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 over-diagnosis of malaria and the under-recognition of dengue in many countries in sub-Saharan 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 Real-Time 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.