Chikungunya and dengue virus infection among febrile children in North-Eastern Tanzania: prospective study

Abstract Background There are several unknown illnesses including chikungunya and dengue viruses that present with fever in children. Therefore there are many cases that are misdiagnosed. Consequently we performed a study to determine the clinical characteristics of dengue and chikungunya in order to assist clinicians in management. Methods A total of 196 children with history of fever for ≤ 10 days were enrolled prospectively at Kilimanjaro Christian Medical Centre from September 2015 to May 2016. All cases were screened for chikungunya and dengue viruses by PCR as well as other febrile illnesses such as malaria, bacteria and HIV through other diagnostic method. We performed logistic regression to find association between clinical symptoms and chikungunya infection. Results In our study, 21.9% (43/196) of the cases received laboratory investigations and the diagnoses were as follows; malaria only (n = 1, 0.5%), bacterial infections only (n = 4, 2.0%), HIV/AIDS only (n = 37, 18.9%), as well as malaria, meningitis and urinary tract co-infection (n = 1, 0.5%). Further investigation of all cases revealed that 11.7%( 23) had chikungunya virus while none had dengue virus. For the cases of chikungunya, 78.3% (18) were below 5 years of age, 65.2%( 15) were females, majority were from Kilimanjaro 95.7%( 22) and Arusha region 4.3% (1). The clinical features were as follows; nausea/vomit 50.0% (98), cough 48.5% (95), convulsion/comma 34.7%( 68), diarrhea 26.0% (51), joint pain 13.3% (26), sore throat 7.1%( 14), rashes 4.1%(8)chills 2.6%༈5༉. Nevertheless, there was no statistical significant relationship between chikungunya virus and aforementioned symptoms/signs according to logistic regression. Conclusion This study reveals that chikungunya infection is common cause of febrile illnesses; however it does not have treatment. Therefore, we encourage chikungunya infection to be included in routine investigation as these children are receiving inappropriate treatments such as antibiotics and ant malarial which should be avoided in order to minimize over use of drugs and resource wastage.