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.