|
1
|
De Weggheleire A, Nkuba-Ndaye A, Mbala-Kingebeni P, Mariën J, Kindombe-Luzolo E, Ilombe G, Mangala-Sonzi D, Binene-Mbuka G, De Smet B, Vogt F, Selhorst P, Matungala-Pafubel M, Nkawa F, Vulu F, Mossoko M, Pukuta-Simbu E, Kinganda-Lusamaki E, Van Bortel W, Wat’senga-Tezzo F, Makiala-Mandanda S, Ahuka-Mundeke S. A Multidisciplinary Investigation of the First Chikungunya Virus Outbreak in Matadi in the Democratic Republic of the Congo. Viruses 2021; 13:v13101988. [PMID: 34696418 PMCID: PMC8541179 DOI: 10.3390/v13101988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/29/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Anja De Weggheleire
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
- Correspondence: ; Tel.: +32-494-368-535
| | - Antoine Nkuba-Ndaye
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier University, 34090 Montpellier, France
| | - Placide Mbala-Kingebeni
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Joachim Mariën
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Esaie Kindombe-Luzolo
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Gillon Ilombe
- Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (G.I.); (G.B.-M.); (F.W.-T.)
- Global Health Institute, Antwerp University, 2000 Antwerp, Belgium
| | - Donatien Mangala-Sonzi
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Guillaume Binene-Mbuka
- Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (G.I.); (G.B.-M.); (F.W.-T.)
| | - Birgit De Smet
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Florian Vogt
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia
| | - Philippe Selhorst
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Mathy Matungala-Pafubel
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Frida Nkawa
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Fabien Vulu
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| | - Mathias Mossoko
- Direction de Lutte contre la Maladie, Ministry of Health, B.P. 3040 Kinshasa I, Democratic Republic of the Congo;
| | - Elisabeth Pukuta-Simbu
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Eddy Kinganda-Lusamaki
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Wim Van Bortel
- Outbreak Research Team, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.M.); (B.D.S.); (F.V.); (P.S.); (W.V.B.)
| | - Francis Wat’senga-Tezzo
- Department of Entomology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (G.I.); (G.B.-M.); (F.W.-T.)
| | - Sheila Makiala-Mandanda
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
| | - Steve Ahuka-Mundeke
- Department of Virology, National Institute of Biomedical Research, B.P. 1197 Kinshasa I, Democratic Republic of the Congo; (A.N.-N.); (P.M.-K.); (E.K.-L.); (F.N.); (E.P.-S.); (E.K.-L.); (S.M.-M.); (S.A.-M.)
- Department of Medical Biology, University of Kinshasa, B.P. 127 Kinshasa IX, Democratic Republic of the Congo; (D.M.-S.); (M.M.-P.); (F.V.)
| |
Collapse
|