Seroprevalence of chikungunya fever virus and O’nyong Nyong fever virus among febrile patients visiting selected hospitals in 2011-2012 Trans Nzoia County, Kenya

Kevin K. Kamau, Gabriel Magoma, Allan Ole Kwallah, Charles K. Syengo, Matilu Mwau


Background: Chikungunya virus (CHIKV) is an alphavirus in the Semliki Forest complex, and is most closely related to O’Nyong Nyong virus (ONNV). CHIKV and ONNV are mosquito-borne alphaviruses endemic in East Africa that cause acute febrile illness and arthralgia. The objectives of this study were to measure seroprevalence of CHIKV and ONNV in selected health facilities in Western Kenya and link it to demographics and other risk factors.

Methods: The study design was cross sectional in selected health facilities. We tested for anti-CHIKV antibodies using In-house Indirect IgG Enzyme Linked Immunosorbent Assay (ELISA) and In-house IgM Capture ELISA and confirmed with Focus Reduction Neutralization Test (FRNT) for specific alphavirus neutralizing antibodies against CHIKV or ONNV. Mean, median and standard deviation were used to summarize the data. Comparisons of means and medians were done using Student’s t test. Prevalence rates were determined using descriptive statistics (e.g. proportions, rates).

Results: From the 382 samples that were successfully collected, 114 (29.84%) had anti-CHIKV antibodies by the ELISA test. Of these, 27 (7.1%) had CHIKV-specific neutralizing antibodies and 5 (1.3%) had ONNV-specific neutralizing antibodies. Age was significantly associated with seropositivity (OR=1.03; P=0.015, 95% C.I 1.01-1.06). Males were less likely to be seropositive (OR=0.67; P=0.358, 95% C.I 0.27-1.52). Risk factors associated with seropositivity included collecting firewood (OR=2.73 95% 1.13- 6.41) and walls with holes and cracks (OR=0.23 95% C.I 0.04 -0.86).

Conclusions: Both CHIKV and ONNV infections were confirmed in the participants’ more so in women and adults, demonstrating undocumented and ongoing transmission in Western Kenya. In 2011 and 2012 CHIKV and ONNV contributed 8.4% of fevers presented in the three selected health facilities in Western Kenya.


Chikungunya virus, Focus reduction neutralization test, O’Nyong Nyong virus, Western Kenya

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Pfeffer M, Dobler G. Emergence of zoonotic arboviruses by animal trade and migration. Parasites & vectors. 2010 Dec;3(1):35.

Kuniholm MH, Wolfe ND, Huang CY, Mpoudi-Ngole E, Tamoufe U, Burke DS, et al. Seroprevalence and distribution of Flaviviridae, Togaviridae, and Bunyaviridae arboviral infections in rural Cameroonian adults. The American journal of tropical medicine and hygiene. 2006 Jun 1;74(6):1078-83.

Meltzer E. Arboviruses and viral hemorrhagic fevers (VHF). Infectious Disease Clinics. 2012 Jun 1;26(2):479-96.

Weaver SC, Rico-Hesse R, Scott TW. Genetic diversity and slow rates of evolution in New World alphaviruses. InGenetic Diversity of RNA Viruses. Springer, Berlin, Heidelberg. 1992:99-117.

Toivanen A. Alphaviruses: an emerging cause of arthritis?. Current opinion in rheumatology. 2008 Jul 1;20(4):486-90.

Powers AM, Brault AC, Tesh RB, Weaver SC. Re-emergence of Chikungunya and O’nyong-nyong viruses: evidence for distinct geographical lineages and distant evolutionary relationships. General Virology. 2000 Feb 1;81(2):471-9.

Robinson MC. An epidemic of virus disease in Southern Province, Tanganyika territory, in 1952–1953. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1955 Jan 1;49(1):28-32.

Lumsden WH. An epidemic of virus disease in Southern Province, Tanganyika territory, in 1952–1953 II. General description and epidemiology. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1955 Jan 1;49(1):33-57.

Powers AM, Brault AC, Shirako Y, Strauss EG, Kang W, Strauss JH, Weaver SC. Evolutionary relationships and systematics of the alphaviruses. J virology. 2001 Nov 1;75(21):10118-31.

ole Kwallah A, Inoue S, Thairu-Muigai AW, Kuttoh N, Morita K, Mwau M. Seroprevalence of yellow Fever virus in selected health facilities in western Kenya from 2010 to 2012. Japanese J infectious diseases. 2015;68(3):230-4.

Awando MM, Ongus JA, Ouma JR. Seroprevalence of dengue virus among febrile patients visiting selected hospitals in the western region of Kenya, 2010/2011. African J Health Sciences. 2013;26(4).

Mwongula AW, Mwamburi LA, Matilu M, Siamba DN, Wanyama FW. Seroprevalence of Chikungunya Infection in Pyretic Children Seeking Treatment in Alupe District Hospital, Busia County Kenya. Int J Curr Microbiol App Sci. 2013;2:130-9.

