Abstract
Dengue virus (DENV) is an arthropod-borne virus (arbovirus) transmitted by the Aedes mosquitoes, mainly Aedes aegypti. Dengue fever is a rapidly growing disease with expanding geographical distribution worldwide. We investigated a high number of non-malaria febrile cases reported to health clinics in refugee camps in the five states of Darfur between August 2015 and March 2016. The clinical presentation of cases and case definition criteria suggested involvement of one or more arboviral hemorrhagic fevers. Out of 560 suspected cases, we collected and analyzed 204 blood samples and serologically positive samples were confirmed by PCR. We identified 32 (15.7%) dengue viral infections, six West Nile virus infections, and three Crimean–Congo viral infections. Dengue infections were found in four out of the five Darfur states. We reported the first dengue fever outbreak in the Darfur region. Our results highlight the need for public health education and further molecular, phylogenetic, and entomological investigations for a better understanding of the disease transmission and the associated risk factors in the region.
Highlights
Dengue fever (DF) is a mosquito-borne viral disease caused by one of four closely-related dengue virus serotypes (DENV1–4) of the genus Flavivirus and family Flaviviridae and it is mainly transmitted by Aedes aegypti with other species of Aedes mosquito involved [1,2]
We report the first outbreak of dengue and dengue hemorrhagic fever along with West Nile virus and Crimean–Congo hemorhagic fever infections in the greater Darfur region, Western Sudan
Following a well-established case definition (Sudan Federal Ministry of Health) based on the clinical presentation, we identified suspected cases of hemorrhagic fever presenting to the health clinics of 29 refugee-camps in East, West, South, North, and Central Darfur states (Figure 1) between August 29 2015 and February 16 2016
Summary
Dengue fever (DF) is a mosquito-borne viral disease caused by one of four closely-related dengue virus serotypes (DENV1–4) of the genus Flavivirus and family Flaviviridae and it is mainly transmitted by Aedes aegypti with other species of Aedes mosquito involved [1,2]. Dengue infection has different clinical presentations ranged from a self-limiting flu-like illness to the fatal severe form of dengue hemorrhagic fever or dengue shock syndrome [1,3]. Dengue virus transmission is influenced by several factors, including climate change [7], the global trade, human population dynamics, and international travel, that facilitate the spread of the vectors and introduction of the DENV into new areas [8,9,10,11,12]. The unnoticeable, persistent transmission of the dengue virus usually results in the emergence of epidemics of different scales which are mainly influenced by the human population density, susceptibility, and previous exposure to DENV and the density of the mosquito vectors [1,16,17]. Armed conflicts and living in a humanitarian setting renders communities more vulnerable to infectious diseases, including DF [18]
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