Dengue and Chikungunya among Febrile Outpatients in Kinshasa, Democratic Republic of Congo: a cross-sectional study

BackgroundPathogens causing acute fever, with the exception of malaria, remain largely unidentified in sub-Saharan Africa, given the local unavailability of diagnostic tests and the broad differential diagnosis.\n\nMethodology/Principal FindingsWe conducted a cross-sectional study including outpatient acute febrile syndromes in both children and adults, between November 2015 and June 2016 in Kinshasa, Democratic Republic of Congo. Serological and molecular diagnostic tests for arboviral infections were performed on blood, including PCR and NS1-RDT for acute, and ELISA and IFAT for past infections.\n\nConclusions/SignificanceAmong 342 patients, aged 2 to 68 years, 45.3% tested positive on malaria Rapid Diagnostic Test. However, 87.7% received antimalarial and 64.3% antibacterial treatment. Further investigation among 235 fever cases revealed 19 (8.1%) acute dengue and 2 (0.9%) acute chikungunya infections, with an important proportion of participants already exposed to flaviviridae (possibly dengue) and alphaviridae (possibly chikungunya) in the past, namely 30.2 % and 26.4% respectively. We found no evidence of exposure to Zika nor yellow fever virus.\n\nAuthor SummarySam Proesmans is a medical doctor, currently doing a fellowship in internal medicine at the University of Antwerp, Belgium. He holds a Master of Public Health from Columbia University, New York City, USA. His primary research interest lies in infectious diseases, from a public health point of view and he believes that this study is proof that the differential diagnosis should include arboviral infection, given the hitherto unseen evidence of high arbivirus infection rates in the Democratic Republic of Congo, in that they are mostly misdiagnosed as malaria or bacterial infections.