Country experience: dengue in Ethiopia
My name is Yibeltal Akelew and I'm from the Department of Immunology and Molecular Biology School of Biomedical and Laboratory Science, Debre Markos University, Ethiopia. Despite outbreak reports and some serological surveys, the dengue virus is the most significant under-recognized arbovirus in Ethiopia. I have been working on a project looking at acute fever for a masters thesis in Ethiopia that mainly focuses on arboviruses (dengue, chikungunya, and yellow fever), bacterial causes and malaria with different biomarkers.
Photo: RNA extraction using Maxwell 16-instrument (Yibeltal Akelew)
Patients are being misdiagnosed and treated with antibiotics or anti-malarial drugs: when patients are negative for malaria, based on rapid diagnostic tests (RDT) or diagnosis using microscopy, antibiotics will be prescribed in many cases.
When we started our project with clinicians, none were thinking that dengue or arboviruses were likely to be found in Ethiopia, despite previous reports of dengue virus outbreaks. Also, there are currently more than 45,000 chikungunya cases following recent outbreaks in Diredawa, Ethiopia, yet the extent of this disease remains under-recognized. The widespread perception is that arboviruses are less likely to be found in our country, supported by the fact that there was no suspected clinical diagnosis yet.
However, our work has shown that dengue is the most prevalent cause of acute undifferentiated fever in our study area. We were using different diagnostic tests: RDTs (targeting Ig-G, Ig-M, and NS-1), ELISA (Ig-G and Ig-M) and reverse transcription PCR (RT-PCR). In the end, we found 56 positive samples in at least one of the diagnostic tests (28%). The manuscript of this work will be sent for publication soon. Moreover, we were able to confirm the dengue DEN-3 serotype using RT-PCR. This serotype is a new finding in Ethiopia, which might be spread from a neighboring country like Sudan.
In conclusion, our work emphasizes that dengue is rapidly spreading across different countries. In resource-limited countries like Ethiopia with no diagnostic facility for non-malarial febrile illness, dengue remains significantly under-recognized.
I would be glad to do further research with any collaborative researcher or organization to understand the burden and pathogenic role of dengue (immunological and molecular aspects) in Ethiopia.
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Yibeltal Akelew is a Masters student in immunology at the University of Gondar, Ethiopia. Yibeltal's project was focused on acute fever in Ethiopia, and particularly on determining the causes of acute undifferentiated fever using immunoassays. This includes many lab methods.
