Abstract
Introduction: Most febrile illnesses in Ghana are often misdiagnosed and presumptively treated as malaria. This situation may be due to the inappropriate diagnostic tool, clinical oversight and lack of awareness of some of the disease conditions that might have been present in the country. This study sought to investigate the seroprevalence of dengue virus, geographical location of participants with circulating antibodies and finally evaluate the diagnostic accuracy of a Rapid diagnostic kit (RDT) using Enzyme Linked Immuno-Sorbent Assay (ELISA) as a gold standard for confirmation. Method: A hospital-based cross-sectional study was conducted among adults (≥18) attending the University of Cape Coast Hospital. From each participant, 3 - 4 ml of venous blood was drawn and serum was tested for IgG and IgM using RDT methods. Positive samples were selected for ELISA confirmation. Statistical analysis was performed using SPSS (v.20) and STATA (v.14) software. Results: A total of 270 participants were enrolled in the study. The geometric mean age was 32 years. Overall, Dengue virus (DENV) IgG seroprevalence by RDT was 10 (3.7%). Seroprevalence of IgG and IgM by the ELISA method was 34 (12.6%) and 6 (2.2%) respectively. Females recorded a high seroprevalence (7.4%) than males (5.2%) in terms of past exposure (IgG). On current exposure (IgM), females recorded a high seroprevalence (1.5%) than males (0.7%). Seroprevalence of individuals with dual positivity ((IgG + IgM+) (acute secondary infection) was 1.9%. Those with primary and recent infection (IgM+ only) were 0.4% whiles those with past and probably secondary infection (IgG+ only) were 10.7%. The odds of dengue exposure were significantly high among participants with ages 50 - 59 as compared to their other counterparts (AOR = 3.5, p = 0.03). Diagnostic accuracy of RDT kit was poor (Kappa value = 0.373 and 0.0001). Elmina was noted to record the highest seroprevalence values for both anti-dengue IgG (3.3%) and IgM (1.85%). Conclusion: The seroprevalence of anti-dengue IgG and IgM among participants suggests that dengue virus is in circulation in Cape Coast Metropolis and Komenda Edina Eguafo Abirem Municipality.
Highlights
Most febrile illnesses in Ghana are often misdiagnosed and presumptively treated as malaria
This study sought to investigate the seroprevalence of dengue virus, geographical location of participants with circulating antibodies and evaluate the diagnostic accuracy of a Rapid diagnostic kit (RDT) using Enzyme Linked Immuno-Sorbent Assay (ELISA) as a gold standard for confirmation
This increases the vulnerability of the local residents to the infection since some of these travelers may be coming from hyperendemic areas that might have been exposed to the virus
Summary
Most febrile illnesses in Ghana are often misdiagnosed and presumptively treated as malaria. Dengue virus (DENV) IgG seroprevalence by RDT was 10 (3.7%). Females recorded a high seroprevalence (7.4%) than males (5.2%) in terms of past exposure (IgG). On current exposure (IgM), females recorded a high seroprevalence (1.5%) than males (0.7%). Seroprevalence of individuals with dual positivity ((IgG + IgM+) (acute secondary infection) was 1.9%. The odds of dengue exposure were significantly high among participants with ages 50 - 59 as compared to their other counterparts (AOR = 3.5, p = 0.03). Seroprevalence surveys had revealed dengue exposure in sub-Saharan Africa [5] with West Africa as the probable region for the viral transmission due to the presence of the transmitting vector, urbanization, poor sanitary measures and inadequate diagnostic tool [6]
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