Chikungunya Co-infection Research Articles

Global Prevalence of Zika and Chikungunya Coinfection: A Systematic Review and Meta-Analysis.

Zika virus (ZIKV) and chikungunya virus (CHIKV) are arthropod-borne viruses with significant pathogenicity, posing a substantial health and economic burden on a global scale. Moreover, ZIKV-CHIKV coinfection imposes additional therapeutic challenges as there is no specific treatment for ZIKV or CHIKV infection. While a growing number of studies have documented the ZIKV-CHIKV coinfection, there is currently a lack of conclusive reports on this coinfection. Therefore, we performed a systematic review and meta-analysis to determine the true statistics of ZIKV-CHIKV coinfection in the global human population. Relevant studies were searched for in PubMed, Scopus, and Google Scholar without limitation in terms of language or publication date. A total of 33 studies containing 41,460 participants were included in this meta-analysis. The study protocol was registered with PROSPERO under the registration number CRD42020176409. The pooled prevalence and confidence intervals of ZIKV-CHIKV coinfection were computed using a random-effects model. The study estimated a combined global prevalence rate of 1.0% [95% CI: 0.7-1.2] for the occurrence of ZIKV-CHIKV coinfection. The region of North America (Mexico, Haiti, and Nicaragua) and the country of Haiti demonstrated maximum prevalence rates of 2.8% [95% CI: 1.5-4.1] and 3.5% [95% CI: 0.2-6.8], respectively. Moreover, the prevalence of coinfection was found to be higher in the paediatric group (2.1% [95% CI: 0.0-4.2]) in comparison with the adult group (0.7% [95% CI: 0.2-1.1]). These findings suggest that the occurrence of ZIKV-CHIKV coinfection varies geographically and by age group. The results of this meta-analysis will guide future investigations seeking to understand the underlying reasons for these variations and the causes of coinfection and to develop targeted prevention and control strategies.

Clinical, epidemiological, and molecular investigation of Kyasanur forest disease from Karnataka state, India during 2018-2019

Background In this study, we carried out an investigation of Kyasanur Forest Disease (KFD) suspected human cases reported in Karnataka state, India from December 2018 to June 2019. Methods The clinical samples of KFD suspected cases (n = 1955) from 14 districts of Karnataka were tested for KFD using real-time RT-PCR and IgM ELISA. Further, the KFD-negative samples were tested for IgM antibodies against dengue and chikungunya viruses. Monkey samples (n = 276) and tick pools (n = 11582) were also screened using real-time RT-PCR. KFD-positive samples were further analysed using next-generation sequencing along with clinico-epidemiological analysis. Results Of all, 173 (8.8%) cases tested positive for KFD either by real-time RT-PCR (n = 124), IgM ELISA (n = 53) or both tests (n = 4) from seven districts. Among KFD-negative cases, IgM antibody positivity was observed for dengue (2.6%), chikungunya (5.8%), dengue and chikungunya coinfection (3.7%). KFD cases peaked in January 2019 with fever, conjunctivitis, and myalgia as the predominant symptoms and a mortality of 4.6%. Among confirmed cases, 41% received a single dose and 20% received two doses of the KFD vaccine. Of the seven districts with KFDV positivity, Shivamogga and Hassan districts reported KFD viral RNA positivity in humans, monkeys, and ticks. Sequencing analysis of 2019 cases demonstrated a difference of less than 1.5% amino acid compared to prototype KFDV. Conclusion Although the KFD has been endemic in many districts of Karnataka state, our study confirms the presence of KFDV for the first time in two new districts, i.e. Hassan and Mysore. A comparative analysis of KFDV infection among the KFD-vaccinated and non-vaccinated populations demonstrated an insignificant difference.

