Prevalence and Risk Factors of Dengue Virus Infection Among Febrile Patients in a Malaria Hyperendemic Area of Southern Mali.

Background: Dengue virus is a major cause of febrile illness and is often misdiagnosed as malaria in regions lacking appropriate diagnostics. This study assessed the prevalence and risk factors for dengue infection among febrile patients attending community health centers in the malaria hyperendemic Sikasso region of southern Mali. Methods: From June (beginning of the rainy season) to December (post rainy season) 2023, patients presenting with fever at four community health centers (Bamba, Fakola, Filamana, and Guélélenkoro) were tested for dengue infection using rapid diagnostic tests. A multivariate logistic regression model was applied to identify risk factors associated with symptomatic infection. Results: Of 251 enrolled patients, 63.0% were male, and the median age was 15 years (± 13.7). The prevalence of dengue infection varied between 9.7% to 47.8% with the highest observed in December after the rainy season. Headache, muscle pain, and abdominal pain were the most common clinical symptoms associated with dengue fever. Children 5-15 years had significantly higher risk of infection compared to those under 5 years of age (OR = 7.4; 95% CI [1.44; 38.26]). The risk of infection was highest in November (OR = 4.29; 95% CI [1.12; 16.48]) and December (OR = 10.30; 95% CI [2.56; 41.36]). Conclusion: Dengue infections contribute substantially to febrile illness in southern Mali, particularly among school-aged children, mainly during the late rainy season and early dry season. The finding highlights the need for integration of dengue testing into routine diagnostic protocols for febrile patients in malaria-endemic rural settings to reduce misdiagnosis and improve patient outcomes.