Nature communications · 2025
Uncovering the viral aetiology of undiagnosed acute febrile illness in Uganda using metagenomic sequencing.
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Ashraf Shirin, Jerome Hanna, Bugembe Daniel Lule, Ssemwanga Deogratius, Byaruhanga Timothy, Kayiwa John Timothy, Downing Robert, Salazar-Gonzalez Jesus F, Salazar Maria G, Shepherd James G, Wilkie Craig, Davis Chris, Logan Nicola, Vattipally Sreenu B, Wilkie Gavin S, da Silva Filipe Ana, Ssekagiri Alfred, Namuwulya Prossy, Bukenya Henry, Kigozi Brian K, McConnell Weronika Witkowska, Willett Brian J, Balinandi Stephen, Lutwama Julius, Kaleebu Pontiano, Bwogi Josephine, Thomson Emma C
Аннотация
Viruses associated with acute febrile illness in Africa cause a spectrum of clinical disease from mild to life-threatening. Routine diagnostic methods are insufficient to identify all viral pathogens in this region. In this study, 1281 febrile Ugandan patients were prospectively recruited as part of the CDC-UVRI Acute Febrile Illness Study and pre-screened for common pathogens. 210/1281 undiagnosed samples, and 20 additional samples from viral outbreaks were subjected to metagenomic sequencing. Viral pathogens were identified in 44/230 (19%), including respiratory, hepatitis, blood-borne, gastrointestinal and vector-borne viruses. Importantly, one case of Crimean-Congo haemorrhagic fever and two cases each of Rift Valley fever, dengue and yellow fever were detected in 7/230 (3%) of cases. Le Dantec virus, last reported in 1969, was also identified in one patient. The presence of high-consequence and (re-)emerging viruses of public health concern highlights the need for enhanced population-based diagnostic surveillance in the African region.