Prevalence of dengue viral infections among febrile patients in Mombasa County, Kenya

Abstract

Dengue virus infection is one of the major global public health problems. It is caused by one of the four dengue virus (DENV) serotypes that are transmitted by Aedes mosquitoes. Following infection, an individual remains vulnerable to re-infection with a different serotype of the DENV. The infection usually occurs with clinical manifestations ranging from an asymptomatic or mild febrile illness as classical dengue fever to the potentially life-threatening illness, dengue hemorrhagic fever and dengue shock syndrome. Despite the public health relevance, prevalence of DENV infections among febrile patients in Mombasa County is unknown. This study was conducted from February 2012 to July 2012 among patients visiting Coast Province General Hospital with high fever. The study was aimed at determining the prevalence of DENV infection among febrile patients and describe the month-wise trend of the disease. A total of 390 blood serum samples were collected and DENV specific IgM and flavivirus IgG antibodies were determined by in-house enzyme linked immunosorbent assay (ELISA). Out of 390 febrile cases, 54 (13.9%) were found to be positive for anti-DENV IgM. Among the 54 dengue positive cases, 37 (68.5 %) were primary DENV infection and 17 (31.5%) were secondary DENV infection. The most affected age group was 36-45 years (20.4%) and least affected group being 6-15years (8.3%). Prevalence in difference age groups was statistically significant (p = 0.021). Primary DENV infection was common among the age group between 36-45 years while secondary dengue affected mostly the age group 26-35 years. In terms of primary DENV infection against secondary DENV infection, it was observed that infants (<1 year) were the most affected but this was not statistically significant (p = 0.057). The relationship between gender and DENV infections was not statistically significant (p = 0.936). Although, females aged between 26-35 years (p = 0.010) and males aged above 46 years (p = 0.012) were the most affected with DENV infection. Month-wise distribution of DENV infection was observed in February (20.0%) with least occurrence in July (4.7%). The association between the month and occurrence of disease was not statistically significant (p = 0.325). The present study has reported 13.9% prevalence of Dengue virus infections as the cause of acute undifferentiated fever among febrile patients in Mombasa County. Thus, calls for government attention to develop resources at hospital laboratories for early dengue diagnosis and management of patients, coupled with general awareness among the public and constant vigilance by the health care officials could help in combating dingue