الفهرس 
TitleOnly 14 pages are availabe for public view
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Abstract
Dengue is an acute mosquito-borne viral infection that places a significant socioeconomic and disease burden on many subtropical and tropical regions of the world (infecting 2.5 billion people worldwide). As a result of practices that are conducive for mosquito breading, its vector is widespread in Sudan and this could result to possible DENV outbreaks in the Red Sea State, Sudan and beyond.
The objective of this study was to determine the sero-prevalence of acute infections of Dengue virus among participants presenting with malaria-like symptoms (fever, headache, rash, vomit, and joint pain) in Port Sudan teaching hospital, Sudan.
This was a cross-sectional study with 540 patients complaining of fever, headache, going pain, vomiting, presenting at Port Sudan teaching hospital, Sudan, during the period from the November to December 2017. Dengue serotype prevalence was determined using DEN-IgM and IgG antibodies by enzyme linked immunosorbent assay (ELISA). Malaria infection was detected using direct microscopy (Thick blood film) by Giemsa stain.
Out of the 540 patients, 56.5 % (305) were females and 235 (43.5 %) were males. Only 0.2 % (1/540) was positive for DENV IgM and 9.4 % (51/540) for DENV IgG. The co infection was 27 (5%) out of which 14 were male and 13 were females. Malaria prevalence was 70.7 % (382/540). Co-infection was 27 (5%). According to residence there were 212 (38.3%) cases living in the eastern province, 183 (33.9%) in the southern dium, 145 (26.9%) in town center. The median age was 23 years. The common symptom among the cases included in this study were high grade fever (100%), headache (100%), joint pain (100%), followed by anorexia (37.6%), Abdominal Pain (30.4%), vomiting (19.4%), Fatigue (22.2%), eye pain (5.2%) and skin rash (0.7%).
Our study highlights the global prevalence of cases of co-infection and their geographical distribution, which could help in systematic planning, surveillance, diagnosis and health care delivery to the affected population.
Even with the scarce case reports in Africa, the co-infections of malaria and dengue have recently been recognized to be an important clinical problem. Considering the possibility of concurrent infection in cases of atypical clinical manifestations or acute febrile illness, an early diagnosis is essential. Thereby, the treatment regime can be lifesaving.
Further study is needed to fully identify the factors associated with and predisposing to dengue infection, surveillance and intensive vector control program should be instituted.
IN CONCLUSION
1. Dengue and Malaria are endemic in many parts of our country, cause profound physical effects and financial impact to the patients and their families.
2. This study found that over a period between November to December 2017, the incidence of dengue-malaria co-infection was (27) 5% of 540 suspected dengue fever cases.
3. Prolonged and high-grade fever, thrombocytopenia, diarrhea, Jaundice and hepatomegaly were some of the signs and symptoms associated with cases of coinfection. Therefore,
Summary and conclusion
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physicians and health care workers need to distinguish between dengue viral infection and malaria infection for appropriate case management and control operations, as both infections cause many constitutional clinical symptoms and may not be clinically distinguishable.
4. Our study highlights the global prevalence of cases of coinfection and their geographical distribution, which could help in systematic planning, surveillance, diagnosis and health care delivery to the affected population.
5. Even with the scarce case reports in Africa, the co-infections of malaria and dengue have recently been recognized to be an important clinical problem. Considering the possibility of concurrent infection in cases of atypical clinical manifestations or acute febrile illness, an early diagnosis is essential. Thereby, the treatment regime can be lifesaving.
6. There is a great need to increase awareness of this concurrent infection among physicians and other healthcare personnel, and there is also a need for them to report the incidences.
7. Development of new diagnostic tests to detect both infections in a single test format, and the implementation of public engagement programs for prevention and control of these mosquito transmitted infections, are warranted.
8. Further detailed studies and operational research with more advanced epidemiological methodologies are important to fill the existing knowledge gaps in terms of dengue dynamics in the region.
9. Additionally, advanced monitoring vector dynamics would be helpful in determining the presence of contemporaneous infections in a locality with considerable accuracy, as well as formulating strategies and plans with a greater emphasis on vector control methods to reduce the transmission of infection and control future epidemics.
10. Effective and continuous monitoring of resistance status in vectors is the most important factor in managing resistance and as soon as early signs of resistance are noticed, alternative insecticides and approaches for vector control must be used.
11. Virus isolation attempts and subsequent molecular characterization studies (viral genome sequencing and phylogeny) are deemed necessary for tracing the movement of the virus in the region and to determine the genetic lineages of DENV serotypes circulating in Sudan.
12. While there is no vaccine or specific treatment for dengue, malaria is treatable; however, any delay in treatment may lead to poor outcomes.
13. Now dengue is both a health threat and endemic to almost all Provinces of Sudan. Therefore, more scientific research in a developing country like Sudan is needed in order to develop new or improved dengue control approaches and techniques.