Evidence map›Paper›PMID 40622975›Full record

ArticlePloS one2025

Chikungunya masquerading as dengue infection in Sri Lanka uncovered by metagenomics.

K M Ahsanul Kabir, Chathurani Sigera, Sachith Maduranga, Praveen Weeratunga, Senaka Rajapakse, Deepika Fernando, Andrew R Lloyd, Rowena A Bull, Chaturaka Rodrigo

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PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

K M Ahsanul KabirFaculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.
Chathurani SigeraFaculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Sachith MadurangaFaculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-1511-883X
Praveen WeeratungaFaculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Senaka RajapakseFaculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Deepika FernandoFaculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Andrew R LloydFaculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-6277-8887
Rowena A BullFaculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.
Chaturaka RodrigoFaculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-2189-9177

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDengue is a significant threat to human health in South and Southeast Asia where patients are treated without diagnostic confirmation during outbreaks. This approach, though cost-effective may miss important infections especially those caused by other arboviruses (e.g., Zika, Chikungunya and West Nile virus). This study aimed to diagnose missed infections mimicking dengue by using metagenomic next generation sequencing (mNGS). METHODS AND PRINCIPAL

findingsTotal nucleic acid (DNA and RNA) was extracted and subjected to mNGS from acute infection plasma of 60 patients from a prospective cohort study in Sri Lanka in which patients with clinically suspected dengue fever were recruited but were later confirmed as dengue-negative by NS1 antigen testing and by dengue-specific reverse transcription and polymerase chain reaction (RT-PCR) analysis. mNGS data revealed missed chikungunya and dengue infections in five patients each, and a possible bacterial infection by Klebsiella pneumoniae in another patient. It was not possible to differentiate chikungunya infections from dengue infections based on clinical features or routine non-diagnostic laboratory tests conducted in early infection (e.g., full blood count, C-reactive protein level). Phylogenetic analysis showed that the chikungunya sequences from this study were closely related to those sequenced from Maldives, Malaysia, India and Singapore between 2015-2019.

conclusionsChikungunya infection may masquerade as dengue especially in low- and middle-income countries where dengue is treated based on clinical suspicion only - without confirmatory testing. As both infections are likely prevalent worldwide, but the complications and natural history of chikungunya and dengue infections are quite different, the addition of cheap and accessible diagnostics for both infections should be pursued in endemic countries.

Indexed as

Chikungunya FeverChikungunya virusDengueMetagenomicsAdolescentAdultDengue VirusDiagnosis, DifferentialFemaleHigh-Throughput Nucleotide SequencingHumansMaleMiddle AgedPhylogenyProspective StudiesSri Lanka

Identifiers

PMID40622975
PMCPMC12233278

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.