Seroprevalence of Dengue chikungunya mono infection and co-infection: A hospital-based study from Jabalpur, India

Introduction: Dengue and chikungunya infections are one of the most common arboviral infections affecting people globally, including India. Both are vector born viral infections sharing common vector. Hence in areas where both viruses co-circulate, they can be transmitted together. There are few reports discussing the dengue-chikungunya coinfection from cental India, so present study was planned to study the prevalence of dengue chikungunya monoinfection as well as coinfection from this part of the country. Materials and methods: All the samples received in the laboratory were subjected to Enzyme Linked Immunosorbent assay (ELISA) test to detect the presence of immunoglobulin M (IgM) antibodies against both CHIKV and DENV. Results: Out of total 2009 samples from suspected patients for dengue infection, 192 (9.5%) samples were positive for DENV while CHIK IgM antibodies were positive in 157 (7.8%) patients. Co-infection was seen in 68 (3.4%) cases. Conclusion: Present study suggests co-infections with dengue and chikungunya virus occur in areas where both viruses co-circulate. Both the illness present with overlapping signs and symptoms, making diagnosis and treatment difficult. Repeated outbreaks of both the infections suggest that the epidemiology of these viruses is changing. Thus, in clinically suspected cases it is advisable to test for both viruses for better patient care

CHIKUNGUNYA, SCRUB TYPHUS MONO, AND CO-INFECTION AMONG PATIENTS WITH UNDIFFERENTIATED FEBRILE ILLNESS: A HOSPITAL-BASED STUDY

Objectives: Chikungunya virus is a common arthropod-related acute febrile disease and it is transmitted by Aedes aegypti or Aedes albopictus species. On the other hand, the bacterium Orientia tsutsugamushi causes scrub typhus, which is also an acute febrile illness with multiple organ involvement. Coinfection of chikungunya and scrub typhus may lead to severe manifestation including severe respiratory and central nervous system (CNS) complications. Coinfection of chikungunya and scrub typhus may lead to severe manifestation including severe respiratory and CNS complications. Therefore, the proper diagnosis can prevent the clinical complications. The aim and objective of our study is to find the seroprevalence of chikungunya and scrub typhus and coinfection of both through medical assessment and serological research of these patients presented with acute febrile infection at Diamond Harbour Government Medical College and Hospital. Methods: A prospective study was conducted from August 2022 to January 2023 at VRDL, Department of Microbiology, Diamond Harbour Government Medical College and Hospital. Serum was collected for IgM antibody enzyme-linked immunosorbent assay (ELISA) for scrub typhus (In bios kit) and Chikungunya (NIV Chikungunya IgM Capture ELISA Kit) test. Four hundred and eighty-seven samples were tested for IgM antibody by chikungunya and scrub typhus ELISA kit. Result: The present study demonstrated that, from the month of August 2022 to January 2023, 67% of chikungunya cases, 25% cases with only scrub typhus, and 8% cases with both chikungunya and scrub typhus presented positive. A present study shows that chikungunya is slightly more prevalent in males as compared to females, where scrub typhus is equally positive in both male and female patients. Conclusion: Laboratory testing of both of the diseases can prevent the complication of other suspected disease in coinfected patients.

Prevalence of Chikungunya and Scrub Typhus Coinfection among Dengue Negative Patients in Kolkata, India-A Newly Emerging Public Health Hazard

The chikungunya virus (CHIKV) and scrub typhus infection has scattered worldwide creating human health hazards in India and Asia specific region. We aimed to identify chikungunya, scrub typhus, and their co-infection in dengue-negative samples having undifferentiated febrile illnesses. Enzyme linked immunosorbent assay (ELISA) methods were used to detect the chikungunya and scrub typhus specific IgM antibody by using chikungunya IgM capture ELISA kit and scrub typhus IgM Microlisa ELISA kit, respectively. OD value was measured with the help of BeneSphera (India) ELISA microplate reader. Among 490 suspected patients, 57 (11.63%) samples were tested positive for chikungunya IgM antibodies, while 43 (8.77%) came positive for scrub typhus IgM antibodies, but all samples tested negative for dengue IgM antibodies. Additionally, 5% of the total positive cases were positive for both chikungunya and scrub typhus infection. Our study offers a hypothesis regarding one of the possible causes of the decline in the frequency of scrub typhus and chikungunya cases reported in Kolkata and other districts of West Bengal. As an outcome, physicians treating undifferentiated febrile patients in endemic locations should look for chikungunya, scrub typhus, and existing coinfection between them to avoid delayed diagnosis and provide proper treatment against these infections.

