Siddig Emmanuel Edwar, Mohamed Nouh Saad, Ahmed Ayman
Faculty of Medical Laboratory Sciences University of Khartoum Khartoum Sudan.
Department of Medical Microbiology and Infectious Diseases ErasmusMC, University Medical Center Rotterdam Rotterdam The Netherlands.
Clin Case Rep. 2024 Jun 11;12(6):e9079. doi: 10.1002/ccr3.9079. eCollection 2024 Jun.
In countries like Sudan, where several infectious diseases are prevalent, health care providers should not be satisfied with initial detection of a single pathogen and whenever it is feasible, they should investigate coinfections. Infections with high mortality or severe morbidity should be prioritized during the differential diagnosis particularly for diseases with similar clinical manifestations to reduce the death and disability rates. However, this requires substantial improvement in the diagnostic capacity.
Here we report a case of dengue and malaria coinfection from the southeast region of Sudan, bordering Ethiopia and Eritrea. A 25-year-old male from Sudan presented with symptoms of fever, chills, vomiting, and muscle and joint pain. Laboratory investigations confirmed a coinfection of dengue and malaria, which is assumingly not uncommon in areas heavily syndemic with several diseases but it is severely under-detected, underreported, and underestimated. The case has fully recovered after the supportive care for dengue and chemotherapy treatment for malaria. In such a case, it was important to monitor the patient's recovery and the treatment outcome through clinical indicators and laboratory parameters to update the treatment course whenever needed, according to response. The increasing burden and outbreaks of vector-borne diseases including dengue and malaria in Sudan, indicates the need for improving the implementation of the global vector control response that established by the World Health Organization. Additionally, the increasing prevalent of coinfections is urging substantial improvement in the diagnostic capacity in endemic countries.
在苏丹等多种传染病流行的国家，医疗保健提供者不应满足于最初检测到单一病原体，只要可行，就应调查合并感染情况。在鉴别诊断过程中，应优先考虑高死亡率或高发病率的感染，尤其是对于临床表现相似的疾病，以降低死亡率和残疾率。然而，这需要大幅提高诊断能力。
在此，我们报告一例来自苏丹东南部地区（与埃塞俄比亚和厄立特里亚接壤）的登革热和疟疾合并感染病例。一名25岁的苏丹男性出现发热、寒战、呕吐以及肌肉和关节疼痛症状。实验室检查证实为登革热和疟疾合并感染，在多种疾病严重共发的地区，这种情况可能并不罕见，但严重漏检、漏报且被低估。该病例在接受登革热支持治疗和疟疾化疗后已完全康复。在这种情况下，通过临床指标和实验室参数监测患者的康复情况和治疗结果非常重要，以便根据反应在需要时调整治疗方案。苏丹包括登革热和疟疾在内的媒介传播疾病负担不断增加且疫情频发，这表明需要加强世界卫生组织制定的全球媒介控制应对措施的实施。此外，合并感染的日益普遍促使流行国家大幅提高诊断能力。
