Seroprevalence of Chikungunya Virus Infection and Its Sociodemographic Characteristics in Febrile Patients Attending Coast General Teaching and Referral Hospital Kenya

Abstract

Arboviruses including Chikungunya and Dengue are recognized causes of acute febrile illness, in the tropics and have been responsible for outbreaks worldwide. During the past few years, there has been a dramatic resurgence of a well-known arboviral diseases thought to be effectively controlled or unimportant. However, these arbovirus diseases are not usually regarded as a differential diagnosis in patients with fever in Kenyan health institutions because of lack of readily available and affordable diagnostic tests to detect them and a low index of suspicion. Thus, most arboviruses remain undiagnosed and as a result, the frequency of arbovirus disease and the public health threat they pose is greatly underestimated. The nonspecific nature of the clinical signs and symptoms of Chikungunya virus (CHIKV) makes it difficult to differentiate it from illnesses such as malaria, typhoid and other known bacterial infections. Despite this, few surveys have been done to document the magnitude of infection from CHIKV in the Kenyan Coast. This study was done to determine the Seroprevalence of Chikungunya virus in febrile patients attending Coast General Teaching and Referral hospital, to establish socio-demographic correlates of exposure to Chikungunya in febrile patients attending Coast General Teaching and Referral Hospital and lastly to determine the impact of temperature and rainfall in chikungunya transmission This was a retrospective hospital-based cross-sectional survey conducted at the Coast General Teaching and Referral Hospital in Mombasa Kenya. Samples used were from January 2014 to December 2015. Patients seen at Coast General Teaching and Referral Hospital presenting with febrile symptoms of unknown causes such as malaria, typhoid and other known bacterial infections were eligible. Venous blood that had been collected previously and stored for testing was used. Enzyme-linked Immunosorbent Assays (ELISA) were done to screen for the presence of CHIKV antibodies and confirmed using Focus Reduction Neutralization Test (FRNT). Data analysis was performed using R Studio version 1.2.5033 (2009-2019 R Studio, Inc.) and STATA CORP Version 14.2. Between January 2014 to December 2015, 476 eligible patients aged between 0 and 81 years were included in this study. Of these, 264 (55.46%) were male, 209 (43.91%) were female while 3 (0.63%) did not indicate their gender. The overall Seroprevalence of CHIKV was 9.7% (46). Age and occupation were significantly associated with seropositivity. CHIKV seropositivity peaked at high temperatures and during low rainfall. This study suggests people in the Kenyan coast are exposed to CHIKV and possibly other arboviruses. Further studies are required to determine the prevalence and distribution of arboviruses in the wider coastal community. There is a need to maintain constant epidemiological and entomological surveillance. Seroprevalence can be predicted using temperature and rainfall patterns.