ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
High Burden of Coinfections With Epidemic-Prone Pathogens Among Febrile Patients in Nigeria: A Multi-Pathogen Surveillance Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Etiologies of community-acquired febrile illness identified by TaqMan Array Card qPCR on blood samples: a systematic review and meta-analysis.Journal of clinical microbiology · 2026Pooled it
- First laboratory-confirmed fatal dengue virus infection and its implications for national arboviral surveillance in Liberia.IJID regions · 2026Article
- Epidemiology and Clinical Characteristics of Human Rickettsial Infections Detected in Nigeria: Discovery of a Significant Contributor to Acute Febrile Illness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
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23 authors.
Funding
Abstract
backgroundCharacterizing the etiology of acute febrile illness (AFI) remains a critical public health priority in malaria-endemic regions such as Nigeria, where constrained diagnostic capacity frequently contributes to misdiagnosis and delays in outbreak detection and response. This study aimed to explore the burden and nature of pathogen coinfections among febrile patients and to assess whether coinfection patterns were associated with clinical or epidemiologic differences.
methodsPatients presenting with AFI at tertiary hospitals in north-central and southern Nigeria were screened for 25 pathogens using the TaqMan Array Card multi-pathogen polymerase chain reaction. Enrollment was conducted over a 12-month period at each site, August 2023 to September 2024. The analysis focused on the pathogen distribution in coinfections and any associated outcomes for coinfected patients.
resultsAmong the 1200 participants enrolled, 20 pathogens were detected in 57.9% of enrollees. Coinfections were detected in 12.6%. Among them, 2 pathogens were detected in 36.0% and 3 or 4 pathogens were detected in 1.2%. Nearly all coinfections included either Plasmodium or Rickettsia. Notably, coinfected patients were not clinically distinguishable from those with single-pathogen infections based on severity of the illness, presence of underlying health conditions, or risk behaviors such as use of mosquito nets. Among those with viral hemorrhagic fevers, those with coinfections exhibited a notably higher case fatality rate (11.5%) than those with single-pathogen infections (4.2%).
conclusionsGiven the challenge of clinically distinguishing between infections with overlapping symptomology, there is an urgent need for multi-pathogen diagnostics for clinical and public health use.
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