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Serological Evidence of Chikungunya Virus among Acute Febrile Patients in Southern Mozambique.

Gudo ES, Pinto G, Vene S, Mandlaze A, Muianga AF, Cliff J, Falk K - PLoS Negl Trop Dis (2015)

Bottom Line: Seroconversion or a four-fold titer rise was confirmed in 9 (4.3%) patients.The results of this study strongly suggest that CHIKV is circulating in southern Mozambique.We recommend that CHIKV should be considered in the differential diagnosis of acute febrile illness in Mozambique and that systematic surveillance for CHIKV should be implemented.

View Article: PubMed Central - PubMed

Affiliation: National Institute of Health, Ministry of Health, Maputo, Mozambique.

ABSTRACT

Background: In the last two decades, chikungunya virus (CHIKV) has rapidly expanded to several geographical areas, causing frequent outbreaks in sub-Saharan Africa, South East Asia, South America, and Europe. Therefore, the disease remains heavily neglected in Mozambique, and no recent study has been conducted.

Methods: Between January and September 2013, acute febrile patients with no other evident cause of fever and attending a health center in a suburban area of Maputo city, Mozambique, were consecutively invited to participate. Paired acute and convalescent serum samples were requested from each participant. Convalescent samples were initially screened for anti-CHIKV IgG using a commercial indirect immunofluorescence test, and if positive, the corresponding acute sample was screened using the same test.

Results: Four hundred patients were enrolled. The median age of study participants was 26 years (IQR: 21-33 years) and 57.5% (224/391) were female. Paired blood samples were obtained from 209 patients, of which 26.4% (55/208) were presented anti-CHIKV IgG antibodies in the convalescent sample. Seroconversion or a four-fold titer rise was confirmed in 9 (4.3%) patients.

Conclusion: The results of this study strongly suggest that CHIKV is circulating in southern Mozambique. We recommend that CHIKV should be considered in the differential diagnosis of acute febrile illness in Mozambique and that systematic surveillance for CHIKV should be implemented.

No MeSH data available.


Related in: MedlinePlus

Flowchart of recruitment of study participants and sample testing.Study participants were split into two groups, those who returned to the convalescent visit (left side of the flowchart) and those who were lost at follow-up (right side of the flow chart). The left side of the flow chart demonstrates that out of 400 recruited patients, 209 returned for the follow-up visit and their convalescent samples were initially screened for anti-CHIKV IgG. Out of 208 tested samples, 55 (26.4%) were positive and 153 (75.6%) were negative. Further, the corresponding 55 acute samples of the positive samples were screened for anti-CHIKV IgG. A total of 44 (21.2%) were positive with stationary titers, 3 (1.4%) were positive with four fold titer rise and 6 (2.9%) seroconverted. The right side of the flow chart demonstrates that 191 individuals did not return for their follow-up; 156 acute samples were available for testing and of these 38 (24.4%) and 118 (75.6%) were positive and negative, respectively. * Percentage against the total number of patients who returned to convalescent visit. ** Samples not tested because of insufficient volume
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pntd.0004146.g002: Flowchart of recruitment of study participants and sample testing.Study participants were split into two groups, those who returned to the convalescent visit (left side of the flowchart) and those who were lost at follow-up (right side of the flow chart). The left side of the flow chart demonstrates that out of 400 recruited patients, 209 returned for the follow-up visit and their convalescent samples were initially screened for anti-CHIKV IgG. Out of 208 tested samples, 55 (26.4%) were positive and 153 (75.6%) were negative. Further, the corresponding 55 acute samples of the positive samples were screened for anti-CHIKV IgG. A total of 44 (21.2%) were positive with stationary titers, 3 (1.4%) were positive with four fold titer rise and 6 (2.9%) seroconverted. The right side of the flow chart demonstrates that 191 individuals did not return for their follow-up; 156 acute samples were available for testing and of these 38 (24.4%) and 118 (75.6%) were positive and negative, respectively. * Percentage against the total number of patients who returned to convalescent visit. ** Samples not tested because of insufficient volume

Mentions: Convalescent serum samples were initially screened for anti-CHIKV IgG at a 1:20 dilution using a commercial indirect immunofluorescence test (IIFT) (EUROIMMUN AG, Lübeck, Germany). If the screening result of convalescent sample was positive, corresponding acute and convalescent samples were tested in parallel in a dilution series to determine possible sero-conversions or titer rises. Acute samples from patients who did not return for a convalescent visit were also screened for anti-CHIKV IgG (Fig 2). The manufacturer claims that sensitivity and specificity of the assay is 95% and 100%, respectively.