Study of kaempferol in the treatment of COVID-19 combined with Chikungunya co-infection by network pharmacology and molecular docking technology

Chikungunya (CHIK) patients may be vulnerable to coronavirus disease (COVID-19). However, presently there are no anti-COVID-19/CHIK therapeutic alternatives available. The purpose of this research was to determine the pharmacological mechanism through which kaempferol functions in the treatment of COVID-19-associated CHIK co-infection. We have used a series of network pharmacology and computational analysis-based techniques to decipher and define the binding capacity, biological functions, pharmacological targets, and treatment processes in COVID-19-mediated CHIK co-infection. We identified key therapeutic targets for COVID-19/CHIK, including TP53, MAPK1, MAPK3, MAPK8, TNF, IL6 and NFKB1. Gene ontology, molecular and upstream pathway analysis of kaempferol against COVID-19 and CHIK showed that DEGs were confined mainly to the cytokine-mediated signalling pathway, MAP kinase activity, negative regulation of the apoptotic process, lipid and atherosclerosis, TNF signalling pathway, hepatitis B, toll-like receptor signaling, IL-17 and IL-18 signaling pathways. The study of the gene regulatory network revealed several significant TFs including KLF16, GATA2, YY1 and FOXC1 and miRNAs such as let-7b-5p, mir-16-5p, mir-34a-5p, and mir-155-5p that target differential-expressed genes (DEG). According to the molecular coupling results, kaempferol exhibited a high affinity for 5 receptor proteins (TP53, MAPK1, MAPK3, MAPK8, and TNF) compared to control inhibitors. In combination, our results identified significant targets and pharmacological mechanisms of kaempferol in the treatment of COVID-19/CHIK and recommended that core targets be used as potential biomarkers against COVID-19/CHIK viruses. Before conducting clinical studies for the intervention of COVID-19 and CHIK, kaempferol might be evaluated in wet lab tests at the molecular level.

Imported malaria with chikungunya co-infection: A case report

Malaria is a parasitic disease caused by and is associated with acute febrile episodes. The disease burden is highest in Southeast Asia. Various measures are being taken to curb the disease in different countries. Even after the introduction of various programmes there has been reports of imported malaria which has been transported from highly endemic countries to less endemic or countries not having cases of Malaria. Not only this, various other viral disease come in as coinfection with malaria which makes the situation even worse. Here we describe one such case of malaria imported from traveller from Nigeria to India who also developed coinfection with Chikungunya.

COINFECTION OF DENGUE AND CHIKUNGUNYA VIRUSES: A PREVALENCE STUDY IN A TERTIARY HOSPITAL AT HYDERABAD, INDIA.

Background & objectives: Dengue and Chikungunya fever are the endemic arboviral infections appearing to be increasing in all parts of India. This study aims to determine the prevalence of Dengue and Chikungunya co-infection among acute febrile illness cases. A prospective observational study was conducted including patients with an acute febrile illnessMethods: whose blood samples were collected and subjected to tests like IgM & IgG ELISA for dengue virus and IgM Capture ELISA for Chikungunya virus. Among the 90 samples that were subjected to both Dengue and Chikungunya virus tests for coinfections, 18 samples testedResults: positive for both Dengue and Chikungunya tests conrming coinfections. Chikungunya virus can be confusedInterpretation and conclusion: with diseases such as Dengue based on the similarity of the symptoms and sharing of vectors. Thus the differential diagnosis of these infections is essential for clinical management and epidemiological study in the tropics.

Comodulation of Dengue and Chikungunya Virus Infection During a Coinfection Scenario in Human Cell Lines.

