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Chikungunya Virus Infections Unmasked from Suspected Malaria Febrile Patients in Northeastern Nigeria

Marycelin M Baba1,, Bashir Muhammad2, Yaga S Jackson3, Kunle Ijaya4, Bamidele Soji Oderinde1

1Department of Medical Laboratory Science, University of Maiduguri, College of Medical Sciences, University of Maiduguri, P.M.B. 1069, Maiduguri, Nigeria

2Department of Science Laboratory Technology, Federal Polytechnic Kaltungo, Gombe State

3Department of Mathematical Sciences, University of Maiduguri, P.M.B. 1069, Maiduguri, Nigeria

4World Health Organization, 4th Floor, United Nations House, Plot 617/618, Central, Area District, PMB 2861, Abuja, Nigeria

American Journal of Epidemiology and Infectious Disease. 2023, 11(1), 11-17. DOI: 10.12691/ajeid-11-1-2
Received July 17, 2023; Revised August 18, 2023; Accepted August 25, 2023

Abstract

Background: Chikungunya is an emerging global threat because of the unprecedented magnitude of its spread and highly debilitating disease. Objective: This study was informed by the need to use serological methods to unmask the chikungunya virus (CHIKV) from suspected malaria patients. Methodology: The ELISA IgM and PRNT90 (nAb) were used to assess the presence of CHIKV antibodies. Findings: Of 530 patients, 129 (24.3%) had CHIKV IgM, 199 (37.5%) neutralizing antibody (nAb) and 23 (4.3%) IgM + nAb. Only 4.3% of the patients and 43.9% of the IgM negatives had CHIKV nAb indicating acute and past infections respectively. Of 200 patients from Adamawa State, 6.5%, 42.5%, and 3.5% were CHIKV IgM, nAb, and IgM + nAb respectively. In Borno State, 47.0% were IgM, 49.0% nAb and 4.5% were IgM+ nAb . Of 130 samples from Bauchi State, 72.3% had IgM, 16 (12.3%) nAb, and 5.4% IgM + nAb. CHIKV infections in Bauchi and Borno were significantly higher than in Adamawa but residents of the three states are at risk. This study also detected co-infections between CHIKV and flaviviruses at varied degrees: dengue viruses (DENV) (17.7%), Zika virus (ZIKV) (1.5%, West Nile virus (WNV) (4.0%), and yellow fever virus (YFV) (1.3%). The type of settlement, gender, age, and yellow fever vaccination status of the patients were not significantly associated with CHIKV nAb. However, patients aged >60 years were more likely to have experienced CHIKV infections than younger age groups. CHIKV nAb and samples collected 1-7 days after the onset of symptoms were significantly different from those within 7-10 days. CHIKV nAb among recipients of anti-malaria anti/antibiotics treatments and those untreated were significantly associated. Conclusion: The persistent misdiagnosis of CHIKV infections poses a global public health threat in the phase of climate change if unchecked. Misuse of antibiotics/antimalaria could lead to antimicrobial resistance

Keywords:

Chikungunya virus, malaria, ELISA IgM, neutralizing antibody, febrile illness, Nigeria
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