Dengue in Western Uganda: a prospective cohort of children presenting with undifferentiated febrile illnes
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Date
2020Author
Boyce, Ross M.
Collins, Matthew
Muhindo, Rabbison
Nakakande, Regina
Ciccone, Emily J.
Grounds, Samantha
Espinoza, Daniel
Zhu, Yerun
Matte, Michael
Ntaro, Moses
Nyehangane, Dan
Juliano, Jonathan J.
Mulogo, Edgar Mugema
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Background: The spatial distribution and burden of dengue in sub-Saharan Africa remains highly uncertain, despite high levels of ecological suitability. The goal of this study was to describe the epidemiology of dengue among a cohort of febrile children presenting to outpatient facilities located in areas of western Uganda with differing levels of urbanicity and malaria transmission intensity.
Methods: Eligible children were first screened for malaria using rapid diagnostic tests. Children with a negative malaria result were tested for dengue using a combination NS1/IgM/IgG rapid test (SD Bioline Dengue Duo). Confirmatory testing by RT-PCR was performed in a subset of participants. Antigen-capture ELISA was performed to estimate sero-prevalence.
Results: Only 6 of 1416 (0.42%) children had a positive dengue rapid test, while none of the RT-PCR results were positive. ELISA testing demonstrated reactive IgG antibodies in 28 (2.2%) participants with the highest prevalence seen at the urban site in Mbarara (19 of 392, 4.9%, p < 0.001).
Conclusions: Overall, these findings suggest that dengue, while present, is an uncommon cause of non-malarial, pediatric febrile illness in western Uganda. Further investigation into the ecological factors that sustain low-level transmission in urban settings are urgently needed to reduce the risk of epidemics
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