The Dengue virus (DENV) and Chikungunya virus (CHIKV) are the arboviruses that pose a threat to global public health. Coinfection and antibody-dependent enhancement are major areas of concern during DENV and CHIKV infections, which can alter the clinical severity. Acute hepatic illness is a common manifestation and major sign of disease severity upon infection with either dengue or chikungunya. Hence, in this study, we characterized the coexistence and interaction between both the viruses in human hepatic (Huh7) cells during the coinfection/superinfection scenario. We observed that prior presence of or subsequent superinfection with DENV enhanced CHIKV replication. However, prior CHIKV infection negatively affected DENV. In comparison to monoinfection, coinfection with both DENV and CHIKV resulted in lower infectivity as compared to monoinfections with modest suppression of CHIKV but dramatic suppression of DENV replication. Subsequent investigations revealed that subneutralizing levels of DENV or CHIKV anti-sera can respectively promote the ADE of CHIKV or DENV infection in FcγRII bearing human myelogenous leukemia cell line K562. Our observations suggest that CHIKV has a fitness advantage over DENV in hepatic cells and prior DENV infection may enhance CHIKV disease severity if the patient subsequently contracts CHIKV. This study highlights the natural possibility of dengue–chikungunya coinfection and their subsequent modulation in human hepatic cells. These observations have important implications in regions where both viruses are prevalent and calls for proper management of DENV-CHIKV coinfected patients.

Global prevalence of dengue and chikungunya coinfection: A systematic review and meta-analysis of 43,341 participants

Dengue and chikungunya virus are important arboviruses of public health concern. In the past decades, they have accounted for numerous outbreaks of dengue and chikungunya in different parts of the world. Several cases of concurrent infection of dengue and chikungunya have been documented. However, the true burden of this concurrent infection is unknown. Here, a systematic review and meta-analysis of published data on the prevalence of dengue and chikungunya coinfection in the human population was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Six electronic databases (Web of science, Embase, PubMed, ScienceDirect, Scopus, and Google Scholar) were searched without year or language restrictions for relevant studies. The study protocol was registered with PROSPERO (CRD42020175344). Eighty-three studies involving a total of 43,341 participants were included. The random-effects model was employed to calculate the summary estimates. A pooled global prevalence of 2.5% (95% CI: 1.8–3.4) was obtained for dengue and chikungunya coinfection. Males and females appear to be coinfected at a fairly similar rate. Among the regions, Asia accounted for the highest prevalence (3.3%, 95% CI: 2.3–4.6) while North America was the least (0.8%, 95% CI: 0.3–2.4). The prevalence estimates varied across different countries. A much higher prevalence rates were obtained for Colombia (37.4%, 95% CI: 9.1–78.1), Madagascar (18.2%, 95% CI: 10.1–30.6), Laos (12.5%, 95% CI: 5.3–26.7), Maldives (4.5%, 95% CI: 1.5–13.0) and Thailand (3.7%, 95% CI: 0.4–26.3). This first extensive systematic review and meta-analysis reveals dengue and chikungunya coinfection as a global problem worthy of consideration. It is therefore pertinent that both infections be assessed during diagnosis, mosquito vector control practices be implemented, and vaccine development strides be supported globally.

Trend analysis in seroprevalence of dengue, chikungunya and malaria: A seven-year serological study from a tertiary care hospital of Maharashtra, India.

