Volume 86, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.


Article metrics loading...

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

Full text loading...



  1. Jupp P, McIntosh B, Monath T, , 1988. Chikungunya virus disease. , ed. The Arboviruses: Epidemiology and Ecology. Boca Raton, FL: CRC Press, 137157. [Google Scholar]
  2. Gubler DJ, Monath T, , 1988. Dengue. , ed. The Arboviruses: Ecology and Epidemiology. Boca Raton, FL: CRC Press, 223260. [Google Scholar]
  3. Leroy EM, Nkoghe D, Ollomo B, Nze-Nkogue C, Becquart P, Grard G, Pourrut X, Charrel R, Moureau G, Ndjoyi-Mbiguino A, De-Lamballerie X, , 2009. Concurrent Chikungunya and dengue virus infections during simultaneous outbreaks, Gabon, 2007. Emerg Infect Dis 15: 591593.[Crossref] [Google Scholar]
  4. Diallo M, Sall AA, Moncayo AC, Ba Y, Fernandez Z, Ortiz D, Coffey LL, Mathiot C, Tesh RB, Weaver SC, , 2005. Potential role of sylvatic and domestic African mosquito species in dengue emergence. Am J Trop Med Hyg 73: 445449. [Google Scholar]
  5. McCrae AW, Henderson BE, Kirya BG, Sampala SD, , 1971. Chikungunya virus in the Entebbe area of Uganda: isolations and epidemiology. Trans R Soc Trop Med Hyg 65: 152168.[Crossref] [Google Scholar]
  6. Vasilakis N, Cardosa J, Hanley KA, Holmes EC, Weaver SC, , 2011. Fever from the forest: prospects for the continued emergence of sylvatic dengue virus and its impact on public health. Nat Rev Microbiol 9: 532541.[Crossref] [Google Scholar]
  7. Ross RW, , 1956. The Newala epidemic. III. The virus: isolation, pathogenic properties, and relationship to the epidemic. J Hyg (Lond) 54: 177191.[Crossref] [Google Scholar]
  8. Pastorino B, Muyembe-Tamfum JJ, Bessaud M, Tock F, Tolou H, Durand JP, Peyrefitte CN, , 2004. Epidemic resurgence of Chikungunya virus in Democratic Republic of the Congo: identification of a new central African strain. J Med Virol 74: 277282.[Crossref] [Google Scholar]
  9. Gear J, Reid F, , 1957. The occurrence of dengue-like fever in north-eastern Transvaal. S Afr Med J 31: 253257. [Google Scholar]
  10. 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]
  11. Kanesa-thasan N, Chang GJ, Smoak BL, Magill A, Burrous MJ, Hoke CH, , 1998. Molecular and epidemiologic analysis of dengue virus isolates from Somalia. Emerg Infect Dis 4: 299303.[Crossref] [Google Scholar]
  12. Gubler DJ, Sather GE, Kuno G, Cabral JR, , 1986. Dengue 3 virus transmission in Africa. Am J Trop Med Hyg 35: 12801284. [Google Scholar]
  13. World Health Organization, 2009. Dengue in Africa: emergency of DENV-3, Cote d'Ivoire, 2008. Wkly Epidemiol Rec 84: 8596. [Google Scholar]
  14. Gubler DJ, , 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11: 480496. [Google Scholar]
  15. Moi ML, Takasaki T, Kotaki A, Tajima S, Lim CK, Sakamoto M, Iwagoe H, Kobayashi K, Kurane I, , 2010. Importation of dengue virus type 3 to Japan from Tanzania and Cote d'Ivoire. Emerg Infect Dis 16: 17701772.[Crossref] [Google Scholar]
  16. Gautret P, Simon F, Hervius Askling H, Bouchaud O, Leparc-Goffart I, Ninove L, Parola P, , EuroTravNet, 2010. Dengue type 3 infections in European travellers returning from the Comoros and Zanzibar, February–April 2010. Euro Surveill 15: 19541. [Google Scholar]
  17. Crump JA, Ramadhani HO, Morrissey AB, Msuya LJ, Yang L-Y, Chow S-C, Morpeth SC, Reyburn H, Njau BN, Shaw AV, Diefenthal HC, Bartlett JA, Shao JF, Schimana W, Cunningham CK, Kinabo GD, , 2011. Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected children and infants in northern Tanzania. Trop Med Int Health 16: 830837.[Crossref] [Google Scholar]
  18. Crump JA, Ramadhani HO, Morrissey AB, Saganda W, Mwako MS, Yang L-Y, Chow S-C, Morpeth SC, Reyburn H, Njau BN, Shaw AV, Diefenthal HC, Shao JF, Bartlett JA, Maro VP, , 2011. Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania. Clin Infect Dis 52: 341348.[Crossref] [Google Scholar]
