Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania.
Department of Pediatric and Child Health Bugando Medical Centre, Mwanza, United Republic of Tanzania.
PLoS One. 2024 Oct 11;19(10):e0309613. doi: 10.1371/journal.pone.0309613. eCollection 2024.
Plasmodium spp. infections and cases of malaria are a long-standing public health problem for children living in middle- and low-income countries. Dengue virus causes an emerging under-recognized disease burden. A cross sectional study was conducted between March 2020 and December 2021 to determine the status of malaria and dengue fever, and the associated factors in children living in Mwanza, Tanzania. Clinical features were recorded; blood samples were analyzed using dengue NS1 rapid diagnostics test (NS1-RDT), malaria rapid diagnostic test (MRDT) and PCR and microscopy for malaria parasites. Descriptive analysis was based on infection status; odds ratio and confidence interval were used to determine the factors associated with dengue fever and malaria. The prevalence of malaria in the 436 children included in the final analysis was 15.6%, 8.5%, and 12.1% as determined by MRDT, blood smear examination and PCR, respectively. The prevalence of dengue fever determined by the NS1-RDT was 7.8%. Body rash, muscle and joint/bone pain were associated with a positive rapid dengue test result. Retro-orbital pain characterized Plasmodium spp. and dengue virus co-infections. Clinical signs and symptoms could not readily differentiate between malaria and dengue fever patients or patients co-infected with both causative agents underscoring the urgent need for the accurate laboratory diagnostics. Additional large-scale studies are required to assess the epidemiological burden of acute febrile illness in developing countries and to produce data that will guide empirical treatment.
疟原虫属感染和疟疾病例是中低收入国家儿童长期存在的公共卫生问题。登革热病毒导致一种新兴的认识不足的疾病负担。本横断面研究于 2020 年 3 月至 2021 年 12 月在坦桑尼亚姆万扎进行，旨在确定疟疾和登革热的现状以及生活在该地的儿童的相关因素。记录临床特征；使用登革热 NS1 快速诊断检测（NS1-RDT）、疟疾快速诊断检测（MRDT）和聚合酶链反应（PCR）以及显微镜检查疟原虫分析血液样本。描述性分析基于感染状况；使用比值比和置信区间确定与登革热和疟疾相关的因素。在最终分析的 436 名儿童中，MRDT、血涂片检查和 PCR 分别确定疟疾的患病率为 15.6%、8.5%和 12.1%。NS1-RDT 确定的登革热患病率为 7.8%。皮疹、肌肉和关节/骨骼疼痛与快速登革热检测结果呈阳性相关。眶后疼痛是疟原虫属和登革热病毒合并感染的特征。临床体征和症状不能轻易区分疟疾和登革热患者或同时感染两种病原体的患者，这突显了准确实验室诊断的迫切需要。需要开展更多的大规模研究，以评估发展中国家急性发热疾病的流行病学负担，并提供指导经验性治疗的数据。
