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A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo

Authors :
Anja De Weggheleire
Antoine Nkuba-Ndaye
Placide Mbala-Kingebeni
Joachim Mariën
Esaie Kindombe-Luzolo
Gillon Ilombe
Donatien Mangala-Sonzi
Guillaume Binene-Mbuka
Birgit De Smet
Florian Vogt
Philippe Selhorst
Mathy Matungala-Pafubel
Frida Nkawa
Fabien Vulu
Mathias Mossoko
Elisabeth Pukuta-Simbu
Eddy Kinganda-Lusamaki
Wim Van Bortel
Francis Wat’senga-Tezzo
Sheila Makiala-Mandanda
Steve Ahuka-Mundeke
Source :
Viruses, Vol 13, Iss 10, p 1988 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

Early March 2019, health authorities of Matadi in the Democratic Republic of the Congo alerted a sudden increase in acute fever/arthralgia cases, prompting an outbreak investigation. We collected surveillance data, clinical data, and laboratory specimens from clinical suspects (for CHIKV-PCR/ELISA, malaria RDT), semi-structured interviews with patients/caregivers about perceptions and health seeking behavior, and mosquito sampling (adult/larvae) for CHIKV-PCR and estimation of infestation levels. The investigations confirmed a large CHIKV outbreak that lasted February–June 2019. The total caseload remained unknown due to a lack of systematic surveillance, but one of the two health zones of Matadi notified 2686 suspects. Of the clinical suspects we investigated (n = 220), 83.2% were CHIKV-PCR or IgM positive (acute infection). One patient had an isolated IgG-positive result (while PCR/IgM negative), suggestive of past infection. In total, 15% had acute CHIKV and malaria. Most adult mosquitoes and larvae (>95%) were Aedes albopictus. High infestation levels were noted. CHIKV was detected in 6/11 adult mosquito pools, and in 2/15 of the larvae pools. This latter and the fact that 2/6 of the CHIKV-positive adult pools contained only males suggests transovarial transmission. Interviews revealed that healthcare seeking shifted quickly toward the informal sector and self-medication. Caregivers reported difficulties to differentiate CHIKV, malaria, and other infectious diseases resulting in polypharmacy and high out-of-pocket expenditure. We confirmed a first major CHIKV outbreak in Matadi, with main vector Aedes albopictus. The health sector was ill-prepared for the information, surveillance, and treatment needs for such an explosive outbreak in a CHIKV-naïve population. Better surveillance systems (national level/sentinel sites) and point-of-care diagnostics for arboviruses are needed.

Details

Language :
English
ISSN :
19994915
Volume :
13
Issue :
10
Database :
Directory of Open Access Journals
Journal :
Viruses
Publication Type :
Academic Journal
Accession number :
edsdoj.f7044aa9ee5d47d195163e74a7b3a1b3
Document Type :
article
Full Text :
https://doi.org/10.3390/v13101988