Epidemiological analysis of emerging and re-emerging virus infections in Mozambique

Ali, Sadia (2022): Epidemiological analysis of emerging and re-emerging virus infections in Mozambique: from arbovirus to SARS-CoV-2. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background Emerging and re-emerging viral infections are an increasing important concern for global public health. Previous studies conducted in Mozambique have shown occurrence of several emerging virus infections, including arbovirus. However, existing evidence on arbovirus is not recent and no data exists on co-occurrence of arbovirus and malaria. Besides, the ongoing COVID-19 pandemic hit Mozambique since March 2020, causing until mid-2021 three waves. There is a lack of an in-depth characterization of the epidemiologic profile of COVID-19 in Mozambique. Methods Samples from acute febrile patients selected retrospectively (2009 to 2015) and prospec-tively (2017 a 2018) were screened for Dengue, Chikungunya and Zika virus using com-mercially available ELISA. Additionally, we reviewed records of suspected and con-firmed cases of COVID-19 collected in 11 provinces of Mozambique between March 2020 to September 2021. All of confirmed COVID-19 cases were subsequently mapped. Results From the 895 retrieved samples, the positive samples we found 54 (6.0%) were IgM an-ti-CHIKV, 160 (17.8%) positive for IgG anti-CHIKV, 16/577 (2.8%) for DENV-NS1. And IgM anti-ZIKV were also found in 42/850 (4.9%). For the prospective approach, of the 906 participants, the positive frequency was as follow 134 (14.8%) for IgM anti-CHIKV, 332 (36.6%) for IgG anti-CHIKV, 64 (7.1%) for IgM anti-DENV, 16 (1.8%) NS1-DENV and 83 (9.2%) for IgM anti-ZIKV. Malaria was diagnosed in 56 (6.2%) participants, 16 (1.1%) of whom were also IGM-positive for CHIKV, 3 (5.4%) for DENV-IgM and 10 (0.4%) for ZIKV. Regarding COVID-19, a total 778,926 individuals were screened for SARS-CoV-2 using Rt-PCR real time and Ag-RDT between 22 March 2020 and 30 September 2021, of whom (17.8%; 138,468/778,926) returned positive. The number of cas-es was increased by more than 60,000 from the first to the third wave of COVID-19 pan-demicand the Chi-square test revealed significant differences between the three waves (p<0.01). Conclusion This study represents the largest serological study of arbovirus in febrile patients con-ducted in Mozambique. The results from this study indicate that first: for several years CHIKV, DENV and ZIKV have silently circulated and the Mozambicans across all prov-inces. And second, that co-occurrence between malaria and CHIKV, DENV and ZIKV among febrile patients is more common than previously thought. In addition, our analysis also describes the three waves of COVID-19 in Mozambique. The findings raise the need for increased awareness of arboviral infection as another cause of acute febrile illness and recommend active surveillance of viral emerging diseases to improve human public health.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Emerging infectious diseases, Arbovirus, Dengue virus, Chikungunya virus, Zika virus, Malaria, Epidemiology, SARS-CoV-2, COVID-19, Mozambique
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 24. Oktober 2022
• 1. Bericht­erstatter:in: Hölscher, Michael