Serological Evidence of Chikungunya Virus among Acute Febrile Patients in Southern Mozambique.

Gudo ES, Pinto G, Vene S, Mandlaze A, Muianga AF, Cliff J, Falk K - PLoS Negl Trop Dis (2015)

Flowchart of recruitment of study participants and sample testing.Study participants were split into two groups, those who returned to the convalescent visit (left side of the flowchart) and those who were lost at follow-up (right side of the flow chart). The left side of the flow chart demonstrates that out of 400 recruited patients, 209 returned for the follow-up visit and their convalescent samples were initially screened for anti-CHIKV IgG. Out of 208 tested samples, 55 (26.4%) were positive and 153 (75.6%) were negative. Further, the corresponding 55 acute samples of the positive samples were screened for anti-CHIKV IgG. A total of 44 (21.2%) were positive with stationary titers, 3 (1.4%) were positive with four fold titer rise and 6 (2.9%) seroconverted. The right side of the flow chart demonstrates that 191 individuals did not return for their follow-up; 156 acute samples were available for testing and of these 38 (24.4%) and 118 (75.6%) were positive and negative, respectively. * Percentage against the total number of patients who returned to convalescent visit. ** Samples not tested because of insufficient volume
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608817&req=5

pntd.0004146.g002: Flowchart of recruitment of study participants and sample testing.Study participants were split into two groups, those who returned to the convalescent visit (left side of the flowchart) and those who were lost at follow-up (right side of the flow chart). The left side of the flow chart demonstrates that out of 400 recruited patients, 209 returned for the follow-up visit and their convalescent samples were initially screened for anti-CHIKV IgG. Out of 208 tested samples, 55 (26.4%) were positive and 153 (75.6%) were negative. Further, the corresponding 55 acute samples of the positive samples were screened for anti-CHIKV IgG. A total of 44 (21.2%) were positive with stationary titers, 3 (1.4%) were positive with four fold titer rise and 6 (2.9%) seroconverted. The right side of the flow chart demonstrates that 191 individuals did not return for their follow-up; 156 acute samples were available for testing and of these 38 (24.4%) and 118 (75.6%) were positive and negative, respectively. * Percentage against the total number of patients who returned to convalescent visit. ** Samples not tested because of insufficient volume
Mentions: Convalescent serum samples were initially screened for anti-CHIKV IgG at a 1:20 dilution using a commercial indirect immunofluorescence test (IIFT) (EUROIMMUN AG, Lübeck, Germany). If the screening result of convalescent sample was positive, corresponding acute and convalescent samples were tested in parallel in a dilution series to determine possible sero-conversions or titer rises. Acute samples from patients who did not return for a convalescent visit were also screened for anti-CHIKV IgG (Fig 2). The manufacturer claims that sensitivity and specificity of the assay is 95% and 100%, respectively.

Bottom Line: Seroconversion or a four-fold titer rise was confirmed in 9 (4.3%) patients.The results of this study strongly suggest that CHIKV is circulating in southern Mozambique.We recommend that CHIKV should be considered in the differential diagnosis of acute febrile illness in Mozambique and that systematic surveillance for CHIKV should be implemented.

View Article: PubMed Central - PubMed

Affiliation: National Institute of Health, Ministry of Health, Maputo, Mozambique.

ABSTRACT

Background: In the last two decades, chikungunya virus (CHIKV) has rapidly expanded to several geographical areas, causing frequent outbreaks in sub-Saharan Africa, South East Asia, South America, and Europe. Therefore, the disease remains heavily neglected in Mozambique, and no recent study has been conducted.

Methods: Between January and September 2013, acute febrile patients with no other evident cause of fever and attending a health center in a suburban area of Maputo city, Mozambique, were consecutively invited to participate. Paired acute and convalescent serum samples were requested from each participant. Convalescent samples were initially screened for anti-CHIKV IgG using a commercial indirect immunofluorescence test, and if positive, the corresponding acute sample was screened using the same test.

Results: Four hundred patients were enrolled. The median age of study participants was 26 years (IQR: 21-33 years) and 57.5% (224/391) were female. Paired blood samples were obtained from 209 patients, of which 26.4% (55/208) were presented anti-CHIKV IgG antibodies in the convalescent sample. Seroconversion or a four-fold titer rise was confirmed in 9 (4.3%) patients.

Conclusion: The results of this study strongly suggest that CHIKV is circulating in southern Mozambique. We recommend that CHIKV should be considered in the differential diagnosis of acute febrile illness in Mozambique and that systematic surveillance for CHIKV should be implemented.

No MeSH data available.


Related in: MedlinePlus