  19. Mayhood MK, Afwamba IA, Odhiambo CO, Ndanu E, Thielman NM, Morrissey AB, Shao JF, Pence BW, Crump JA, , 2008. Validation, performance under field conditions, and cost-effectiveness of Capillus HIV-1/HIV-2 and Determine HIV-1/2 rapid human immunodeficiency virus antibody assays using sequential and parallel testing algorithms in Tanzania. J Clin Microbiol 46: 39463951.[Crossref] [Google Scholar]
  20. Scott LE, Crump JA, Msuya E, Morrissey AB, Venter WF, Stevens WS, , 2011. Abbott RealTime HIV-1 m2000rt viral load testing: manual extraction versus the automated m2000sp extraction. J Virol Methods 172: 7880.[Crossref] [Google Scholar]
  21. Crump JA, Scott LE, Msuya E, Morrissey AB, Kimaro EE, Shao JF, Stevens WS, , 2009. Evaluation of the Abbott m2000rt RealTime HIV-1 assay with manual sample preparation compared with the ROCHE COBAS AmpliPrep/AMPLICOR HIV-1 MONITOR 1.5 using specimens from East Africa. J Virol Methods 162: 218222.[Crossref] [Google Scholar]
  22. Lai YL, Chung YK, Tan HC, Yap HF, Yap G, Ooi EE, Ng LC, , 2007. Cost-effective real-time reverse transcriptase PCR (RT-PCR) to screen for dengue virus followed by rapid single-tube multiplex RT-PCT for serotyping the virus. J Clin Microbiol 45: 935941.[Crossref] [Google Scholar]
  23. Pastorino B, Bessaud M, Grandadam M, Murri S, Tolou HJ, Peyrefitte CN, , 2005. Development of a TaqMan RT-PCR assay without RNA extraction for the detection and quantification of African Chikungunya viruses. J Virol Methods 124: 6571.[Crossref] [Google Scholar]
  24. Scaramozzino N, Crance JM, Jouan A, DeBriel DA, Stoll F, Garin D, , 2001. Comparison of flavivirus universal primer pairs and development of a rapid, highly sensitive heminested reverse transcriptase-PCR assay for detection of flaviviruses targeting to a conserved region of the NS5 gene sequences. J Clin Microbiol 39: 19221927.[Crossref] [Google Scholar]
  25. Figueiredo LT, Simoes MC, Cavalcante SM, , 1989. Enzyme immunoassay for the detection of dengue IgG and IgM antibodies using infected mosquito cells as antigen. Trans R Soc Trop Med Hyg 83: 702707.[Crossref] [Google Scholar]
  26. World Health Organization, 2006. Antiretroviral Therapy of HIV Infection in Infants and Children: Towards Universal Access. World Health Organization, ed. Geneva: WHO, 144. [Google Scholar]
  27. Tanzania National Bureau of Statistics, 2002. Village Statistics, 2002 Population and Housing Census. Dar es Salaam, Tanzania. Available from https://www.nbs.go.tz. Accessed March 25, 2010. [Google Scholar]
  28. Saathoff E, Schneider P, Kleinfeldt V, Geis S, Haule D, Maboko L, Samky E, de Souza M, Robb M, Hoelscher M, , 2008. Laboratory reference values for health adults from southern Tanzania. Trop Med Int Health 13: 612625.[Crossref] [Google Scholar]
  29. Buchanan AM, Muro FJ, Gratz J, Crump JA, Musyoka AM, Sichangi MW, Morrissey AB, M'rimberia JK, Njau BN, Msuya LJ, Bartlett JA, Cunningham CK, , 2010. Establishment of hematological and immunological reference values for healthy Tanzanian children in the Kilimanjaro Region. Trop Med Int Health 15: 10111021. [Google Scholar]
  30. Kam YW, Ong EK, Renia L, Tong JC, Ng LF, , 2009. Immuno-biology of Chikungunya and implications for disease intervention. Microbes Infect 11: 11861196.[Crossref] [Google Scholar]
  31. Rianthavorn P, Prianantathavorn K, Wuttirattanakowit N, Theamboonlers A, Poovoravorn P, , 2010. An outbreak of Chikungunya in southern Thailand from 2008 to 2009 caused by African strains with A226V mutation. Int J Infect Dis 14 (Suppl 3): e161e165.[Crossref] [Google Scholar]
