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Cited by 29Viral Infections and VectorsMosquito-borne diseases and controlViral Infections and Outbreaks Research

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Viral haemorrhagic fevers and malaria co-infections among febrile patients seeking health care in Tanzania

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Rugarabamu, Sima, Rumisha, Susan F., Mwanyika, Gaspary O., Sindato, Calvin, Lim, Hee-Young, Misinzo, Gerald, Mboera, Leonard E. G.·2022·Infectious Diseases of Poverty
DOI 10.1186/s40249-022-00959-zPMC PMC9036688

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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 diagnosis 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 immunosorbent 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.

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  • Seroprevalence estimates of MVD and EVD are often reported together, with estimates for MVD consistently lower than for EVD.

    “Seroprevalence estimates of MVD and EVD are often reported together, with estimates for MVD consistently lower than for EVD, e.g. (35,36,44,54).”

    From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [44]

    The Results (Table 2) report EVD and MVD together, with three EVD-positive participants versus one MVD-positive participant. The Background also reports a separate Tanzanian study with EVD seroprevalence of 3.4% and MVD seroprevalence of 1.2%. These examples support lower MVD estimates, but this paper does not establish that estimates are often reported together or that MVD is consistently lower across studies. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • The evidence gathered indicates high susceptibility to MVD among populations in the surveyed regions, including Tanzania.

    “Overall, the evidence gathered here indicates high susceptibility to MVD among populations in the surveyed regions, including Tanzania, where one of the subsequent 2023 MVD outbreaks occurred (44).”

    From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [44]

    The citation is attached to the clause about a 2023 MVD outbreak in Tanzania, rather than clearly to the citing authors’ conclusion about susceptibility. The source’s Background describes Tanzania as at high risk but says no clinical MVD case had been reported there; our copy does not address a subsequent 2023 outbreak (searched: 2023 Marburg outbreak in Tanzania). (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Metadata

Authors
Rugarabamu, S., Rumisha, S. F., Mwanyika, G. O., Sindato, C., Lim, H.-Y., Misinzo, G., & Mboera, L. E. G.
Affiliations
  • Muhimbili University of Health and Allied Sciences (TZ)
  • The Kids Research Institute Australia (AU)
  • Mbeya University of Science and Technology (TZ)
  • Southern African Centre for Infectious Disease Surveillance (TZ)
  • Korea Disease Control and Prevention Agency (KR)
Corresponding author
Mboera, Leonard E. G.
ORCID
Venue
Infectious Diseases of Poverty
Publisher
Springer Science and Business Media LLC
Published
2022-04-25
Volume
11
Issue
1
Pages
33-33
ISSN
2049-9957 (ISSN-L)
DOI
10.1186/s40249-022-00959-z
PMC
PMC9036688
OpenAlex
W4226044412
Cited by
29
References
1
Citations by year
2026: 8 · 2025: 8 · 2024: 4 · 2023: 8 · 2022: 1
FWCI
2.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Infectious Diseases of Poverty (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Korea Centers for Disease Control and Prevention (4845-300-340-01))
Topics
  • Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
  • Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
Keywords
viral hemorrhagic fever, malaria co-infection, Crimean-Congo hemorrhagic fever, Ebola virus disease, Marburg virus disease, Rift Valley fever, yellow fever, zoonoses, IgM, febrile illness, differential diagnosis, Tanzania, sub-Saharan Africa, clinical symptoms, primary care patients
MeSH terms
Adolescent, Adult, Animals, Antibodies, Viral, Hemorrhagic Fever Virus, Crimean-Congo, Cross-Sectional Studies, Delivery of Health Care, Fever, Hemorrhagic Fever, Crimean, Hemorrhagic Fevers, Viral, Humans, Immunoglobulin M, Malaria, Middle Aged, Tanzania, Hemorrhagic Fever, Ebola, Young Adult, Coinfection

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