1 Introduction
Malaria and arboviral diseases including Chikungunya are major
mosquito-borne diseases that challenge health system and pose
substantial threats to human health, and socioeconomic stability and
development, particularly in under-resourced endemic countries mainly in
Africa [1 - 8]. The co-circulation and dual burden of both diseases
is increasingly prevalent in Africa including Sudan, where the interplay
of these infections exhausted the fragile health system, complicated
diseases prevention and control as well as health outcomes of the local
population [5, 9 - 18].
Malaria in human is mainly caused by one or more of five species ofPlasmodium parasites, primarily transmitted by various species of
Anopheles mosquitoes including Anopheles arabiensis, An. funestus,
An. pharoensis, and An. stephensi [14, 19, 20].Plasmodium falciparum and Plasmodium vivax are the
predominant species affecting the majority of humans at risk of malaria
[21 - 23]. Conversely, Chikungunya fever result from infection with
Chikungunya virus belong to alphavirus belong to the Togaviridae family, primarily spread by Aedes mosquitoes [24 - 26].
In tropical regions, the geographic distribution and transmission areas
for these diseases frequently overlap, leading to a heightened risk of
co-infections [1- 5, 27 - 30]. Several factors, including conflicts,
climate change, globalization, urbanization, deforestation, and the
establishment of agricultural settlements in peri-urban areas enhance
the spread of invasive disease vectors and emergence of infectious
diseases [31 - 38]. These factors increase the environmental
suitability, population vulnerability, and health systems susceptibility
to the emergence and development of diseases outbreaks [39 - 42].
Sudan, characterized by its diverse ecological zones, limited resources,
and fragile health system, this increased the country vulnerability to
wide range of endemic diseases [43 - 54]. Among these, malaria
continues to be a leading cause of morbidity and mortality, and it’s
co-circulating with viral infections such as Hepatitis viruses and
several arboviruses like dengue, Rift valley fever [30, 55 - 57].
The clinical presentations of these diseases frequently overlap, which
eventually challenges the limited local diagnostic capacity
[1,5,10,11, 30, 55].
In this communication, we present a case of Chikungunya and malaria
co-infection in Sudan. Documenting challenges and best practices in
investigating co-infection in high burden and limited resources country;
Sudan. Through this case report, we aim to enhance awareness among
healthcare providers and foster improved differential diagnosis and
diagnostic protocols to coop up the rapidly growing prevalence and
burden of infectious diseases.