INVESTIGATION OF DENGUE EXPOSURE AND INFECTION IN GHANAIAN CHILDREN WITH MALARIA

ABSTRACT Background: Dengue and malaria are two important mosquito-borne diseases. Together, both diseases are indistinguishable due to similarities in clinical and laboratory characteristics. These similarities have contributed immensely to the overdiagnosis of malaria and the under-recognition of dengue in many countries in subSaharan Africa. No baseline study has yet been conducted in Ghana to estimate the burden of dengue. This study therefore set out to estimate the prevalence of dengue infection in a population of Ghanaian children confirmed with malaria. Methods: Archived plasma samples, obtained from 216 study participants aged 2-14 years enrolled in a malaria study, were tested for the presence of dengue using RealTime Reverse Transcriptase PCR, dengue Rapid Diagnostic Test (RDT) and dengue IgM/IgG capture ELISA. The study was conducted in three ecological zones of Ghana namely: Kintampo, Navrongo and Accra. Results: Dengue RDT and dengue IgM/IgG capture ELISAs estimated a prevalence of 54% and 24%, respectively. Dengue IgG capture ELISA showed that majority of seropositive study participants were positive for IgG (20%) and this was statistically significant between Kintampo and Navrongo. Estimated IgM/IgG ratio of 0.11 indicated that dengue infection was as a consequence of a previous exposure. Further analysis showed that 22% of the study population were confirmed with exposure to dengue-malaria while exposure to malaria only, dengue only and absence of either diseases was confirmed in 70%, 2% and 6% of study population respectively. Molecular tests indicated negative for dengue in all study participants. Conclusion: Results in the study suggest an exposure to dengue virus in a subset of Ghanaian population. However, the inability to detect and identify circulating serotype calls for more research in this regard