Acute Flavivirus and Alphavirus Infections among Children in Two Different Areas of Kenya, 2015

Abstract

Alphaviruses and flaviviruses are known to be endemic in Eastern Africa, but few data are available to evaluate the prevalence of these infections. This leads to missed opportunities for prevention against future outbreaks. This cohort study investigated the frequency of alphavirus and flavivirus incident infections in two regions of Kenya and identified potential risk factors. Seroconversions for alphavirus and flavivirus infections were identified by immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA) in a cohort of 1,604 acutely ill children over the year 2015. The annual incidence was 0.5% (0.2-1.2%) for alphaviruses and 1.2% (0.7-2.2%) for flaviviruses. Overall, seroprevalence was significantly higher for alphaviruses in western Kenya than on the coast (P = 0.014), whereas flavivirus seroprevalence was higher on the coast (P = 0.044). Poverty indicators did not emerge as risk factors, but reliance on household water storage was associated with increased exposure to both alphaviruses and flaviviruses (odds ratio = 2.3).

Figure 1.

Alphavirus and flavivirus seroprevalence. Seroprevalence was assessed by anti-IgG ELISA. * = P ≤ 0.05, ** = P ≤ 0.01, *** = P ≤ 0.001, all P-values were calculated using pair-wise Fisher’s exact test. (A) Alphavirus, as represented by “chikungunya (CHIKV),” and flavivirus, as represented by “Dengue (DENV),” seroprevalence by study site. (B) Alphavirus and flavivirus seroprevalence by western or coastal location. (C and D) Alphavirus and flavivirus seroprevalence by respective age range.