Haddow AJ, Davies CW, Walker AJ. O'nyong-nyong fever: An epidemic virus disease in East Africa 1. Introduction. Transactions Royal Soci Trop Med Hyg. 1960 Nov 1;54(6):517-22.

Williams MC, Woodall JP, Corbet PS, Gillett JD. O'nyong-nyong fever: An epidemic virus disease in East Africa VIII. Virus isolations from anopheles mosquitoes. Transactions Royal Soci Trop Med Hyg. 1965 May 1;59(3):300-6.

Tsai TF, Sanders EJ, Hendricks E, Dougle M, Sluys D, Van den Born BJ, et al. Serololgical Evidence of O'Nyong Nyong Viral Infection in Kenya, 1994-95. American J Trop Med Hyg. 1997;57:365.

LaBeaud AD, Banda T, Brichard J, Muchiri EM, Mungai PL, Mutuku FM, et al. High rates of o’nyong nyong and Chikungunya virus transmission in coastal Kenya. PLoS neglected tropical diseases. 2015 Feb 6;9(2):e0003436.

Robin S, Ramful D, Le Seach F, Jaffar-Bandjee MC, Rigou G, Alessandri JL. Neurologic manifestations of pediatric chikungunya infection. child neurology. 2008 Sep;23(9):1028-35.

Igarashi A. Technical Manual of Arbovirus study. Japan;2000.

Chanas AC, Hubalek Z, Johnson BK, Simpson DI. A comparative study of O'nyong nyong virus with Chikungunya virus and plaque variants. Archives of virology. 1979 Sep 1;59(3):231-8.

Schoepp RJ, Rossi CA, Khan SH, Goba A, Fair JN. Undiagnosed acute viral febrile illnesses, Sierra Leone. Emerging infectious diseases. 2014 Jul;20(7):1176.

Zim MM, Sam IC, Omar SS, Chan YF, AbuBakar S, Kamarulzaman A. Chikungunya infection in Malaysia: comparison with dengue infection in adults and predictors of persistent arthralgia. J Clinical Virology. 2013 Feb 1;56(2):141-5.

Bendel RB, Afifi AA. Comparison of stopping rules in forward “stepwise” regression. J American Statistical association. 1977 Mar 1;72(357):46-53.

Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. American J epidemiology. 1989 Jan 1;129(1):125-37.

Ochieng C, Ahenda P, Vittor AY, Nyoka R, Gikunju S, Wachira C, et al. Seroprevalence of infections with dengue, rift valley fever and chikungunya viruses in Kenya, 2007. PloS one. 2015 Jul 15;10(7):e0132645.

Beaty BJ, Calisher CH. Arboviruses. In: Lennette EH, Lennette DA, Lennette ET, editors. Diagnostic procedures for viral, rickettsial, and chlamydial infections. Washington (DC). American Public Health Association. 1995:189-212.

Mwau M, Kubo T, Nzou S, Kageha S, Ngoi J, Demba N, Morita K. Seroprevalence of Chikungunya, West Nile Virus and Dengue Virus in Febrile Patients visiting selected health facilities in Trans Nzoia County. African J Pharmacol Therapeutics. 2012 Dec 31;1(4).

Lanciotti RS, Ludwig ML, Rwaguma EB, Lutwama JJ, Kram TM, Karabatsos N, et al. Emergence of epidemic O'nyong-nyong fever in Uganda after a 35-year absence: genetic characterization of the virus. Virology. 1998 Dec 5;252(1):258-68.

Tappe D, Kapaun A, Emmerich P, de Mendonca Campos R, Cadar D, Günther S, et al. O’nyong-nyong virus infection imported to Europe from Kenya by a traveler. Emerging infectious diseases. 2014 Oct;20(10):1766.

Schwartz O, Albert ML. Biology and pathogenesis of chikungunya virus. Nature Reviews Microbiology. 2010 Jul;8(7):491.

Mbaika S, Lutomiah J, Chepkorir E, Mulwa F, Khayeka-Wandabwa C, Tigoi C, et al. Vector competence of Aedes aegypti in transmitting Chikungunya virus: effects and implications of extrinsic incubation temperature on dissemination and infection rates. Virology J. 2016 Dec;13(1):114.

Suhrbier A, Linn ML. Clinical and pathological aspects of arthritis due to ross river virus and other Alphaviruses. Curr Opin Rheumatol. 2004;16:374-9.

Staples JE, Breiman RF, Powers AM. Chikungunya fever: an epidemiological review of a re-emerging infectious disease. Clinical infectious diseases. 2009 Sep 15;49(6):942-8.

Hoarau JJ, Bandjee MC, Trotot PK, Das T, Li-Pat-Yuen G, Dassa B, et al. Persistent chronic inflammation and infection by Chikungunya arthritogenic alphavirus in spite of a robust host immune response. J Immunology. 2010 May 15;184(10):5914-27.