Zerfu Biruk, Kassa Tesfu, Mamo Gezahegne, Larrick James W, Legesse Mengistu
Center for Pathobiology Research, Aklilu Lemma Institute of Health Research (ALIHR), Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Infect Dis. 2025 Jul 28;25(1):948. doi: 10.1186/s12879-025-11406-3.
Dengue fever (DF) is caused by dengue virus (DENV) and is primarily spread through bites of infected Aedes mosquitoes in tropical and subtropical regions, including Ethiopia. In the Afar region, DF is often misdiagnosed as malaria due to limited diagnostic capabilities. This study assessed the seroprevalence of DENV infection among febrile patients in healthcare facilities in the Afar region.
A cross-sectional study was conducted from September 2022 to March 2023 in Amibara, Harunka and Awash Sebat city administration districts, involving febrile patients suspected of having malaria. Sociodemographic data, clinical features and blood samples were collected from participants after obtaining informed consent or assent. Following blood film examination for Plasmodium infection, sera were tested for anti-DENV IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Data were entered into Epi Data 3.1 and analyzed with Stata/SE 14.2. A p-value < 0.05 was considered significant.
A total of 411 febrile patients (55.5% female, aged 5-80 years, with a mean age of 27.3 ± 13.8 years) participated in the study. Among those tested for anti-DENV antibodies, 101/410 (24.6%) were positive for anti-DENV IgM, indicating an acute DENV infection, and 142/367 (38.7%) were positive for anti-DENV IgG, revealing previous exposure. Only 44/411 (10.7%) were positive for Plasmodium infection, while 18/410 (4.4%) were co-infected with malaria and acute DENV infection and 18/367 (4.9%) were positive for both malaria and previous exposure to DENV. Those diagnosed with malaria were nearly 2.5 times more likely to test positive for acute DENV infection than those without malaria (AOR = 2.37; 95% CI 1.14-4.92). The odds of positivity for previous exposure were about two times higher in females than in males (AOR = 2.24; 95% CI 1.32-3.26) and in government and private sector employees than in pastoralists and agro-pastoralists (AOR = 1.90; 95% CI 1.03-8.15), while patients aged 11-20 years had lower odds of previous exposure than those aged 5-10 years (AOR = 0.35; 95% CI 0.14-0.88). Experiencing muscle pain was associated with twice the odds of previous exposure (AOR = 1.90; 95% CI 1.04-3.49).
The study reveals a high seroprevalence of DENV infection among febrile patients in the study area, highlighting the need for routine diagnosis and management of DF in this setting. Improving vector control, disease surveillance and public awareness would be crucial for combating DF and other mosquito-borne diseases.
登革热（DF）由登革病毒（DENV）引起，主要通过受感染的伊蚊叮咬在包括埃塞俄比亚在内的热带和亚热带地区传播。在阿法尔地区，由于诊断能力有限，登革热常被误诊为疟疾。本研究评估了阿法尔地区医疗机构中发热患者的登革病毒感染血清阳性率。
2022年9月至2023年3月，在阿米巴拉、哈伦卡和阿瓦什·塞巴特市行政区开展了一项横断面研究，研究对象为疑似感染疟疾的发热患者。在获得知情同意或同意后，收集参与者的社会人口统计学数据、临床特征和血样。在进行疟原虫感染血片检查后，使用酶联免疫吸附测定（ELISA）检测血清中的抗登革病毒IgM和IgG抗体。数据录入Epi Data 3.1并使用Stata/SE 14.2进行分析。p值<0.05被认为具有统计学意义。
共有411名发热患者（55.5%为女性，年龄5至80岁，平均年龄27.3±13.8岁）参与了研究。在检测抗登革病毒抗体的患者中，101/410（24.6%）抗登革病毒IgM呈阳性，表明为急性登革病毒感染，142/367（38.7%）抗登革病毒IgG呈阳性，表明既往有过接触。仅44/411（10.7%）疟原虫感染呈阳性，18/410（4.4%）同时感染疟疾和急性登革病毒感染，18/367（4.9%）疟疾和既往接触登革病毒均呈阳性。被诊断为疟疾的患者急性登革病毒感染检测呈阳性的可能性比未患疟疾的患者高近2.5倍（调整后比值比[AOR]=2.37；95%置信区间[CI]1.14 - 4.92）。既往接触阳性的几率在女性中比男性高约两倍（AOR = 2.24；95% CI 1.32 - 3.26），在政府和私营部门员工中比牧民和农牧民高（AOR = 1.90；95% CI 1.03 - 8.15），而11至20岁的患者既往接触的几率低于5至10岁的患者（AOR = 0.35；95% CI 0.14 - 0.88）。经历肌肉疼痛与既往接触几率增加两倍相关（AOR = 1.90；95% CI 1.04 - 3.49）。
该研究揭示了研究区域发热患者中登革病毒感染的血清阳性率较高，突出了在此环境中对登革热进行常规诊断和管理的必要性。加强病媒控制、疾病监测和公众意识对于抗击登革热和其他蚊媒疾病至关重要。