  32. Staikowsky F, Talarim F, Grivard P, Souab A, Schuffenecker I, Le Roux K, Lecuit M, Michault A, , 2009. Prospective study of chikungunya virus acute infection in the Island of La Reunion during the 2005–2006 outbreak. PLoS ONE 4: e7603.[Crossref] [Google Scholar]
  33. Schwartz O, Albert ML, , 2010. Biology and pathogenesis of Chikungunya virus. Nat Rev Microbiol 8: 491500.[Crossref] [Google Scholar]
  34. Labadie K, Larcher T, Joubert C, Mannioui A, Delache B, Brochard P, Guigand L, Dubreil L, Lebon P, Verrier B, de Lamballerie X, Suhrbier A, Cherel Y, Le Grand R, Roques P, , 2010. Chikungunya disease in nonhuman primates involves long-term viral persistence in macrophages. J Clin Invest 120: 894906.[Crossref] [Google Scholar]
  35. Rajapakse S, Rodrigo C, Rajapakse A, , 2010. Atypical manifestations of Chikungunya infection. Trans R Soc Trop Med Hyg 104: 8996.[Crossref] [Google Scholar]
  36. Das T, Jaffar-Bandjee MC, Hoarau JJ, Krejbich Trotot P, Denizot M, Lee-Pat-Yuen G, Sahoo R, Guirand P, Ramful D, Robin S, Alessandri JL, Gauzere BA, Gasque P, , 2010. Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus. Prog Neurobiol 91: 121129.[Crossref] [Google Scholar]
  37. Chretien J-P, Anyamba AA, Bedno SA, Breiman RF, Sang R, Sergon K, Powers AM, Onyango CO, Small J, Tucker CJ, Linthicum KJ, , 2007. Drought-associated Chikungunya emergence along coastal East Africa. Am J Trop Med Hyg 76: 405407. [Google Scholar]
  38. Westbrook CJ, Reiskind MH, Pesko KN, Greene KE, Lounibos LP, , 2010. Larval environmental temperature and the susceptibility of Aedes albopictus Skuse (Diptera: Culicidae) to Chikungunya virus. Vector Borne Zoonotic Dis 10: 241247.[Crossref] [Google Scholar]
  39. Lindegren G, Vene S, Lundkvist A, Falk KI, , 2005. Optimized diagnosis of acute dengue fever in Swedish travelers by a combination of reverse transcription-PCR and immunoglobulin M detection. J Clin Microbiol 43: 28502855.[Crossref] [Google Scholar]
  40. Raengsakulrach B, Nisalak A, Maneekarn N, Yenchitsomanus PT, Limsomwong C, Jairungsri A, Thirawuth V, Green S, Kalayanarooj S, Suntayakorn S, Sittisombut N, Malasit P, Vaughn D, , 2002. Comparison of four reverse transcription-polymerase chain reaction procedures for the detection of dengue virus in clinical specimens. J Virol Methods 105: 219232.[Crossref] [Google Scholar]
  41. Gubler DJ, Gubler DJ, Kuno G, , 1997. Laboratory diagnosis of dengue virus infections. , eds. Dengue and Dengue Hemorrhagic Fever. Oxford: CABI, 31333. [Google Scholar]
  42. Blacksell SD, Mammen MP, Thongpaseuth S, Gibbons RV, Jarman RG, Jenjaroen K, Nisalak A, Phetsouvanh R, Newton PN, Day NPJ, , 2008. Evaluation of the Panbio dengue virus nonstructural 1 antigen detection and immunoglobulin M antibody enzyme-linked immunosorbent assays for the diagnosis of acute dengue infections in Laos. Diagn Microbiol Infect Dis 60: 4349.[Crossref] [Google Scholar]
  43. Vazquez S, Hafner G, Ruiz D, Calzada N, Guzman MG, , 2007. Evaluation of immunoglobulin M and G capture enzyme-linked immunosorbent assay Panbio kits for diagnostic dengue infections. J Clin Virol 39: 194198.[Crossref] [Google Scholar]
  44. Watthanaworawit W, Turner P, Turner CL, Tanganuchitcharnchai A, Jarman RG, Blacksell SD, Nosten FH, , 2011. A prospective evaluation of diagnostic methodologies for the acute diagnosis of dengue virus infection on the Thailand-Myanmar border. Trans R Soc Trop Med Hyg 105: 3237.[Crossref] [Google Scholar]
  45. McBride WJ, Mullner H, LaBrooy JT, Wronski I, , 1998. The 1993 dengue 2 epidemic in north Queensland: a serosurvey and comparison of hemagglutination inhibition with ELISA. Am J Trop Med Hyg 59: 457461. [Google Scholar]

Data & Media loading...

  • Received : 21 Jun 2011
  • Accepted : 29 Sep 2011
  • Published online : 01 Jan 2012

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