, malaria is a leading and potentially deadly cause of fever; however, myriad alternative etiologies exist. Identifying the cause of fever allows optimal management, but this depends on many factors including thorough knowledge of circulating infections. Arboviruses such as dengue (DENV) cause fever and may be underdiagnosed in sub-Saharan Africa where malaria is a major focus. We examined cases of fever in western Cameroon that tested negative for malaria and found 13.5% (13/96) were due to DENV, with 75% (9/12) of these being DENV serotype 2 infections. Two complete DENV2 genomes were obtained and clustered closely to recent isolates from Senegal and Burkina Faso. The seroprevalence of DENV in this region was 24.8% (96/387). Neutralizing antibodies to DENV2 were detected in all (15/15) seropositive samples tested. Chikungunya (CHIKV) is an arthritogenic alphavirus that is transmitted by Aedes mosquitoes, the same principal vector as DENV. The seroprevalence for CHIKV was 15.7% (67/427); however, CHIKV did not cause a single case of fever in the 96 subjects tested. Of note, being seropositive for one arbovirus was associated with being seropositive for the other (Χ2 = 16.8, p<0.001). Taken together, these data indicate that Aedes-transmitted arboviruses are endemic in western Cameroon and are likely a common but underappreciated cause of febrile illness. This work supports the need for additional study of arboviruses in sub-Saharan Africa and efforts to improve diagnostic capacity, surveillance systems, and arbovirus prevention strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aedes*
  • Animals
  • Antibodies, Neutralizing
  • Arboviruses*
  • Cameroon / epidemiology
  • Chikungunya Fever*
  • Coinfection* / epidemiology
  • Dengue*
  • Fever / epidemiology
  • Humans
  • Malaria*
  • Mosquito Vectors
  • Seroepidemiologic Studies

Substances

  • Antibodies, Neutralizing

Grants and funding

Field work in Cameroon was supported in part by awards to (IMA) as a fellow of the MARCAD Consortium, which received grants from the DELTAS Africa Initiative (DEL-15-010 107741/A/15/Z) of the African Academy of Sciences. The DELTAS AFRICA Programme received funds from the Wellcome Trust and UKAid. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.