Volume 97, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Malaria remains a significant cause of morbidity and mortality in West Africa, but the contribution of other vector-borne infections (VBIs) to the burden of disease has been understudied. We used rapid diagnostic tests (RDTs) for three VBIs to test blood samples from 1,795 febrile residents of Bo City, Sierra Leone, over a 1-year period in 2012–2013. In total, 24% of the tests were positive for malaria, fewer than 5% were positive for markers of dengue virus infection, and 39% were positive for IgM directed against chikungunya virus (CHIKV) or a related alphavirus. In total, more than half (55%) of these febrile individuals tested positive for at least one of the three VBIs, which highlights the very high burden of vector-borne diseases in this population. The prevalence of positives on the Chikungunya IgM and dengue tests did not vary significantly with age ( > 0.36), but higher rates of malaria were observed in children < 15 years of age ( < 0.001). Positive results on the Chikungunya IgM RDTs were moderately correlated with rainfall ( = 0.599). Based on the high prevalence of positive results on the Chikungunya IgM RDTs from individuals Bo and its environs, there is a need to examine whether an ecological shift toward a greater burden from CHIKV or related alphaviruses is occurring in other parts of Sierra Leone or the West African region.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. GBD 2013 DALYs and HALE Collaborators, 2015. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and health life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet 386: 21452191.[Crossref] [Google Scholar]
  2. GBD 2013 Mortality and Cause of Death Collaborators, 2015. Global, regional, and national age-sex specific and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386: 117171.[Crossref] [Google Scholar]
  3. World Health Organization, 2015. World Malaria Report 2015. Geneva, Switzerland: World Health Organization. [Google Scholar]
  4. Statistics Sierra Leone (SSL), 2014. Malaria Indicator Survey 2013 Final Report. Freetown, Sierra Leone: SSL and ICF International. [Google Scholar]
  5. Roth PJ, Grant DS, Ngegbai AS, Schieffelin J, McClelland RS, Jarrett OD, , 2015. Factors associated with mortality in febrile patients in a government referral hospital in the Kenema district of Sierra Leone. Am J Trop Med Hyg 92: 172177.[Crossref] [Google Scholar]
  6. Ansumana R, Jacobsen KH, Leski TA, Covington AL, Bangura U, Hodges MH, Lin B, Bockarie AS, Lamin JM, Bockarie MJ, Stenger DA, , 2013. Reemergence of chikungunya virus in Bo, Sierra Leone. Emerg Infect Dis 19: 11081110.[Crossref] [Google Scholar]
  7. de Araújo Lobo JM, Mores CN, Bausch DG, Christofferson RC, , 2016. Serological evidence of under-reported dengue circulation in Sierra Leone. PLoS Negl Trop Dis 10: e0004613.[Crossref] [Google Scholar]
  8. Boisen ML, ., 2015. Multiple circulating infections can mimic the early stages of viral hemorrhagic fevers and possible human exposure to filoviruses in Sierra Leone prior to the 2014 outbreak. Viral Immunol 28: 1931.[Crossref] [Google Scholar]
  9. Schoepp RJ, Rossi CA, Khan SH, Goba A, Fair JN, , 2014. Undiagnosed acute viral febrile illnesses, Sierra Leone. Emerg Infect Dis 20: 1175.[Crossref] [Google Scholar]
  10. Climate Change Knowledge Portal: The World Bank Group, 2016. Average Monthly Temperature and Rainfall for Sierra Leone from 1990–2012 . Available at: http://sdwebx.worldbank.org/climateportal/index.cfm?page=country_historical_climate&ThisCCode=SLE. Accessed December 21, 2016.
  11. Djallé D, Gody JC, Moyen JM, Tekpa G, Ipero J, Madji N, Breurec S, Manirakiza A, , 2014. Performance of Paracheck™-Pf, SD Bioline malaria Ag-Pf and SD Bioline malaria Ag-Pf/pan for diagnosis of falciparum malaria in the Central African Republic. BMC Infect Dis 14: 109.[Crossref] [Google Scholar]
  12. World Health Organization, 2015. Malaria Rapid Diagnostic Test Performance: Results of WHO Product Testing of Malaria RDTs: Round 6 (2014–2015). Geneva, Switzerland: World Health Organization. [Google Scholar]
  13. World Health Organization, 2016. Malaria: Rapid Diagnostic Tests . Available at: http://www.who.int/malaria/areas/diagnosis/rapid_diagnostic_tests/en/. Accessed December 21, 2016.
  14. Odaga J, Sinclair D, Lokong JA, Donegan S, Hopkins H, Garner P, , 2014. Rapid diagnostic tests versus clinical diagnosis for managing people with fever in malaria endemic settings. Cochrane Database Syst Rev 4: CD008998. [Google Scholar]
  15. Standard Diagnostics, 2016. SD Chikungunya IgM . Available at: http://www.standardia.com/en/home/product/Rapid_Diagnostic_Test/Anti-Chickungunya_IgM.html. Accessed December 21, 2016.
  16. Johnson BW, Goodman CH, Holloway K, de Salazar PM, Valadere AM, Drebot MA, , 2016. Evaluation of commercially available chikungunya virus immunoglobulin M detection assays. Am J Trop Med Hyg 95: 182192.[Crossref] [Google Scholar]
  17. Kosasih H, Widjaja S, Surya E, Hadiwijaya SH, Butarbutar DP, Jaya UA, Nurhayati Alisjahbana B, Williams M, , 2012. Evaluation of two IgM rapid immunochromatographic tests during circulation of Asian lineage chikungunya virus. Southeast Asian J Trop Med Public Health 43: 5561. [Google Scholar]
  18. Prat CM, Flusin O, Panella A, Tenebray B, Lanciotti R, Leparc-Goffart I, , 2014. Evaluation of commercially available serologic diagnostic tests for chikungunya virus. Emerg Infect Dis 20: 21292132.[Crossref] [Google Scholar]
  19. O'Hearn AE, Voorhees MA, Fetterer DP, Wauquier N, Coomber MR, Bangura J, Fair JN, Gonzalez J-P, Schoepp RJ, , 2016. Serosurveillance of viral pathogens circulating in West Africa. Virol J 13: 163.[Crossref] [Google Scholar]
  20. Baba M, Logue CH, Oderinde B, Abdulmaleek H, Williams J, Lewis J, Laws TR, Hewson R, Marcello A, Agaro P, , 2013. Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria. J Infect Dev Ctries 7: 5159.[Crossref] [Google Scholar]
  21. Jentes ES, Robinson J, Johnson BW, Conde I, Sakouvougui Y, Iverson J, Beecher S, Bah MA, Diakite F, Coulibaly M, Bausch DG, , 2010. Acute arboviral infections in Guinea, West Africa, 2006. Am J Trop Med Hyg 83: 388394.[Crossref] [Google Scholar]

Data & Media loading...

Supplemental Table

  • Received : 11 Oct 2016
  • Accepted : 12 Mar 2017
  • Published online : 07 Aug 2017

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error