Abstract
With the growing success of controlling malaria in Sub-Saharan Africa, the incidence of fever due to malaria is in decline, whereas the proportion of patients with non-malaria febrile illness (NMFI) is increasing. Clinical diagnosis of NMFI is hampered by unspecific symptoms, but early diagnosis is a key factor for both better patient care and disease control. The aim of this study was to determine the arboviral aetiologies of NMFI in low resource settings, using a mobile laboratory based on recombinase polymerase amplification (RPA) assays. The panel of tests for this study was expanded to five arboviruses: dengue virus (DENV), zika virus (ZIKV), yellow fever virus (YFV), chikungunya virus (CHIKV), and rift valley fever virus (RVFV). One hundred and four children aged between one month and 115 months were enrolled and screened. Three of the 104 blood samples of children <10 years presented at an outpatient clinic tested positive for DENV. The results were confirmed by RT-PCR, partial sequencing, and non-structural protein 1 (NS1) antigen capture by ELISA (Biorad, France). Phylogenetic analysis of the derived DENV-1 sequences clustered them with sequences of DENV-1 isolated from Guangzhou, China, in 2014. In conclusion, this mobile setup proved reliable for the rapid identification of the causative agent of NMFI, with results consistent with those obtained in the reference laboratory’s settings.
Highlights
In Africa, fever is the most common symptom leading patients to seek health care [1,2]
Prospective molecular screening on non-malaria febrile illness (NMFI) was conducted between September
Our results suggest that the RT-recombinase polymerase amplification (RPA) could be an alternative to real-time PCR in low resource settings
Summary
In Africa, fever is the most common symptom leading patients to seek health care [1,2]. With encouraging gains in malaria control in Sub-Saharan African countries, the incidence of this disease is in decline, leading to a decreasing proportion of febrile illness attributable to malaria. Between 2000 and 2013, malaria mortality rates decreased by 47% globally, and by 54% in sub-Saharan Africa—the region most affected by the disease—whereas the proportion of patients presenting with non-malaria febrile illness (NMFI) increased, respectively [4]. Acute febrile episodes are caused by various bacterial and viral pathogens, and infections with these agents result in patients presenting with malaria-like. Resulting in a resource-poor higher mortality than malaria, NMFIs areThe not objective being reliably access to diagnostics facilities in many endemic settings [1,6,7]
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