Abstract
Acute febrile patients presenting at hospitals in Douala, Cameroon between July and December 2020, were screened for dengue infections using real time RT-PCR on fragments of the 5' and 3' UTR genomic regions. In total, 12.8% (41/320) of cases examined were positive for dengue. Dengue virus 3 (DENV-3) was the most common serotype found (68.3%), followed by DENV-2 (19.5%) and DENV-1 (4.9%). Co-infections of DENV-3 and DENV-2 were found in 3 cases. Jaundice and headache were the most frequent clinical signs associated with infection and 56% (23/41) of the cases were co-infections with malaria. Phylogenetic analysis of the envelope gene identified DENV-1 as belonging to genotype V, DENV-2 to genotype II and DENV-3 to genotype III. The simultaneous occurrence of three serotypes in Douala reveals dengue as a serious public health threat for Cameroon and highlights the need for further epidemiological studies in the major cities of this region.
Highlights
Dengue is one of the most important mosquito-borne infections worldwide and its disease burden, one of the greatest in global health
The most common clinical signs found in our cohort were headache (63.7%), asthenia (58.7%) and joint pain (47.8%); jaundice and rash were reported from 16 and 4 patients respectively, out of the 320 individuals included in the study (Table 2)
Three dengue serotypes were found, dengue virus (DENV)-1, DENV-2, and Dengue virus 3 (DENV-3) in patients aged from 3 years to 75 years, but significantly more were in adults (81.1%) than in children below 15 years old (18.9%; χ2 = 21.84, df = 1), (Table 3)
Summary
Dengue is one of the most important mosquito-borne infections worldwide and its disease burden, one of the greatest in global health. The global incidence of dengue has increased by over 30 fold in recent decades, reaching today’s level of approximately 400 million infections affecting half of the world’s population in the 125 countries at risk of infection [1,2]. Dengue results from an infection with dengue virus (DENV) of the genus Flavivirus (Flaviviridae family). Dengue infections in humans are typically inapparent but can involve a range of clinical presentations from mild fever to the complications that can result in the potentially fatal severe Dengue [4,5]. A major determinant of disease severity is the timing and sequence of infection as infection with one virus serotype confers a lifelong homotypic immunity but subsequent reinfection with a different serotype increases the risk of severe disease [4]. The last two decades have been marked by an unprecedented global expansion of the vectors rapidly followed by dengue, the result of globalscale human-driven changes such as massively increased urbanization, deforestation and ineffective vector control, and latterly climate change, all contributing to increase in vector transmission from human to human [2]
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