Epidemiological Characteristic of Malaria Coinfected with Dengue Fever in Hodeidah, Yemen

Abstract

Introduction: Malaria and dengue fever are the most prevalent vector-borne diseases in tropical areas and represent major public health problems. They are transmitted by mosquito namely Anopheles and Aedes aegypti, respectively. Hodeidah is a high density with these vectors. Also, co-infection of these diseases has (malaria and dengue) become undetected due to lack of suspicious clinical suspicion and overlapping symptoms. Aim of the Study: The study aimed to detect the prevalence of co-infection with malaria and dengue fever, determine the clinical presentation within febrile patients in Hodeidah city and determine some potential risk factors associated with co-infection. Methods: A cross-sectional study was conducted (from January to December 2017) in febrile patients. All patients were designed into three groups: Group A (co-infected with malaria and dengue); Group B (malaria as mono-infection) and Group C (dengue as mono-infection). The diagnosis of malaria was by microscopic and rapid diagnostic test (RDT) and the dengue virus was detected using enzyme-linked immunosorbent assay (ELISA). The diagnosis was performed in Center of Tropical Medicine and Infectious Diseases (CTMID), Authority of AL-Thawra Public Hospital-Hodeidah, in collaboration with the Tihama Foundation for Medical-Pharmaceutical Studies and Research (TFMPSR), Hodeidah, Yemen. Results: Out of 270 febrile patients, 82 cases (30.4%) patients were malaria – dengue coinfection, 100 cases (37.0%) of malaria, 21 cases (7.7%) of dengue and 67 cases (24.8%) were non-malaria and non-dengue. The most common symptoms were fever, headache, arthralgia, myalgia and retro-orbital pain, where the clinical symptoms of co-infected patients were more like dengue than malaria. One death was reported in malaria – dengue coinfection, with a case fatality rate (CFR%)  of 1.2% (1/82). Conclusion: Our results show a high prevalence of malaria – dengue coinfecion in Hodeidah, Yemen as the first time. These due to a high density of vectors in this region and endemic areas for malaria and dengue. Furthermore, surveillance strategies, preventive measures and healthcare worker's education are critical for curtailing this problem and lifesaving.