Abstract
Little is known about the extent and serotypes of dengue viruses circulating in Africa. We evaluated the presence of dengue viremia during 4 years of surveillance (2014–2017) among children with febrile illness in Kenya. Acutely ill febrile children were recruited from 4 clinical sites in western and coastal Kenya, and 1,022 participant samples were tested by using a highly sensitive real-time reverse transcription PCR. A complete case analysis with genomic sequencing and phylogenetic analyses was conducted to characterize the presence of dengue viremia among participants during 2014–2017. Dengue viremia was detected in 41.9% (361/862) of outpatient children who had undifferentiated febrile illness in Kenya. Of children with confirmed dengue viremia, 51.5% (150/291) had malaria parasitemia. All 4 dengue virus serotypes were detected, and phylogenetic analyses showed several viruses from novel lineages. Our results suggests high levels of dengue virus infection among children with undifferentiated febrile illness in Kenya.
Highlights
Dengue virus (DENV) is a reemerging arbovirus with an expansive worldwide range [1]
Given the mounting evidence for dengue in Africa, we evaluated the presence of dengue viremia during 4 years of surveillance (2014–2017) among children with febrile illness in coastal and western Kenya by using a highly-sensitive, multiplexed, real-time reverse transcription PCR and genomic sequencing
RNA extraction and complementary DNA (cDNA) synthesis were successful for 1,022 specimens that were shipped to the United States for DENV nucleic acid analysis
Summary
Recent modeling studies suggest wider dengue circulation in Africa than previously recognized [2]. Both major dengue vectors (Aedes aegypti and Ae. albopictus mosquitoes) are present in Africa [3,4]. Dengue viremia among returning travelers from Africa and scattered reports from individual countries suggest ongoing dengue circulation in Africa [2]. The first DENV-3 strains isolated from humans from Africa were reported from Mozambique during 1984 [9]. Given the mounting evidence for dengue in Africa, we evaluated the presence of dengue viremia during 4 years of surveillance (2014–2017) among children with febrile illness in coastal and western Kenya by using a highly-sensitive, multiplexed, real-time reverse transcription PCR (rRT-PCR) and genomic sequencing. We report the clinical manifestations, associated factors, serotypes, and phylogenetic relationships
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