Dengue, chikungunya and malaria are mosquito-borne infections, which have shared endemicity and similar clinical presentation. Simultaneous co-infection with more than one infectious agent complicates the diagnosis and further course of treatment. This study aims to determine the seroprevalence and trend of malaria, dengue and chikungunya from 2014-2020 in a tertiary care hospital of western India. The present study was retrospective descriptive record-based. Serum samples from clinically suspected dengue and chikungunya were subjected to both IgM antibody capture ELISA kits produced by National Institute of Virology (NIV), Pune, India. They were also subjected to ELISA based NS1Ag testing. In Suspected malaria cases, blood collected in EDTA tubes was subjected for Rapid Malaria antigen testing. Statistical analysis was performed using MS Excel and JMP Software. Seropositivity of malaria was comparatively higher in 2014 (5.53%) and a decreasing trend was observed in subsequent years. Majority of malarial infections were caused by Plasmodium vivax (81.67%). There is drastic increase in seropositivity of chikungunya from 2016 (23.67%) and thereafter as compared to 2014 (6.57%) and 2015 (7.29%) indicating its re-emergence. The dengue seropositivity in 2019 (40.19%) was highest in last seven years. Males were predominantly affected, and most affected age group was 21-30 years. Peak transmission was observed in post-monsoon seasons. Dengue and chikungunya co-infection was observed to be 5.79%. This study emphasizes the importance of surveillance studies to understand the trend of vector-borne diseases for prompt diagnosis, management of patients in hospital setup and for early detection and curtailment of outbreaks and epidemics by public health sectors through appropriate vector control programs.

Evidence of chikungunya virus infections among febrile patients at three secondary health facilities in the Ashanti and the Bono Regions of Ghana.

BackgroundChikungunya is now of public health concern globally due to its re-emergence in endemic areas and introduction into new areas of the world. Worldwide, the vectors for transmission of the chikungunya virus are Aedes mosquitoes and these are prevalent in Ghana. Despite its global significance, the true burden of chikungunya virus infection in Ghana is largely unknown and the threat of outbreak remains high owing to international travel. This study sought to determine chikungunya virus infection among febrile patients suspected of having malaria infections at some selected health facilities in the Ashanti, Bono East, and Bono Regions of Ghana.MethodologyThis cross-sectional study recruited six hundred (600) febrile patients suspected of having malaria who submitted their clinical samples to the laboratories of the selected health facilities for the diagnosis of their infections. Five to ten millilitres (5-10ml) of venous blood were collected from each study participant. Sera were separated and tested for anti-chikungunya (IgM and IgG) antibodies using InBios ELISA kit following the manufacturer’s instruction. Samples positive for chikungunya IgM and IgG were selected and tested for chikungunya virus RNA using Reverse Transcription-quantitative Polymerase Chain Reaction. Malaria Rapid Diagnostic Test kits were used to screen the participants for malaria. Structured questionnaires were administered to obtain demographic and clinical information of the study participants.ResultOf the 600 samples tested, the overall seroprevalence of chikungunya was 6%. The seroprevalence of chikungunya IgM and IgG antibodies were 1.8% and 4.2% respectively. None of the chikungunya IgM and IgG positive samples tested positive for chikungunya RNA by RT-qPCR. Of the 600 samples, tested 32.3% (194/600) were positive for malaria parasites. Malaria and chikungunya co-infection was detected in 1.8% (11/600) of the participants.ConclusionFindings from the current study indicate low-level exposure to the chikungunya virus suggesting the virus is circulating and potentially causing morbidity in Ghana.

Prevalence of Malaria and Chikungunya Co-Infection in Febrile Patients: A Systematic Review and Meta-Analysis.

