Chipwaza Beatrice, Mugasa Joseph P, Selemani Majige, Amuri Mbaraka, Mosha Fausta, Ngatunga Steve D, Gwakisa Paul S
Nelson Mandela African Institution of Science and Technology, School of Life Sciences and Bioengineering, Arusha, Tanzania; Ifakara Health Institute, Ifakara, Tanzania.
National Institute for Medical Research, Amani Medical Research Centre, Muheza, Tanga, Tanzania.
PLoS Negl Trop Dis. 2014 Nov 20;8(11):e3335. doi: 10.1371/journal.pntd.0003335. eCollection 2014 Nov.
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.
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.
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.
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.
发热的病毒病因,包括登革热、基孔肯雅热、流感、轮状病毒和腺病毒,在热带和亚热带国家造成了重大疾病负担。发展中国家缺乏诊断设施,导致无法估计此类疾病的真实负担,而且这些疾病普遍报告不足。这些疾病可能与包括疟疾在内的其他急性发热性疾病病因有相似症状,因此在没有实验室检测的情况下进行临床诊断可能很困难。本研究旨在确定病毒病因作为儿童发热的原因及其与疟疾的合并感染情况。
在坦桑尼亚基洛萨区医院进行了为期6个月的横断面研究。研究对象为门诊就诊的2至13岁发热儿童。使用了IgM和IgG ELISA以及PCR等诊断测试。
共纳入364例患者,其中83例(22.8%)有疟原虫,76例(20.9%)有疑似急性登革热感染,其中29例(38.2%)为确诊病例。登革热在≥5岁儿童中比<5岁儿童更易发生(比值比2.28,95%置信区间:1.35 - 3.86)。17例(4.7%)患者被确定为疑似急性基孔肯雅热感染。我们未观察到能将基孔肯雅热感染患者与登革热感染患者或疟疾患者区分开来的症状表现。检测到疟疾与基孔肯雅热、疟疾与登革热以及基孔肯雅热与登革热之间的合并感染。大多数基孔肯雅热和登革热感染患者接受了抗菌治疗。此外,我们的结果显示5例(5.2%)患者感染了流感病毒,5例(12.8%)感染了轮状病毒,2例(5.1%)感染了腺病毒。
我们的结果表明,尽管病毒性疾病是主要的公共卫生问题,但它们作为发热患者发热原因未得到应有的认识。建议重视实验室诊断测试,以便对发热患者进行正确诊断和管理。