TY - JOUR
T1 - A multidisciplinary investigation of the first Chikungunya virus outbreak in Matadi in the Democratic Republic of the Congo
AU - De Weggheleire, Anja
AU - Nkuba-Ndaye, Antoine
AU - Mbala-Kingebeni, Placide
AU - Mariën, Joachim
AU - Kindombe-Luzolo, Esaie
AU - Ilombe, Gillon
AU - Mangala-Sonzi, Donatien
AU - Binene-Mbuka, Guillaume
AU - De Smet, Birgit
AU - Vogt, Florian
AU - Selhorst, Philippe
AU - Matungala-Pafubel, Mathy
AU - Nkawa, Frida
AU - Vulu, Fabien
AU - Mossoko, Mathias
AU - Pukuta-Simbu, Elisabeth
AU - Kinganda-Lusamaki, Eddy
AU - Van Bortel, Wim
AU - Wat'senga-Tezzo, Francis
AU - Makiala-Mandanda, Sheila
AU - Ahuka-Mundeke, Steve
N1 - FTX; DOAJ; (CC BY 4.0)
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - chikungunya
KW - outbreak investigation
KW - multidisciplinary
KW - Democratic Republic of the Congo
KW - Aedes albopictus
KW - FEVER
KW - EPIDEMIOLOGY
KW - INFECTIONS
KW - BO
U2 - 10.3390/v13101988
DO - 10.3390/v13101988
M3 - A1: Web of Science-article
C2 - 34696418
SN - 1999-4915
VL - 13
JO - Viruses-Basel
JF - Viruses-Basel
IS - 10
M1 - 1988
ER -