Background: Co-infection with malaria and chikungunya could exert a significant public health impact with infection misdiagnosis. Therefore, this study aimed to collect qualitative and quantitative evidence of malaria and chikungunya co-infection among febrile patients. Methods: Potentially relevant studies were identified using PubMed, Web of Science, and Scopus. The bias risk of the included studies was assessed using the checklist for analytical cross-sectional studies developed by the Joanna Briggs Institute. The pooled prevalence of malaria and chikungunya co-infection among febrile patients and the pooled prevalence of chikungunya virus (CHIKV) infection among malaria patients were estimated with the random effect model. The odds of malaria and chikungunya co-infection among febrile patients were also estimated using a random effect model that presumed the heterogeneity of the outcomes of the included studies. The heterogeneity among the included studies was assessed using the Cochran Q test and I2 statistics. Publication bias was assessed using the funnel plot and Egger’s test. Results: Of the 1924 studies that were identified from the three databases, 10 fulfilled the eligibility criteria and were included in our study. The pooled prevalence of malaria and chikungunya co-infection (182 cases) among febrile patients (16,787 cases), stratified by diagnostic tests for CHIKV infection, was 10% (95% confidence interval (CI): 8–11%, I2: 99.5%) using RDT (IgM), 7% (95% CI: 4–10%) using the plaque reduction neutralization test (PRNT), 1% (95% CI: 0–2%, I2: 41.5%) using IgM and IgG ELISA, and 4% (95% CI: 2–6%) using real-time RT-PCR. When the prevalence was stratified by country, the prevalence of co-infection was 7% (95% CI: 5–10%, I2: 99.5%) in Nigeria, 1% (95% CI: 0–2%, I2: 99.5%) in Tanzania, 10% (95% CI: 8–11%) in Sierra Leone, 1% (95% CI: 0–4%) in Mozambique, and 4% (95% CI: 2–6%) in Kenya. The pooled prevalence of CHIKV infection (182 cases) among malaria patients (8317 cases), stratified by diagnostic tests for CHIKV infection, was 39% (95% CI: 34–44%, I2: 99.7%) using RDT (IgM), 43% (95% CI: 30–57%) using PRNT, 5% (95% CI: 3–7%, I2: 5.18%) using IgM and IgG ELISA, and 9% (95% CI: 6–15%) using real-time RT-PCR. The meta-analysis showed that malaria and chikungunya co-infection occurred by chance (p: 0.59, OR: 0.32, 95% CI: 0.6–1.07, I2: 78.5%). Conclusions: The prevalence of malaria and chikungunya co-infection varied from 0% to 10% as per the diagnostic test for CHIKV infection or the country where the co-infection was reported. Hence, the clinicians who diagnose patients with malaria infections in areas where two diseases are endemic should further investigate for chikungunya co-infection to prevent misdiagnosis or delayed treatment of concurrent infection.

Comparative Study of Chikungunya Only and Chikungunya-Scrub Typhus Coinfection in Children: Findings from a Hospital-Based Observational Study from Central Nepal.

Objectives Chikungunya and scrub typhus infection are important causes of undifferentiated fever in tropical zones. The clinical manifestations in both conditions are nonspecific and often overlap. This study compares the clinical manifestations and the outcome of chikungunya with chikungunya-scrub typhus coinfection in children. Methods A hospital-based observational study was conducted in children below 15 years of age over 16-month duration in 2017-2018. Chikungunya was diagnosed by IgM ELISA. All positive chikungunya cases were subjected to scrub typhus testing, dengue testing, leptospira testing, and malaria testing. Clinical manifestations and outcomes of all patients were recorded. Results Out of the 382 admitted cases with fever, 11% (n = 42) were diagnosed with chikungunya, and the majority (n = 30, 71.4%) were male. Among the 42 chikungunya cases, 17 (40.5%) tested positive for scrub typhus and one positive for falciparum malaria. Out of a total of 42 chikungunya cases, myalgia, nausea/vomiting, headache, abdominal pain, lymphadenopathy, hepatomegaly, splenomegaly, and edema were 81%, 73.8%, 66.7%, 64.3%, 59.5%, 52.4%, 40.5%, and 38.1%, respectively. Besides, altered sensorium (31%), jaundice (26.2%), dry cough (21.4%), shortness of breath (19%), and seizures (16.7%) were other clinical manifestations present in this group of children. Patients with chikungunya-scrub typhus coinfection reported headaches, pain in the abdomen, dry cough, shortness of breath, seizures, and splenomegaly, significantly more (p value < 0.05) compared to those with chikungunya only. Thirteen (31%) children developed shock, five in the chikungunya group and eight in the chikungunya-scrub typhus coinfection group. Six children in the coinfection group received inotrope. Among the chikungunya-only cases, 22 recovered and one died, whereas in the chikungunya-scrub typhus coinfection group, fourteen recovered and three died. Conclusions Both the chikungunya and scrub typhus coinfection groups shared many similar clinical manifestations. In children, coinfection with scrub typhus often leads to modification of the clinical profile, complications, and chikungunya outcome.

