Table 3.
Summary of case series studies reporting on signs and symptoms of different qRT-PCR-confirmed ZIKV coinfections (n=7 studies)
| Author (year) |
Location | Study year | Study design | Study population* | % female | Mean age (years) | N, total study population | Coinfecting agent(s) | N, coinfection cases | Other pathogens tested (negative) | Frequency of WHO ZIKV signs and symptoms (%) |
Frequency of other reported signs and symptoms (%) | Level of evidence† | ||||||
| Rash | Fever | Arthralgia | Conjunctivitis | Myalgia | Headache | URT symptoms | GI symptoms | ||||||||||||
| Acevedo et al (2017)22 | Ecuador | 2016 | Case series |
Cases with neurological symptoms‡ | 38 | 42 | 16 | CHIKV | 3 | § | NR | 100% | 33% | NR | NR | 33% | NR | NR | 4 |
| Metha et al (2018)29 | Brazil | 2015/2016 | Case series |
Cases with neurological symptoms§ | 50 | 52 | 22 | CHIKV | 2 | DENV | 100% | 50% | 50% | NR | NR | NR | NR | NR | 4 |
| Sardi et al (2016)23 | Brazil | 2015 | Case series |
AVI and of qRT-PCR ZIKV+ infections | NR | NR | 15 | CHIKV | 2 | DENV | 50% | 100% | 50% | 50% | 100% | 50% | NR | 50% | 4 |
| Cabral-Castro et al (2016)21 | Brazil | 2015/2016 | Case series |
Suspected DENV infections | NR | NR | 30 | CHIKV | 1 | DENV | 100% | 100% | 0 | 0 | NR | NR | NR | 100% | 4 |
| Estofolete et al (2018)18 | Brazil | 2016 | Case series |
Suspected arbovirus infections | 42 | 46 | 1254 | DENV | 12 | CHIKV | 58% | 58% | 50% | 25% | 83% | 75% | NR | 17% | 4 |
| Chia et al (2017)15 |
Singapore | 2016 | Case series |
Suspected ZIKV infections | NR | NR | 163 | DENV | 4 | NR | 100% | 100% | 50% | 50% | 75% | 50% | 25% | 75% | 4 |
| Li et al (2017)31 | Singapore | 2016 | Case series |
Suspected ZIKV infections | 50 | 11 | 14 | DENV | 1 | CHIKV | 100% | 100% | 100% | 100% | 100% | 100% | 0 | NR | 4 |
| Acevedo et al (2017)22 | Ecuador | 2015/2016 | Case series |
Cases with neurological symptoms‡ | 38 | 42 | 16 | CHIKV, DENV |
4 | § | NR | 50% | NR | NR | NR | 25% | 25% | 25% | 4 |
| Acevedo et al (2017)22 | Ecuador | 2016 | Case series |
Cases with neurological symptoms‡ | 38 | 42 | 16 | CHIKV, HIV, Toxo |
1 | § | NR | 100% | NR | NR | NR | 100% | NR | NR | 4 |
URT symptoms: pharyngitis, sore throat, cough, pharyngeal congestion, adenopathy. GI symptoms: nausea, diarrhoea, vomiting, constipation, stomach ache.
*Online supplementary table 2 gives details of all study populations.
†All articles were rated according to level of evidence using the Oxford Centre for Evidence-based Medicine’s Levels of Evidence, March 200911
‡Associated with suspected arbovirus infection.
§Tested for DENV; gram stain, HSV1/2/6, CMV, EBV, VZ, Toxo, MTB, enterovirus.
AVI, acute viral illness; CHIKV, chikungunya virus; CMV, cytomegalovirus; DENV, dengue virus; GI, gastrointestinal; HSV, herpes simplex virus; MT, Mycobacterium tuberculosis; NR, not reported; Toxo, Toxoplasma gondii; URT, upper respiratory tract; VZ, varicella zoster.