A STUDY ON DETECTION OF PREVALENCE OF DENGUE, CHIKUNGUNYA, LEPTOSPIROSIS AND THEIR COINFECTION IN ACUTE FEBRILE PATIENTS

Abstract

Abstract : ABSTRACT BACK GROUND The prevalence of Dengue, Chikungunya, and Leptospirosis are increasingly  reported in acutely febrile patients recently. Occurence of    coinfection in these patients will increase the morbidity and  mortality. Early diagnosis of coinfection has got prognostic   significance in treating the patients effectively.AIM The study was undertaken to evaluate the prevalence of Dengue,          Chikungunya, and Leptospira infection in acutely febrile patients and to evaluate their co-infection. Materials 165 adult in patients and outpatients of both sexes with history of 2-10 days fever and joint pain, with or without other signs and symptoms such as rashes, head ache, myalgia, joint swelling, oliguria, jaundice, petechial haemorrhage and conjunctival suffusion were included in the study. All samples were tested for Dengue, Chikungunya and Leptospira, by Dengue IgM capture ELISA, Chikungunya IgM capture ELISA and Macroscopic slide agglutination test respectively. Patients with primary or secondary  immunodeficiency, fever with localizing symptoms suggestive of urinary tract infection, upper respiratory tract infection, central nervous system infections and autoimmune diseases were  excluded from the study. Results Dengue IgM capture ELISA was positive in 45 cases (27.3), Chikungunya IgM capture ELISA was positive in 32 cases (19.4), Macroscopic slide  agglutination test for Leptospirosis was positive in 60 cases (36.4) and 28 (16.9) cases were negative for all three tests. The commonest clinical presentation of Dengue and Chikungunya was maculopapular rashes (46.7) and (53.1) respectively and in leptospirosis was conjunctival suffusion (40). The commonest age group of Dengue and Chikungunya infection was 25­34 yrs(40 and 40.6 respectively) and Leptospirosis was 14-24yrs(31.7). These three infections were common in males.   Commonest coinfection was dengue with chikungunya (9.6) followed by dengue with leptospirosis (2.4). Conclusion    Coinfection of Dengue with Chikungunya and Dengue with  leptospirosis was noted in our study. Therefore screening of cases with fever and arthralgia associated with rashes and  conjunctival suffusion in patients with acute febrile illness will help to detect coinfection and to initiate appropriate treatment.

Keyword :Coinfection, IgM Capture ELISA, Macroscopic Slide Agglutination Test.