Abstract
BackgroundDengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts.MethodsIn 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats, which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA barcoding of the specimens to validate identifications.ResultsThe most rural commune (Mont Ngafula) had the highest pupal index (number of Aedes spp. pupae per 100 inspected houses) at 246 (20) pupae/100 houses, and Breteau index (BI; number of containers positive for immature stages of Aedes spp. per 100 households) at 82.2 (19.5) positive containers/100 houses for the rainy (and dry) season, respectively. The BI was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N’Djili in the rainy (and dry) season, respectively. The house index (number of houses positive for at least one container with immature stages of Aedes spp. per 100 inspected houses) was, on average, across all communes, 27.5% (7.6%); and the container index (number of containers positive for immature stages of Aedes spp. per 100 inspected containers) was 15.0% (10.0%) for the rainy (and dry) season, respectively. The vast majority of Aedes-positive containers were found outside the houses [adjusted odds ratio 27.4 (95% confidence interval 14.9–50.1)]. During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season rubbish and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season.ConclusionsIn both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target the key types of containers for Aedes larvae, which are mainly located in outdoor spaces, for larval habitat destruction or reduction.Graphical
Highlights
Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide
Few reports have shown the importance of dengue as a cause of acute fever in these settings. This is a case for the presence of dengue in the Democratic Republic of Congo (DRC), where the virus was found in stored samples: a dengue antigen test was positive for three suspected chikungunya cases in Kinshasa in 2012 [11]; 0.6% of dried blood spots taken during a Demographic Health Survey were positive in 2013–2014 [12]; and 3.5% of suspected cases of yellow fever in the Bas Congo region between 2002 and 2013 were dengue positive [13]
Aedes larval indices were higher in the rainy than in the dry season (p < 0.001; Table 2), with a Breteau index (BI) of 45.35 versus 10.39 positive containers/100 houses, a container index (CI) of 14.9% versus 10.02% and a house index (HI) of 27.53% versus 7.63%, respectively (Table 1)
Summary
Yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. Few reports have shown the importance of dengue as a cause of acute fever in these settings This is a case for the presence of dengue in the Democratic Republic of Congo (DRC), where the virus was found in stored samples: a dengue antigen test was positive for three suspected chikungunya cases in Kinshasa in 2012 [11]; 0.6% of dried blood spots taken during a Demographic Health Survey were positive in 2013–2014 [12]; and 3.5% of suspected cases of yellow fever in the Bas Congo region between 2002 and 2013 were dengue positive [13]. Zika has been rarely detected in sub-Saharan Africa [26], but several yellow fever outbreaks, with the last major one in 2016, have been described [27]
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