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A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo
Early March 2019, health authorities of Matadi in the Democratic Republic of the Congo alerted a sudden increase in acute fever/arthralgia cases, prompting an outbreak investigation. We collected surveillance data, clinical data, and laboratory specimens from clinical suspects (for CHIKV-PCR/ELISA,...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541179/ https://www.ncbi.nlm.nih.gov/pubmed/34696418 http://dx.doi.org/10.3390/v13101988 |
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author | De Weggheleire, Anja Nkuba-Ndaye, Antoine Mbala-Kingebeni, Placide Mariën, Joachim Kindombe-Luzolo, Esaie Ilombe, Gillon Mangala-Sonzi, Donatien Binene-Mbuka, Guillaume De Smet, Birgit Vogt, Florian Selhorst, Philippe Matungala-Pafubel, Mathy Nkawa, Frida Vulu, Fabien Mossoko, Mathias Pukuta-Simbu, Elisabeth Kinganda-Lusamaki, Eddy Van Bortel, Wim Wat’senga-Tezzo, Francis Makiala-Mandanda, Sheila Ahuka-Mundeke, Steve |
author_facet | De Weggheleire, Anja Nkuba-Ndaye, Antoine Mbala-Kingebeni, Placide Mariën, Joachim Kindombe-Luzolo, Esaie Ilombe, Gillon Mangala-Sonzi, Donatien Binene-Mbuka, Guillaume De Smet, Birgit Vogt, Florian Selhorst, Philippe Matungala-Pafubel, Mathy Nkawa, Frida Vulu, Fabien Mossoko, Mathias Pukuta-Simbu, Elisabeth Kinganda-Lusamaki, Eddy Van Bortel, Wim Wat’senga-Tezzo, Francis Makiala-Mandanda, Sheila Ahuka-Mundeke, Steve |
author_sort | De Weggheleire, Anja |
collection | PubMed |
description | Early March 2019, health authorities of Matadi in the Democratic Republic of the Congo alerted a sudden increase in acute fever/arthralgia cases, prompting an outbreak investigation. We collected surveillance data, clinical data, and laboratory specimens from clinical suspects (for CHIKV-PCR/ELISA, malaria RDT), semi-structured interviews with patients/caregivers about perceptions and health seeking behavior, and mosquito sampling (adult/larvae) for CHIKV-PCR and estimation of infestation levels. The investigations confirmed a large CHIKV outbreak that lasted February–June 2019. The total caseload remained unknown due to a lack of systematic surveillance, but one of the two health zones of Matadi notified 2686 suspects. Of the clinical suspects we investigated (n = 220), 83.2% were CHIKV-PCR or IgM positive (acute infection). One patient had an isolated IgG-positive result (while PCR/IgM negative), suggestive of past infection. In total, 15% had acute CHIKV and malaria. Most adult mosquitoes and larvae (>95%) were Aedes albopictus. High infestation levels were noted. CHIKV was detected in 6/11 adult mosquito pools, and in 2/15 of the larvae pools. This latter and the fact that 2/6 of the CHIKV-positive adult pools contained only males suggests transovarial transmission. Interviews revealed that healthcare seeking shifted quickly toward the informal sector and self-medication. Caregivers reported difficulties to differentiate CHIKV, malaria, and other infectious diseases resulting in polypharmacy and high out-of-pocket expenditure. We confirmed a first major CHIKV outbreak in Matadi, with main vector Aedes albopictus. The health sector was ill-prepared for the information, surveillance, and treatment needs for such an explosive outbreak in a CHIKV-naïve population. Better surveillance systems (national level/sentinel sites) and point-of-care diagnostics for arboviruses are needed. |
format | Online Article Text |
id | pubmed-8541179 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85411792021-10-24 A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo De Weggheleire, Anja Nkuba-Ndaye, Antoine Mbala-Kingebeni, Placide Mariën, Joachim Kindombe-Luzolo, Esaie Ilombe, Gillon Mangala-Sonzi, Donatien Binene-Mbuka, Guillaume De Smet, Birgit Vogt, Florian Selhorst, Philippe Matungala-Pafubel, Mathy Nkawa, Frida Vulu, Fabien Mossoko, Mathias Pukuta-Simbu, Elisabeth Kinganda-Lusamaki, Eddy Van Bortel, Wim Wat’senga-Tezzo, Francis Makiala-Mandanda, Sheila Ahuka-Mundeke, Steve Viruses Article Early March 2019, health authorities of Matadi in the Democratic Republic of the Congo alerted a sudden increase in acute fever/arthralgia cases, prompting an outbreak investigation. We collected surveillance data, clinical data, and laboratory specimens from clinical suspects (for CHIKV-PCR/ELISA, malaria RDT), semi-structured interviews with patients/caregivers about perceptions and health seeking behavior, and mosquito sampling (adult/larvae) for CHIKV-PCR and estimation of infestation levels. The investigations confirmed a large CHIKV outbreak that lasted February–June 2019. The total caseload remained unknown due to a lack of systematic surveillance, but one of the two health zones of Matadi notified 2686 suspects. Of the clinical suspects we investigated (n = 220), 83.2% were CHIKV-PCR or IgM positive (acute infection). One patient had an isolated IgG-positive result (while PCR/IgM negative), suggestive of past infection. In total, 15% had acute CHIKV and malaria. Most adult mosquitoes and larvae (>95%) were Aedes albopictus. High infestation levels were noted. CHIKV was detected in 6/11 adult mosquito pools, and in 2/15 of the larvae pools. This latter and the fact that 2/6 of the CHIKV-positive adult pools contained only males suggests transovarial transmission. Interviews revealed that healthcare seeking shifted quickly toward the informal sector and self-medication. Caregivers reported difficulties to differentiate CHIKV, malaria, and other infectious diseases resulting in polypharmacy and high out-of-pocket expenditure. We confirmed a first major CHIKV outbreak in Matadi, with main vector Aedes albopictus. The health sector was ill-prepared for the information, surveillance, and treatment needs for such an explosive outbreak in a CHIKV-naïve population. Better surveillance systems (national level/sentinel sites) and point-of-care diagnostics for arboviruses are needed. MDPI 2021-10-03 /pmc/articles/PMC8541179/ /pubmed/34696418 http://dx.doi.org/10.3390/v13101988 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article De Weggheleire, Anja Nkuba-Ndaye, Antoine Mbala-Kingebeni, Placide Mariën, Joachim Kindombe-Luzolo, Esaie Ilombe, Gillon Mangala-Sonzi, Donatien Binene-Mbuka, Guillaume De Smet, Birgit Vogt, Florian Selhorst, Philippe Matungala-Pafubel, Mathy Nkawa, Frida Vulu, Fabien Mossoko, Mathias Pukuta-Simbu, Elisabeth Kinganda-Lusamaki, Eddy Van Bortel, Wim Wat’senga-Tezzo, Francis Makiala-Mandanda, Sheila Ahuka-Mundeke, Steve A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo |
title | A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo |
title_full | A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo |
title_fullStr | A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo |
title_full_unstemmed | A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo |
title_short | A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo |
title_sort | multidisciplinary investigation of the first chikungunya virus outbreak in matadi in the democratic republic of the congo |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541179/ https://www.ncbi.nlm.nih.gov/pubmed/34696418 http://dx.doi.org/10.3390/v13101988 |
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