Gudo Eduardo Samo, Pinto Gabriela, Vene Sirkka, Mandlaze Arcildo, Muianga Argentina Felisbela, Cliff Julie, Falk Kerstin
National Institute of Health, Ministry of Health, Maputo, Mozambique.
The Public Health Agency of Sweden, Solna, Stockholm, Sweden.
PLoS Negl Trop Dis. 2015 Oct 16;9(10):e0004146. doi: 10.1371/journal.pntd.0004146. eCollection 2015.
In the last two decades, chikungunya virus (CHIKV) has rapidly expanded to several geographical areas, causing frequent outbreaks in sub-Saharan Africa, South East Asia, South America, and Europe. Therefore, the disease remains heavily neglected in Mozambique, and no recent study has been conducted.
Between January and September 2013, acute febrile patients with no other evident cause of fever and attending a health center in a suburban area of Maputo city, Mozambique, were consecutively invited to participate. Paired acute and convalescent serum samples were requested from each participant. Convalescent samples were initially screened for anti-CHIKV IgG using a commercial indirect immunofluorescence test, and if positive, the corresponding acute sample was screened using the same test.
Four hundred patients were enrolled. The median age of study participants was 26 years (IQR: 21-33 years) and 57.5% (224/391) were female. Paired blood samples were obtained from 209 patients, of which 26.4% (55/208) were presented anti-CHIKV IgG antibodies in the convalescent sample. Seroconversion or a four-fold titer rise was confirmed in 9 (4.3%) patients.
The results of this study strongly suggest that CHIKV is circulating in southern Mozambique. We recommend that CHIKV should be considered in the differential diagnosis of acute febrile illness in Mozambique and that systematic surveillance for CHIKV should be implemented.
在过去二十年中,基孔肯雅病毒(CHIKV)已迅速扩展到多个地理区域,在撒哈拉以南非洲、东南亚、南美洲和欧洲频繁引发疫情。因此,在莫桑比克,该疾病仍然严重被忽视,且近期未开展相关研究。
2013年1月至9月期间,连续邀请莫桑比克马普托市郊区一家健康中心的无其他明显发热病因的急性发热患者参与研究。要求每位参与者提供配对的急性期和恢复期血清样本。最初使用商业间接免疫荧光试验对恢复期样本进行抗CHIKV IgG筛查,若呈阳性,则使用相同试验对相应的急性期样本进行筛查。
共招募了400名患者。研究参与者的中位年龄为26岁(四分位间距:21 - 33岁),57.5%(224/391)为女性。从209名患者处获得了配对血样,其中26.4%(55/208)的恢复期样本中出现了抗CHIKV IgG抗体。9名(4.3%)患者确认发生血清学转换或滴度升高四倍。
本研究结果强烈表明CHIKV正在莫桑比克南部传播。我们建议在莫桑比克急性发热疾病的鉴别诊断中应考虑CHIKV,并应实施对CHIKV的系统监测。