Serological and molecular evidence of chikungunya virus infection among febrile outpatients seeking healthcare in Northern Malawi

ABSTRACT

Introduction: Despite global evidence of chikungunya fever (CHIKF) in humans that is caused by chikungunya virus (CHIKV), little is known about the occurrence of CHIKF in Malawi. This study was conducted to determine the seroprevalence of CHIKF and to molecularly confirm the presence of CHIKV ribonucleic acid (RNA) among febrile outpatients seeking health care at Mzuzu Central Hospital in the Northern Region of Malawi.

Methods: Enzyme-immunosorbent assay (ELISA) was used to detect the presence or absence of specific antibodies against CHIKV. Reverse transcription-polymerase chain reaction (RT-PCR) was conducted on randomly selected anti-CHIKV IgM-positive samples to detect CHIKV RNA.

Results: Out of 119 CHIKF suspected samples analyzed, 73 tested positive for anti-CHIKV IgM antibodies, with an overall seroprevalence of 61.3%. Most of the CHIKV infected individuals presented with joint pain, abdominal pain, vomiting and nose bleeding with seroprevalence of 45.2%, 41.1%, 16.4% and 12.3%, respectively. All the randomly selected samples that were positive for CHIKV anti-IgM by ELISA had detectable CHIKV RNA by RT-PCR.

Conclusion: The presence of anti-CHIKV IgM antibodies suggests the presence of recent CHIKV infection. We therefore recommend for the inclusion of CHIKF as the differential diagnosis in febrile ill patients in Mzuzu city, Malawi.

KEYWORDS:

• Chikungunya virus
• seroprevalence
• molecular
• febrile illnesses
• Malawi
• Arboviruses

Acknowledgments

The authors are very grateful to all the participants who took part in this study. We are also very grateful to the laboratory team at Vector-borne Diseases Laboratory, The University of Malawi for the technical expertise during the laboratory analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data and materials

The dataset analyzed during the current study are available from the corresponding author on a reasonable request.

Ethical considerations

Ethical approval to conduct the study was obtained from the College of Medicine Research and Ethics Committee (COMREC) (P.02/20/2956). All study participants were consented and assented by the parents and guardians to participate in the study. The records of all participants were documented through unique identification numbers for anonymity.

Additional information

Funding

This study was supported by the World Bank (WB ACE II Grant P151847) through the Government of the United Republic of Tanzania to FK at SACIDS Africa Centre of Excellence for Infectious Diseases, SACIDS Foundation for One Health, Sokoine University of Agriculture (SUA), Morogoro, Tanzania.