Correlation and epidemiologic distribution of emerging coinfections of Plasmodium falciparum and dengue virus among febrile children in malaria-endemic zones in western Kenya

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Objectives To determine correlation and epidemiological distribution of emerging coinfections of P.falciparum and dengue fever among febrile children in malaria endemic zones in western Kenya Design Prospective cohort study Methods This study was conducted in Kisumu and Busia Counties in western Kenya. Kisumu County is an urban setting while Busia has both peri-urban and rural settings. All the level 2 to 4 public health facilities in Kisumu Central Sub County and Bunyala Sub County in Busia were included. The number of participants recruited per facility was based on the facility level proportions. From each facility level, 18 and 19 participants were recruited in Kisumu and Busia respectively. A total of 380 febrile children below 5 years who screened positive for malaria and or dengue virus and their parents/ guardians agreed to participate were recruited. Demographic parameters were simultaneously analyzed. Statistical analysis was performed using Chi-square test Results Out of the 1,004 participants screened, 380 turned seropositive for either malaria, dengue or co-infected. The overall disease burden was 37.8 %(380/1004). Prevalence of P.falciparum, dengue and coinfections were: 21.4 %(215/1004), 8.9 %(90/1004) and 7.5 %(75/1004) respectively. Busia had the highest P.falciparum- only infections ((31 %(118/380)) while Kisumu had the highest dengue-only infections ((16.6 %(63/380). The distribution of these diseases was not random across the counties but rather associated with the location (X² = 19.45, p < 0.001). At the county level, differences in prevalence were statistically significant for both dengue (p = 0.038) and malaria (p < 0.001), Conclusion This study finding is suggestive of an active spread of dengue virus infections leading to coinfections in this geographical region where malaria is endemic. The high temperatures, precipitation and humidity experienced around Lake Victoria is favoring mosquito vector multiplication hence the sustained mosquito transmitted disease burden. It is also important to empower clinicians on differential diagnoses for appropriate case management as the disease patterns vary meaningfully between the two study sites.

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