When you present at a clinic in Uganda with fever and muscle aches, you will be given a test for malaria. Should you test negative, you will still most likely be given antimalarial medications, which creates two problems.
“You will not get better right away, and malaria medication, which is expensive in Uganda, has been wasted,” says Ross Boyce, MD, MSc, an infectious diseases fellow at UNC. “The symptoms for malaria are similar to dengue, chikungunya and Zika, and the Aedes mosquitoes that carry these viruses are common in Uganda.”
With funding from the UNC School of Medicine’s Office of International Activities’ Global Health Scholars Program and Takeda Pharmaceutical Company, Boyce will work with colleagues at UNC and the Mbarara University of Science and Technology in Uganda to determine what proportion of febrile illness visits are attributable to these mosquito-borne diseases. People testing negative for malaria at three clinics in different regions of Uganda will undergo further testing for dengue, chikungunya and Zika in order to generate a snapshot of how common each virus is in Western Uganda.
“Zika originated in Uganda in the 1940s, and European tourists returning from Uganda have tested positive for dengue. We know these viruses are there, it’s just a matter of proving it,” said Boyce. “Without that evidence, it’s difficult to argue for any investment in better diagnostics and control programs. Given than existing malaria interventions, such a bed-nets, do work well against the outdoor and day-biting Aedes mosquitos, new approaches will be needed.”
Boyce is no stranger to improving diagnostic testing of mosquito-borne infections in Uganda. On March 8, results of his study investigating the use of a two-step diagnostic algorithm utilizing microscopy to detect P. falciparum malaria were published in the Journal of Clinical Microbiology.