Viral haemorrhagic fevers and malaria co‐infections among febrile patients seeking health care in Tanzania
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
Background: In recent years there have been reports of viral haemorrhagic fever (VHF) epidemics in sub-Saharan
Africa where malaria is endemic. VHF and malaria have overlapping clinical presentations making differential diagno‐
sis a challenge. The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria
co-infections among febrile patients seeking health care in Tanzania.
Methods: This facility-based cross-sectional study was carried out between June and November 2018 in Buhigwe,
Kalambo, Kyela, Kilindi, Kinondoni, Kondoa, Mvomero, and Ukerewe districts in Tanzania. The study involved febrile
patients seeking health care from primary healthcare facilities. Blood samples were collected and tested for infections
due to malaria, Crimean-Congo haemorrhagic fever (CCHF), Ebola virus disease (EVD), Marburg virus disease (MVD),
Rift Valley fever (RVF) and yellow fever (YF). Malaria infections were tested using rapid diagnostics tests while exposure
to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immuno‐
sorbent assays. The Chi-square test was used to compare the proportions.
Results: A total of 308 participants (mean age = 35 ± 19 years) were involved in the study. Of these, 54 (17.5%) had
malaria infection and 15 (4.8%) were positive for IgM antibodies against VHFs (RVF = 8; CCHF = 2; EBV = 3; MBV = 1;
YF = 1). Six (1.9%) individuals had both VHF (RVF = 2; CCHF = 1; EVD = 2; MVD = 1) and malaria infections. The highest
co-infection prevalence (0.6%) was observed among individuals aged 46‒60 years (P < 0.05). District was significantly
associated with co-infection (P < 0.05) with the highest prevalence recorded in Buhigwe (1.2%) followed by Kinondoni
(0.9%) districts. Headache (100%) and muscle, bone, back and joint pains (83.3%) were the most significant complaints
among those infected with both VHFs and malaria (P = 0.001).
Conclusions: Co-infections of VHF and malaria are prevalent in Tanzania and affect more the older than the younger
population. Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis, adequate
laboratory diagnosis should be emphasized in the management of febrile illnesses.
Description
Journal of Infectious Diseases of Poverty (2022) pp.11-33
Keywords
Malaria, Viral haemorrhagic fevers, Febrile illnesses, Co-infection, Tanzania