Multiple Serotypes of Dengue Unmasked from Suspected Malaria Patients are Significantly Associated with Yellow Fever Vaccination in Northeastern Nigeria

Bamidele Soji Oderinde¹, Zakari Adamu Shuaibu², Chiamaka Precious Okoye¹, Musa Idowu Audu³, Erick Mora-Cárdenas⁴, Tea Carletti⁴, Alessandro Marcello⁴, Thlama Gulanda Awi¹, Jesse Romeo Buba¹ and Marycelin Mandu Baba^1,

¹Department of Medical Laboratory Science, University of Maiduguri, College of Medical Sciences, University of Maiduguri, P.M.B. 1069, Maiduguri, Nigeria

²Department of Medical Laboratory Science, College of Medical Sciences, Bayero University, Kano, Nigeria

³WHO, Department of Health Emergencies, Abuja, Nigeria

⁴Laboratory of Molecular Virology, International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano, 99, 34149, Trieste, Italy

Cite this paper:
Bamidele Soji Oderinde, Zakari Adamu Shuaibu, Chiamaka Precious Okoye, Musa Idowu Audu, Erick Mora-Cárdenas, Tea Carletti, Alessandro Marcello, Thlama Gulanda Awi, Jesse Romeo Buba and Marycelin Mandu Baba. Multiple Serotypes of Dengue Unmasked from Suspected Malaria Patients are Significantly Associated with Yellow Fever Vaccination in Northeastern Nigeria. American Journal of Epidemiology and Infectious Disease. 2022; 10(1):7-18. doi: 10.12691/ajeid-10-1-2

Abstract

In Nigeria, greater than 70% of febrile illnesses are treated presumptively as malaria, without a laboratory evaluation. This study aimed at providing evidence-based information on the burden, classification of dengue and determination of the circulating Dengue virus (DENV) serotypes in Nigeria. Serum samples from suspected malaria patients who visited randomly selected health institutions in three northeastern states were analyzed using Rapid NS1 antigen detection, IgM and IgG ELISA, NS1 IgG ELISA and plaque reduction neutralization tests (PRNT₉₀). Cumulative results of the study detected 21.3% confirmed, 77.6% highly suggestive and 34% probable dengue. In Bauchi State, the IgG: IgM and IgM: IgG ratio indicated 93.5 % recent secondary and 6.5% primary dengue virus infections respectively. In Borno state, 86.3% had recent secondary dengue by NS1IgG. Five of seven NS1 were single infections, one multiple infection while one was likely to be serotype 1 which was not tested. Serotype 2 was the commonest in the three states but 2 and 4 were significantly higher in Adamawa than Bauchi and Borno. Multiple dengue serotypes obtained including 2 and 3, 3 and 4, 2 and 4 and 2 3, 4 were significantly higher in Adamawa than in Bauchi and Borno states. Antibody to serotype 2 was observed in all the ages studied especially 0-9 and 30-39 years. Numerically, samples collected 1-7 days after onset of symptoms had more DENV NS1 and antibodies than 7-10 days. Patients who received treatment with either or combination of antibiotics/antimalarial are more likely to be protected against dengue than untreated. Similarly, patients who were vaccinated against YF had more neutralizing antibodies to DENV than the unvaccinated and NS1 was more in unvaccinated than the vaccinated. Antibiotics/ antimalarial may ameliorate recovery from acute dengue and Yellow Fever vaccination may reduce dengue burden and its associated complications in resource-constrained countries.

Keywords:
dengue virus malaria antigen antibody serotypes Nigeria

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