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Investigating the etiologies of non-malarial febrile illness in Senegal using metagenomic sequencing

Article scientifique 2024 Anglais

Résumé

The worldwide decline in malaria incidence is revealing the extensive burden of non-malarial febrile illness (NMFI), which remains poorly understood and difficult to diagnose. To characterize NMFI in Senegal, we collected venous blood and clinical metadata in a cross-sectional study of febrile patients and healthy controls in a low malaria burden area. Using 16S and untargeted sequencing, we detected viral, bacterial, or eukaryotic pathogens in 23% (38/163) of NMFI cases. Bacteria were the most common, with relapsing fever Borrelia and spotted fever Rickettsia found in 15.5% and 3.8% of cases, respectively. Four viral pathogens were found in a total of 7 febrile cases (3.5%). Sequencing also detected undiagnosed Plasmodium, including one putative P. ovale infection. We developed a logistic regression model that can distinguish Borrelia from NMFIs with similar presentation based on symptoms and vital signs (F1 score: 0.823). These results highlight the challenge and importance of improved diagnostics, especially for Borrelia, to support diagnosis and surveillance.

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Levine, Z., Sène, A., Mkandawire, W., Dème, A., Ndiaye, T., Sy, M., Gaye, A., Diédhiou, Y., Mbaye, A., Ndiaye, I., Gomis, J., Ndiop, M., Sène, D., Paye, M., MacInnis, B., Schaffner, S., Park, D., Badiane, A., Colubri, A., Ndiaye, M., Sy, N., Sabeti, P., Ndiaye, D., Siddle, K. (2024). Investigating the etiologies of non-malarial febrile illness in Senegal using metagenomic sequencing. https://doi.org/10.1038/s41467-024-44800-7

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Auteur(s)

Zoë C. Levine Aita Sène Winnie Mkandawire Awa B. Dème Tolla Ndiaye Mouhamad Sy Amy Gaye Younouss Diédhiou Amadou Moctar Mbaye Ibrahima Ndiaye Jules F. Gomis Médoune Ndiop Doudou Sène Marietou Faye Paye Bronwyn MacInnis S. F. Schaffner Daniel J. Park Aïda Sadikh Badiane Andrés Colubri Mouhamadou Ndiaye Ngayo Sy Pardis C. Sabeti Daouda Ndiaye Katherine J. Siddle

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