Abstract
BackgroundIn Africa, the magnitude of dengue virus (DENV) transmission is largely unknown. In Burkina Faso, several outbreaks have been reported and data are often based on findings from outbreak investigations.MethodsTo better understand dengue epidemiology and clinical characteristics in Burkina Faso, a fever surveillance study was conducted among patients aged 1–55 years, who presented with non-malarial febrile illness at five primary healthcare facilities in Ouagadougou, Burkina Faso from December 2014 to February 2017, encompassing a 3-month dengue outbreak in September-November 2016. Acute and convalescent blood samples were collected within an interval of 10–21 days between visits. Acute samples were tested with dengue rapid diagnostic tests (RDT) and a selected subset with RT-PCR, and all acute/convalescent samples with IgM/IgG ELISA.ResultsAmong 2929 non-malarial febrile patients, 740 (25%) were dengue–positive based on RT-PCR and/or IgM/IgG ELISA; 428 out of 777 patients (55%) and 312 out of 2152 (14%) were dengue-positive during outbreak and non-outbreak periods, respectively. There were 11% (316/2929) and 4% (129/2929) patients showing positive for NS1 and IgM, on the RDT, respectively. DENV 2 predominated during the outbreak, whereas DENV 3 predominated before the outbreak. Only 25% of dengue-positive cases were clinically diagnosed with suspected dengue. The odds of requiring observation for ≤3 days (versus routine outpatient care) were 11 times higher among dengue-positive cases than non-dengue cases. In adjusted analyses, dengue-positivity was associated with rash and retro-orbital pain (OR = 2.6 and 7.4, respectively) during the outbreak and with rash and nausea/vomiting (OR = 1.5 and 1.4, respectively) during the non-outbreak period.ConclusionDengue virus is an important pathogen in Burkina Faso, accounting for a substantial proportion of non-malarial fevers both during and outside outbreak, but is only infrequently suspected by clinicians. Additional longitudinal data would help to further define characteristics of dengue for improved case detection and surveillance.
Highlights
Dengue Fever (DF) is a mosquito-borne disease caused by four related but antigenically distinct dengue viruses (DENVs, serotypes 1–4)
To better understand dengue epidemiology and clinical characteristics in Burkina Faso, a fever surveillance study was conducted among patients aged 1–55 years, who presented with non-malarial febrile illness at five primary healthcare facilities in Ouagadougou, Burkina Faso from December 2014 to February 2017, encompassing a 3-month dengue outbreak in September-November 2016
Among 2929 non-malarial febrile patients, 740 (25%) were dengue–positive based on RTPCR and/or IgM/IgG Enzyme-Linked Immunosorbent Assay (ELISA); 428 out of 777 patients (55%) and 312 out of 2152 (14%) were dengue-positive during outbreak and non-outbreak periods, respectively
Summary
Dengue Fever (DF) is a mosquito-borne disease caused by four related but antigenically distinct dengue viruses (DENVs, serotypes 1–4). Between 5 August and 12 November 2016, the Burkina Faso MoH conducted an outbreak investigation as part of emergency response in collaboration with World Health Organization (WHO) and 1266 suspected dengue cases were identified by the MoH, with 1061 cases positive by dengue rapid diagnostic test (RDT), and 15 deaths from all 12 districts of Ouagadougou [16, 17]. An even larger outbreak occurred in September 2017, with 9029 suspected dengue cases, 5773 dengue RDT-positive cases, and 18 deaths throughout the country [18]. These repeated outbreaks suggest a considerable dengue burden in Burkina Faso. In Burkina Faso, several outbreaks have been reported and data are often based on findings from outbreak investigations
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