Dengue and Chikungunya Mono and Co-infections among Patients with Acute Febrile Illness

Introduction: Dengue and Chikungunya fever are arboviral diseases which are spread by a common vector. Being clinically indistinguishable, it is necessary to distinguish both either by molecular or serology testing. Aim: To estimate the seroprevalence of Dengue and Chikungunya mono-infection as well as dual infection in patients with acute febrile illness. Materials and Methods: Two hundred patients with acute febrile illness were enrolled from April 2015 to October 2016. Detailed clinical history was documented. Samples were collected and subjected to Polymerase Chain Reaction (PCR) and Enzyme Linked Immuno Sorbent Assay (ELISA) testing. For qualitative data, frequency percentage table was used and association was done using Chi-square test. Results: Out of 200 patients, 8.5% had Chikungunya mono-infection and 41.5% patients had Dengue mono-infection. Dengue and Chikungunya co-infection was found in 4.5% patients. Most affected age group was 18-60 years wherein male preponderance was seen. In Chikungunya fever, 82.4% had morning stiffness and 35.3% had joint swelling; elbow and knee were the most commonly affected joints. In Chikungunya fever, 76.5% patients had restricted joint movements and 52.9% had Visual Analog Score (VAS) of 6-10. In Dengue fever, myalgia (67.5%) and rash (20.5%) were common symptoms. A total of 61.4% patients of Dengue fever had low platelet count. All Chikungunya cases and 88.1% Dengue cases detected by PCR had fever duration of less than five days. 85% of Chikungunya and 69% of Dengue cases detected by IgM ELISA had fever duration of more than five days. Conclusion: Diagnostic algorithms of acute febrile illness cases should include testing by both molecular and serology for both the viruses, which is the absolute need of the hour.

Dynamical analysis of chikungunya and dengue co-infection model

The aim of this paper is to design and analyze a nonlinear mechanistic model for chikungunya (CHIKV) and dengue (DENV) co-endemicity. The model can assess the epidemiological consequences of the spread of each disease on the co-infection transmission dynamics. Although the two diseases are different, they exhibit similar dynamical features which show that to combat/control CHIKV virus (or co-infection with DENV virus) we can employ DENV control strategies and vice versa. Our analytical results show that each sub-model and the full model have two disease-free equilibria (i.e., trivial disease-free equilibrium (TDFE) and non-trivial disease-free equilibrium (NTDFE)). Further, qualitative analyses reveal that each of the sub-models exhibits the phenomenon of backward bifurcation (where a stable NTDFE co-exits with a stable endemic equilibrium (EE)). Epidemiologically, this implies that, in each case (CHIKV or DENV), the basic requirement of making the associated reproduction number to be less-than unity is no longer sufficient for the disease eradication. We further highlight that the full model, consisting of twenty-six (26) mutually exclusive compartments representing the human and mosquito dynamics, also exhibits the phenomenon of backward bifurcation. We fit the full model and its sub-models using realistic data from India. Sensitivity analysis using the partial rank correlation coefficient (PRCC) is used for ranking the importance of each parameter-output. The results suggested that the mosquito removal rates, the transmission rates, and the mosquito maturation rate are the top control parameters for combating CHIKV, DENV and CHIKV-DENV co-infection outbreaks.

