Detection of Dengue and Chikungunya Viruses in Febrile Patients at Greater Accra Regional Hospital

Abstract

Background: Dengue and Chikungunya viruses have become major international public health concerns due to their epidemics and introduction of these viruses in new areas. Reemergence of these arboviruses exert enormous burden on populations, health systems and economies in most tropical countries. In Ghana, little is known is about Dengue and Chikungunya viruses though the country has been enlisted as part of the 34 countries to which the viruses are endemic. Studies and information about these viruses are lacking though the population of the vectors are likely to become wide spread due and there is lack of investigation tools for these viruses in Hospitals and Clinics in the country. Aim: To detect Dengue and Chikungunya viral markers among febrile patients, seen at Greater Accra Regional Hospital, Ghana. Method: This was a hospital-based cross sectional study where whole blood was collected from febrile patients suspected of having Dengue or Chikungunya viral infection at the Greater Accra Regional Hospital. Plasma was used to test for the viral markers of Dengue and Chikungunya using Real-time Reverse Transcriptase PCR, ELISA IgG and IgM and NS1 antigen for Dengue and Chikungunya viruses. Clinical and laboratory test data on patients were also collected and analyzed. Results: A total of 260 febrile patients attending Greater Accra Regional Hospital suspected of Dengue, Chikungunya viral infections or both were recruited over a period of 11 months starting from May 2016 with most of the samples coming between October and December. The study participants comprised of 84 (32%) males and 176 (68%) females. Data on the clinical presentation indicated that frequently reported symptoms other than fever were loss of appetite (92%), joint pain (86%) and muscle pain (85%). In all, the prevalence of Chikungunya specific antibodies was 72 (27.69%) and Dengue specific antibodies was 180 (69.23%). None of the participants tested positive for Dengue by rRT-PCR and NS1 antigen testing. None also tested positive for Chikungunya by rRT-PCR. Conclusion: This study provides evidence that Dengue and Chikungunya viruses are circulating in Ghana. High levels of Dengue and Chikungunya antibodies or patient exposure to these viral agents were observed, which suggests transmission at the study site. Differential diagnosis work-up in febrile patients should be made to include Dengue and Chikungunya infections.