Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria

Marycelin Baba, Christopher H. Logue, Bamidele Oderinde, Hauwa Abdulmaleek, Joshua Williams, James Lewis, Thomas R. Laws, Roger Hewson, Alessandro Marcello, Pierlanfranco D'Agaro

Research output: Contribution to journalArticle

Abstract

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 vectorborne arboviruses becoming serious underlying public health concerns in Nigeria.

Original languageEnglish
Pages (from-to)51-59
Number of pages9
JournalJournal of Infection in Developing Countries
Volume7
Issue number1
Publication statusPublished - 2013

Fingerprint

Arbovirus Infections
Typhoid Fever
Nigeria
Coinfection
Malaria
Fever
Arboviruses
Yellow Fever
West Nile virus
Infection
Viruses
Neutralization Tests
Salmonella typhi
Dengue
Plasmodium falciparum
Neutralizing Antibodies
Diagnostic Errors
Microscopy
Public Health
Serum

Keywords

  • Arbovirus
  • Chikungunya
  • Co-infection
  • Dengue
  • Malaria
  • Nigeria

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology
  • Parasitology
  • Virology

Cite this

Baba, M., Logue, C. H., Oderinde, B., Abdulmaleek, H., Williams, J., Lewis, J., ... D'Agaro, P. (2013). Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria. Journal of Infection in Developing Countries, 7(1), 51-59.

Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria. / Baba, Marycelin; Logue, Christopher H.; Oderinde, Bamidele; Abdulmaleek, Hauwa; Williams, Joshua; Lewis, James; Laws, Thomas R.; Hewson, Roger; Marcello, Alessandro; D'Agaro, Pierlanfranco.

In: Journal of Infection in Developing Countries, Vol. 7, No. 1, 2013, p. 51-59.

Research output: Contribution to journalArticle

Baba, M, Logue, CH, Oderinde, B, Abdulmaleek, H, Williams, J, Lewis, J, Laws, TR, Hewson, R, Marcello, A & D'Agaro, P 2013, 'Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria', Journal of Infection in Developing Countries, vol. 7, no. 1, pp. 51-59.
Baba, Marycelin ; Logue, Christopher H. ; Oderinde, Bamidele ; Abdulmaleek, Hauwa ; Williams, Joshua ; Lewis, James ; Laws, Thomas R. ; Hewson, Roger ; Marcello, Alessandro ; D'Agaro, Pierlanfranco. / Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria. In: Journal of Infection in Developing Countries. 2013 ; Vol. 7, No. 1. pp. 51-59.
@article{73d1d7deb983472eaa38d7ddc5b082b8,
title = "Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria",
abstract = "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 vectorborne arboviruses becoming serious underlying public health concerns in Nigeria.",
keywords = "Arbovirus, Chikungunya, Co-infection, Dengue, Malaria, Nigeria",
author = "Marycelin Baba and Logue, {Christopher H.} and Bamidele Oderinde and Hauwa Abdulmaleek and Joshua Williams and James Lewis and Laws, {Thomas R.} and Roger Hewson and Alessandro Marcello and Pierlanfranco D'Agaro",
year = "2013",
language = "English",
volume = "7",
pages = "51--59",
journal = "Journal of Infection in Developing Countries",
issn = "1972-2680",
publisher = "Journal of Infection in Developing Countries",
number = "1",

}

TY - JOUR

T1 - Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria

AU - Baba, Marycelin

AU - Logue, Christopher H.

AU - Oderinde, Bamidele

AU - Abdulmaleek, Hauwa

AU - Williams, Joshua

AU - Lewis, James

AU - Laws, Thomas R.

AU - Hewson, Roger

AU - Marcello, Alessandro

AU - D'Agaro, Pierlanfranco

PY - 2013

Y1 - 2013

N2 - 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 vectorborne arboviruses becoming serious underlying public health concerns in Nigeria.

AB - 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 vectorborne arboviruses becoming serious underlying public health concerns in Nigeria.

KW - Arbovirus

KW - Chikungunya

KW - Co-infection

KW - Dengue

KW - Malaria

KW - Nigeria

UR - http://www.scopus.com/inward/record.url?scp=84872377279&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872377279&partnerID=8YFLogxK

M3 - Article

C2 - 23324821

AN - SCOPUS:84872377279

VL - 7

SP - 51

EP - 59

JO - Journal of Infection in Developing Countries

JF - Journal of Infection in Developing Countries

SN - 1972-2680

IS - 1

ER -