First report of epidemic dengue fever and malaria co-infections among internally displaced persons in humanitarian camps of North Darfur, Sudan

This study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019. An investigation team was deployed to North Darfur to identify suspected cases and collect blood sam...

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Vydáno v:	International journal of infectious diseases Ročník 108; s. 513 - 516
Hlavní autoři:	Ahmed, Ayman, Eldigail, Mawahib, Elduma, Adel, Breima, Tagwa, Dietrich, Isabelle, Ali, Yousif, Weaver, Scott C.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Canada Elsevier Ltd 01.07.2021 Elsevier
Témata:	Arboviruses Coinfection - epidemiology Dengue - epidemiology Dengue Virus - genetics Dengue with warning signs (DWWS) Disease Outbreaks Epidemic Epidemics Humans Malaria - epidemiology outbreak Phylogeny Refugees Severe dengue fever (SD) Sudan Sudan - epidemiology Sudan Epidemic Dengue with warning signs (DWWS) Arboviruses outbreak Severe dengue fever (SD) Sudan
ISSN:	1201-9712, 1878-3511, 1878-3511
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Abstract	This study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019. An investigation team was deployed to North Darfur to identify suspected cases and collect blood samples, and clinical and demographical data. Blood samples were examined microscopically for Plasmodium spp and tested for dengue (DENV) and yellow fever viruses by reverse transcriptase-quantitative polymerase chain reaction. Between September 7 and December 18, 2019, we clinically identified 18 (24%), 41 (54%), and 17 (22%) cases of dengue fever, dengue with warning signs, and severe dengue, respectively. Blood samples were collected from 22% of patients, and 47% of these tested positive for DENV-1 RNA. We confirmed 32 malaria cases with 5 co-infections with DENV. This outbreak of dengue was the first among IDPs in the humanitarian camps. Our findings indicate that dengue has become endemic or that there has been a new introduction. Further epidemiological, entomological, and phylogenetic studies are needed to understand disease transmission in the area. An early warning and response system and an effective health policy are crucial for preventing and controlling arboviruses in Sudan.
AbstractList	This study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019.OBJECTIVESThis study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019.An investigation team was deployed to North Darfur to identify suspected cases and collect blood samples, and clinical and demographical data. Blood samples were examined microscopically for Plasmodium spp and tested for dengue (DENV) and yellow fever viruses by reverse transcriptase-quantitative polymerase chain reaction.METHODSAn investigation team was deployed to North Darfur to identify suspected cases and collect blood samples, and clinical and demographical data. Blood samples were examined microscopically for Plasmodium spp and tested for dengue (DENV) and yellow fever viruses by reverse transcriptase-quantitative polymerase chain reaction.Between September 7 and December 18, 2019, we clinically identified 18 (24%), 41 (54%), and 17 (22%) cases of dengue fever, dengue with warning signs, and severe dengue, respectively. Blood samples were collected from 22% of patients, and 47% of these tested positive for DENV-1 RNA. We confirmed 32 malaria cases with 5 co-infections with DENV. This outbreak of dengue was the first among IDPs in the humanitarian camps.RESULTSBetween September 7 and December 18, 2019, we clinically identified 18 (24%), 41 (54%), and 17 (22%) cases of dengue fever, dengue with warning signs, and severe dengue, respectively. Blood samples were collected from 22% of patients, and 47% of these tested positive for DENV-1 RNA. We confirmed 32 malaria cases with 5 co-infections with DENV. This outbreak of dengue was the first among IDPs in the humanitarian camps.Our findings indicate that dengue has become endemic or that there has been a new introduction. Further epidemiological, entomological, and phylogenetic studies are needed to understand disease transmission in the area. An early warning and response system and an effective health policy are crucial for preventing and controlling arboviruses in Sudan.CONCLUSIONSOur findings indicate that dengue has become endemic or that there has been a new introduction. Further epidemiological, entomological, and phylogenetic studies are needed to understand disease transmission in the area. An early warning and response system and an effective health policy are crucial for preventing and controlling arboviruses in Sudan. Objectives: This study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019. Methods: An investigation team was deployed to North Darfur to identify suspected cases and collect blood samples, and clinical and demographical data. Blood samples were examined microscopically for Plasmodium spp and tested for dengue (DENV) and yellow fever viruses by reverse transcriptase-quantitative polymerase chain reaction. Results: Between September 7 and December 18, 2019, we clinically identified 18 (24%), 41 (54%), and 17 (22%) cases of dengue fever, dengue with warning signs, and severe dengue, respectively. Blood samples were collected from 22% of patients, and 47% of these tested positive for DENV-1 RNA. We confirmed 32 malaria cases with 5 co-infections with DENV. This outbreak of dengue was the first among IDPs in the humanitarian camps. Conclusions: Our findings indicate that dengue has become endemic or that there has been a new introduction. Further epidemiological, entomological, and phylogenetic studies are needed to understand disease transmission in the area. An early warning and response system and an effective health policy are crucial for preventing and controlling arboviruses in Sudan. This study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019. An investigation team was deployed to North Darfur to identify suspected cases and collect blood samples, and clinical and demographical data. Blood samples were examined microscopically for Plasmodium spp and tested for dengue (DENV) and yellow fever viruses by reverse transcriptase-quantitative polymerase chain reaction. Between September 7 and December 18, 2019, we clinically identified 18 (24%), 41 (54%), and 17 (22%) cases of dengue fever, dengue with warning signs, and severe dengue, respectively. Blood samples were collected from 22% of patients, and 47% of these tested positive for DENV-1 RNA. We confirmed 32 malaria cases with 5 co-infections with DENV. This outbreak of dengue was the first among IDPs in the humanitarian camps. Our findings indicate that dengue has become endemic or that there has been a new introduction. Further epidemiological, entomological, and phylogenetic studies are needed to understand disease transmission in the area. An early warning and response system and an effective health policy are crucial for preventing and controlling arboviruses in Sudan.
Author	Dietrich, Isabelle Breima, Tagwa Weaver, Scott C. Elduma, Adel Ahmed, Ayman Eldigail, Mawahib Ali, Yousif
AuthorAffiliation	f The Pirbright Institute, Pirbright, UK e Health Emergencies and Epidemics Control General Directorate, North Darfur State Ministry of Health, Al Fashir, Sudan d National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum, Sudan c Institute for Human Infections and Immunity and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA b World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA g Health Emergencies and Epidemics Control General Directorate, Sudan Federal Ministry of Health, Khartoum, Sudan a Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
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Keywords	Epidemic Dengue with warning signs (DWWS) Arboviruses outbreak Severe dengue fever (SD) Sudan
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SubjectTerms	Arboviruses Coinfection - epidemiology Dengue - epidemiology Dengue Virus - genetics Dengue with warning signs (DWWS) Disease Outbreaks Epidemic Epidemics Humans Malaria - epidemiology outbreak Phylogeny Refugees Severe dengue fever (SD) Sudan Sudan - epidemiology
Title	First report of epidemic dengue fever and malaria co-infections among internally displaced persons in humanitarian camps of North Darfur, Sudan
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