Serological evidence of chikungunya and malaria co-infection among febrile patients seeking health care in Karagwe district, Tanzania

Background: Chikungunya is an emerging mosquito-borne viral illness of major public health concern and is becoming a common infection in many geographical areas of Tanzania. This study was carried out to determine the incidence of malaria and chikungunya infections among febrile patients seeking medical care in Karagwe district, Tanzania.Methods: Febrile patients were enrolled into the study at Nyakahanga district designated hospital and Kayanga heath centre in May and June 2015. Questionnaires were administered to collect clinical and socio-demographic characteristics of patients. All participants were tested for malaria using malarial rapid diagnostic test and those tested positive by mRDT were confirmed by microscopy. Both outpatients tested malaria positive and negative were further screened for immunoglobulin M (IgM) and G (IgG) antibodies for chikungunya using enzyme-linked immunosorbent assay.Results: A total of 400 febrile patients were enrolled in the study. Out of 400 febrile outpatients tested for malaria, 116 (28.75%) tested positive with mRDT. Microscopy confirmed presence malaria parasites in 112 (96.55%) of the malaria RDT-positive. The overall seroprevalence of chikungunya infection was 24.25% (97/400). Out of those chikungunya seropositive subjects, 89 (91.75%) had no malaria. Co-infection rate of chikungunya and malaria was found to be 7.14% (8/112).Conclusions: Our findings confirmed the existence of chikungunya and malaria co-infection among febrile patients seeking health care in Karagwe district. Chikungunya should be considered in the differential diagnosis of malaria for appropriate case management and in order to monitor the public health burden and to inform possible preventative and control measures.

Clinical profile of dengue fever and coinfection with chikungunya.

Objective:Arthropod-borne viral diseases are a major burden on the health-care system worldwide. Only a few studies have reported on coinfection of dengue fever (DF) with the chikungunya virus in North India. We investigated the seroprevalence and significance of the clinicobiochemical profile of dengue and chikungunya coinfection. Besides this, the authors try to emphasize rationalize platelets transfusion.Material and Methods:The present study was conducted at the Heritage Institute of Medical Science, Varanasi, India, from July to December 2016. A total of 1800 suspected cases with acute viral febrile illness (age >18 years) were investigated to exclude other causes of acute febrile illnesses. Of these, 121 patients (6.72%) were diagnosed as seropositive for dengue and chikungunya mono or coinfection using IgM ELISA and were included in the study.Results:The male gender was predominant. The majority were in the 20–30-year age group with cases peaking in November. There were 102 (84.29%) cases of dengue, 6 (4.95%) cases of chikungunya, and 13 (10.74%) cases positive for coinfection. Fever was present in all cases. Headache followed by nausea/vomiting and generalized weakness were the most common symptoms in patients with DF while body aches and joint pain were most common in those with chikungunya fever. Deranged liver function and leukopenia were the most common complications in dengue.Conclusion:Joint-related symptoms (pain and restricted movements) were statistically significant in chikungunya monoinfection. Two patients with DF were died. There was no significant added severity of clinical features and blood investigations in patients with coinfection with dengue and chikungunya compared to those with monoinfections.

Dengue-Chikungunya Co-Infection: A Case Report from 2017-Chikungunya Outbreak in Dhaka, Bangladesh

A case of dengue virus and chikungunya viruse co-infection is reported here. The patient had fever, severe generalized bodyache, arthritis as well as drowsiness. Laboratory investigations showed dengue-chikungunya co-infection. The objective of our report is to emphasize the co-existence of dengue and chikungunya in a clinical case and to aware the clinicians about chikungunya and dengue co-infection.Birdem Med J 2018; 8(1): 72-74

Dengue Chikungunya co-infection: A live-in relationship??

Dengue and Chikungunya are viral infections that are a major public health hazard in recent times. Both these infections are caused by RNA viruses termed arboviruses owing to their requirement of an arthropod vector to get transmitted to vertebrate hosts. Apart from sharing a common vector, namely Aedes mosquitoes, these infections are also characterized by overlapping clinical presentations and are known to exist as co-infection. The present review traces the history and evolution of co-infection across the globe and provides specific compilation of the scenario in India. Furthermore, clinical manifestations during co-infection are discussed. Lastly, up-to-date information with respect to vector behaviour during co-infection both under laboratory conditions and in natural Aedes populations is reviewed.