Misdiagnosis of Dengue Fever and Co-infection With Malaria and Typhoid Fevers in Rural Areas in Southwest Nigeria

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Abstract BackgroundDengue and malaria have similar symptoms and arthropod vector and their mode of transmission coupled with differential diagnosis. Though typhoid fever differs from dengue and malaria by not having arthropod vector and different mode of transmission, it shares differential diagnosis with Dengue and Malaria which make misdiagnosis possible. This misdiagnosis of these three diseases has since been a major concern towards therapeutic administration because of their co-occurrence in many cases. MethodsThis study focused on the misdiagnosis of dengue fever for malaria or typhoid fever since the three have differential diagnosis and could co-occur. 741 samples were collected from malaria patient and 333 samples for typhoid fever outpatient at the health department facilities in rural communities of South West Nigeria. The samples were tested for dengue virus (DV) NS1 protein, anti DV IgM, anti DV IgG and RT-qPCR. ResultOf all the samples tested 315 (29.4%) were positive to DV NS1 while 50 (6.7%) and 13 (3.9%) of 714 malaria samples and 333 typhoid samples respectively had Dengue fever co-infection. Co-infection of the three types of fever occurred in 5 (0.5%). A total of 54 (5%) DV cases were wrongly diagnosed for malaria while 14 (1.3%) DV cases was wrongly diagnosed as typhoid. ConclusionConclusively, there was significant number of misdiagnosed cases of DV for either malaria or typhoid, hence it is recommended to include DV screening into routine hospital test especially in cases of malaria and typhoid negative by rapid diagnostic testing.

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