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. 2025 Sep 8;15(17):2269.
doi: 10.3390/diagnostics15172269.

Improving Management of Viral Febrile Illness and Reducing the Need for Empiric Antibiotics Using VIDAS® Immunoassay for Dengue and Chikungunya: A West African Multicentric Study

Fanette Ravel  1 , Solenne Robert  1 , Diakourga Arthur Djibougou  2 , Kigninlman Horo  3 , Aristophane Tanon  4 , Privat Ango  3 , Palpouguini Félix Lompo  2 , Faustine Meynier  5 , Ludovic Brossault  1 , Umit Guler  1 , Jacques Simpore  6 , Potiandi Serge Diagbouga  2
Affiliations

Improving Management of Viral Febrile Illness and Reducing the Need for Empiric Antibiotics Using VIDAS® Immunoassay for Dengue and Chikungunya: A West African Multicentric Study

Fanette Ravel et al. Diagnostics (Basel). .

Abstract

Background: Dengue and chikungunya are endemic in West Africa, posing significant public health issues. The aim of this study was to evaluate the impact of differential and systematic diagnosis of dengue and chikungunya on patient management and on antibiotic use in Burkina Faso and Ivory Coast. Methods: A multicenter prospective cohort study was conducted in both countries involving patients with suspected dengue and/or chikungunya viremia. VIDAS® diagnostic tests (bioMérieux SA, Marcy-l'Étoile, France) were provided to the intervention sites, while the control sites initially followed standard of care before testing at the end of the study. The primary outcome was defined as antibiotic prescription or non-initiation/discontinuation, and the secondary endpoints included hospital resource use, patient satisfaction, and health-related quality of life (HRQoL), analyzed through Chi-square and logistic regression using SAS software v9.4. Results: Out of 775 enrolled patients, 767 had corresponding VIDAS® Dengue and VIDAS® Chikungunya results, with 570 having recorded antibiotic therapy (initiated, non-initiated or discontinued). Both Burkina Faso and Ivory Coast observed an increase in antibiotic discontinuation (or non-initiation) rates at the intervention sites compared to control sites: increased from 60% to 78% in Burkina Faso and from 36% to 83% in Ivory Coast. Hospitalization rates within seven days following inclusion were also lower in intervention sites than in the control sites: Burkina Faso 41% as compared with 97% and Ivory Coast 24% as compared with 98%. Patient-reported antibiotic use within seven days post-inclusion was also significantly lower in intervention sites. Conclusions: The results showed a reduction in potential antibiotic overuse and hospital admissions (i.e., hospitalization rates within seven days) in both the Burkina Faso and Ivory Coast interventions sites. These findings emphasize the importance of enhanced diagnostic strategies for the improvement of patient outcomes and the fight against antibiotic resistance. This study also highlights the need for implementing systematic and differential diagnosis of dengue and chikungunya in West Africa where febrile infections are endemic. Further studies are warranted to explore the economic benefits of these diagnostic strategies.

Keywords: VIDAS®; West Africa; antibiotic use; chikungunya; dengue; diagnosis; differential diagnosis.

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Conflict of interest statement

F.R., S.R., F.M., U.G. and L.B. are employees of bioMérieux. P.S.D., K.H., A.T. and P.A. received compensation fees from bioMérieux for this study, in the framework of the agreement signed with their employer entity. This study was funded by bioMérieux. The funder was involved in the design and execution of the study, in the data analysis and interpretation, in the decision to publish the results, and in the writing of the manuscript.

Figures

Figure 1
Figure 1
Study workflow diagram.
Figure 2
Figure 2
Patient inclusion flowchart.
Figure 3
Figure 3
Rate of antibiotic discontinuation or non-initiation per country.
Figure 4
Figure 4
Hospitalization within 7 days after inclusion.
See this image and copyright information in PMC

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