Evidence map›Paper›PMID 41708925›Full record

ArticleNature medicine2026

Deciphering the etiology of the 2024 outbreak of undiagnosed febrile illness in Panzi, Democratic Republic of the Congo.

Tony Wawina-Bokalanga, Jean-Claude Makangara-Cigolo, Rilia Ola-Mpumbe, Emmanuel Lokilo, François Mwakisenda-Tshakotsho, Mbonga Delphine, Immaculée Kahindo, Alphonse Tshonaka-Nkololo, Emmanuel Hasivirwe Vakaniaki, Nicholas Loman and 37 more

Abstract read
In one paragraph

Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

47 authors.

Tony Wawina-BokalangaInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo. tonywawinab@yahoo.fr.ORCID http://orcid.org/0000-0001-6659-0267
Jean-Claude Makangara-CigoloInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.ORCID http://orcid.org/0000-0002-1791-2247
Rilia Ola-MpumbeInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Emmanuel LokiloInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
François Mwakisenda-TshakotshoDivision Provinciale de la Santé du Kwango, Kwango, Democratic Republic of the Congo.
Mbonga DelphineInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Immaculée KahindoInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Alphonse Tshonaka-NkololoDivision Provinciale de la Santé du Kwango, Kwango, Democratic Republic of the Congo.
Emmanuel Hasivirwe VakaniakiInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Nicholas LomanUniversity of Birmingham, Birmingham, UK.
Sarah HoubenDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Raphael Lumembe-NumbiInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Eddy Kinganda-LusamakiInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.ORCID http://orcid.org/0000-0001-9795-0165
Ange Ponga-MusemeInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Yero Mukota-NunguCliniques Universitaires de Kinshasa, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
Anuj KumarDepartment of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID http://orcid.org/0000-0002-5023-7618
Matondo MerisInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Sam WilkinsonUniversity of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-6944-5927
Raquel ColquhounUniversity of Birmingham, Birmingham, UK.
Kelly-Michel KenyeInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Prince Akil-BandaliInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Adrienne Amuri-AzizaInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.ORCID http://orcid.org/0000-0002-5516-0779
Gustavo Sganzerla MartinezDepartment of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID http://orcid.org/0000-0002-7656-0579
David J KelvinDepartment of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Ronald DijkmanInstitute for Infectious Diseases, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0003-0320-2743
Lisa E HensleyUS Department of Agriculture, Manhattan, KS, USA.
Cris KasitaInstitut National de Santé Publique, Kinshasa, Democratic Republic of the Congo.
Franck Kafua-WembaInstitut National de Santé Publique, Kinshasa, Democratic Republic of the Congo.
Dieudonné MwambaInstitut National de Santé Publique, Kinshasa, Democratic Republic of the Congo.
Lorenzo SubissiWorld Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0001-5147-575X
Nicole A HoffDepartment of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA.
Martine PeetersTransVIHMI, Université de Montpellier, INSERM, IRD, Montpellier, France.
Anne W RimoinDepartment of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA.
John L MokiliSan Diego State University, San Diego, CA, USA.
Octavie Lunguya-MetilaInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Edith NkwembeInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Andrew RambautInstitute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0003-4337-3707
Laurens LiesenborghsDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.ORCID http://orcid.org/0000-0001-5616-8548
Nicola LowInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Jason KindrachukDepartment of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID http://orcid.org/0000-0002-3305-7084
Koen VercauterenDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.ORCID http://orcid.org/0000-0003-1472-9938
Robert EdwardsCollege of Science and Engineering, Flinders University, Adelaide, South Australia, Australia.ORCID http://orcid.org/0000-0001-8383-8949
Jenna N KellyInstitute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-7265-2233
Placide Mbala-KingebeniInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo. mbalaplacide@gmail.com.ORCID http://orcid.org/0000-0003-1556-3570
Steve Ahuka-MundekeInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
Dieudonné MumbaInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.ORCID http://orcid.org/0000-0002-5886-2004
Jean-Jacques Muyembe-TamfumInstitut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In late 2024, an outbreak of over 400 cases of undiagnosed febrile illness, predominantly presenting as fever and cough, was reported in Panzi Health Zone, southwestern Democratic Republic of the Congo. Here we conducted an epidemiological and laboratory investigation to determine the etiology of the outbreak. Clinical data and specimens were prospectively collected from 108 individuals, of whom 59/108 (54.6%) were female. Children aged <5 years were the most affected (47/108, 43.5%); 14/32 (43.7%) were malnourished. Oro/nasopharyngeal swabs from 96/108 individuals were PCR tested; 26 blood samples were sequenced. Plasmodium falciparum was detected in 56/108 (51.8%) individuals. Co-infections were also detected, with influenza A(H1N1)pdm09 virus in 16/56 (28.6%) and severe acute respiratory syndrome coronavirus 2 in 10/56 (17.9%) individuals. No novel pathogens were detected via metagenomics. Our findings suggest that the outbreak was primarily associated with a surge in malaria cases, with concurrent viral respiratory infections. Increasing decentralized laboratory capacity and strengthening broader health systems remain crucial for faster outbreak detection and investigation.

Indexed as

CoinfectionCOVID-19FeverInfluenza, HumanMalaria, FalciparumAdolescentAdultChildChild, PreschoolDemocratic Republic of the CongoDisease OutbreaksFemaleHumansInfluenza A Virus, H1N1 SubtypeMaleMetagenomics

Identifiers

PMID41708925
PMCPMC13099642

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