{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:46:04Z","timestamp":1791517564510,"version":"4.3.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014494","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000}}],"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007586","name":"Aix-Marseille Universit\u00e9","doi-asserted-by":"publisher","award":["A*MIDEX AMX-22-IN1-59"],"award-info":[{"award-number":["A*MIDEX AMX-22-IN1-59"]}],"id":[{"id":"10.13039\/100007586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006137","name":"D\u00e9partement Soutien et Formation, Institut de Recherche pour le D\u00e9veloppement","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006137","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>The circulation of arboviruses in sub-Saharan African countries remains poorly documented. The associated health burden may be underestimated and masked by the significance of malaria. Here, we have investigated acute undifferentiated fevers for arboviral infections in Mali (2016\u20132024). To estimate the proportion of patients with arboviral infection, and in particular dengue. A retrospective (2016\u20132022) and a prospective (2023\u20132024) studies were conducted in patients from health centers and hospitals of Mali (mainly in the Bamako region) selected by health professionals. Studies included patients with acute fever lasting less than 7 days; the prospective sub-study excluding pyogenic, urinary, tuberculosis, viral hepatitis, typhoid fever and post-traumatic infections. Blood samples were tested for arboviruses using molecular detection (including serotyping) and genomic sequencing. We collected demographic data and results of malaria testing for all patients and, in the prospective study, a set of clinical data. A total of 2,022 patients were included. Dengue virus (DENV) was the most frequently detected pathogen (retrospective study: 7.6%, 16\/210 patients; prospective study: 29.5%, 535\/1812 patients). We also detected chikungunya virus (n\u2009=\u20097), West Nile virus (n\u2009=\u20092) and Rift Valley fever virus (n\u2009=\u20091). Three serotypes of dengue were identified: DENV-2 (n\u2009=\u2009185), DENV-1 (n\u2009=\u2009113) and DENV-3 (n\u2009=\u2009105); 148 DENV cases could not be typed. For each serotype, phylogenetic analyses identified a major lineage recently originating from the subregion (DENV-1-III; DENV-2-II; DENV-3-III). In contrast to malaria, the dengue detection rate was higher among patients over 18 years of age. The most frequently observed symptoms were headache, asthenia, arthralgia, myalgia and back pain. The mean number of those symptoms per patient was significantly higher in dengue patients. We recorded 6 cases of hemorrhagic dengue, but no deaths and no case requiring transfer to intensive care. Our findings confirm the threat posed by arbovirus infections in Mali, and more specifically the growing burden of dengue fever on public health. Monitoring dengue fever has become a major challenge in sub-Saharan countries in order to determine the conditions necessary for the future implementation of a dengue vaccination policy tailored to the public health objectives of these countries.<\/jats:p>","DOI":"10.1371\/journal.pntd.0014494","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:44:36Z","timestamp":1783532676000},"page":"e0014494","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Study of patients with acute undifferentiated fever identifies dengue as a growing threat to public health in Mali"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-5471","authenticated-orcid":true,"given":"Lassina","family":"Doumbia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Thirion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphaelle","family":"Klitting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Piorkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayane","family":"Amaral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pezzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yacouba","family":"Kone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumar","family":"Kokena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Grard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"de Lamballerie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ousmane","family":"Koita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Dubot-P\u00e9r\u00e8s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"issue":"2","key":"pntd.0014494.ref001","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3201\/eid2202.150688","article-title":"Vectorborne infections, Mali","volume":"22","author":"D Safronetz","year":"2016","journal-title":"Emerg Infect Dis"},{"key":"pntd.0014494.ref002","author":"W H O, Regional Office for Africa"},{"key":"pntd.0014494.ref003","volume-title":"Surveillance and control of arboviral diseases in the WHO African region: assessment of country capacities","author":"World Health Organization","year":"2022"},{"key":"pntd.0014494.ref004","author":"World Health Organization","year":"2023"},{"key":"pntd.0014494.ref005","author":"WHO, Regional Office for Africa"},{"key":"pntd.0014494.ref006","volume-title":"Weekly Regional Dengue Bulletin 002: 14 January 2024","author":"World Health Organization, Regional Office for Africa","year":"2024"},{"key":"pntd.0014494.ref007","author":"World Health Organization","year":"2024"},{"key":"pntd.0014494.ref008","author":"W H O, Regional Office for Africa","year":"2024"},{"issue":"12","key":"pntd.0014494.ref009","first-page":"420","article-title":"Analysis of a Dengue Virus Outbreak in Rosso, Senegal 2021","volume":"7","author":"I Dieng","year":"2022","journal-title":"Trop Med Infect Dis"},{"issue":"1","key":"pntd.0014494.ref010","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s12985-024-02406-x","article-title":"Molecular surveillance for dengue serotypes among the population living in Moyen-Ogoou\u00e9 province, Gabon; evidence of the presence of dengue serotype 1","volume":"21","author":"R Bikangui","year":"2024","journal-title":"Virol J"},{"issue":"10","key":"pntd.0014494.ref011","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009860","article-title":"Concurrent circulation of dengue serotype 1, 2 and 3 among acute febrile patients in Cameroon","volume":"15","author":"H Simo Tchetgna","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"7","key":"pntd.0014494.ref012","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.3201\/eid3007.240301","article-title":"Emergence of Indigenous Dengue Fever, Niger, October 2023","volume":"30","author":"HI Amadou","year":"2024","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"pntd.0014494.ref013","doi-asserted-by":"crossref","first-page":"374","DOI":"10.4269\/ajtmh.25-0113","article-title":"Analyzing transmission patterns of two dengue virus serotypes during the 2023 outbreak in Mali, West Africa","volume":"113","author":"F Kane","year":"2025","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"pntd.0014494.ref014","first-page":"1","article-title":"Arbovirus epidemics as global health imperative, Africa, 2023","volume":"31","author":"ST Bangoura","year":"2025","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pntd.0014494.ref015","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1186\/s12889-022-12820-x","article-title":"Spatiotemporal analysis of dengue fever in Burkina Faso from 2016 to 2019","volume":"22","author":"CA Ouattara","year":"2022","journal-title":"BMC Public Health"},{"issue":"6","key":"pntd.0014494.ref016","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.3201\/eid2806.212491","article-title":"Retrospective genomic characterization of a 2017 dengue virus outbreak, Burkina Faso","volume":"28","author":"AG Letizia","year":"2022","journal-title":"Emerg Infect Dis"},{"issue":"24","key":"pntd.0014494.ref017","doi-asserted-by":"crossref","first-page":"16912","DOI":"10.3390\/ijerph192416912","article-title":"Re-emergence of dengue serotype 3 in the context of a large religious gathering event in Touba, Senegal","volume":"19","author":"I Dieng","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"pntd.0014494.ref018","first-page":"32","article-title":"The Spatiotemporal distribution and molecular characterization of circulating dengue virus serotypes\/genotypes in Senegal from 2019 to 2023","volume":"9","author":"I Dieng","year":"2024","journal-title":"Trop Med Infect Dis"},{"issue":"10","key":"pntd.0014494.ref019","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009829","article-title":"Emergence of dengue virus serotype 2 in Mauritania and molecular characterization of its circulation in West Africa","volume":"15","author":"T Fouri\u00e9","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0014494.ref020","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40249-016-0120-2","article-title":"Presence of three dengue serotypes in Ouagadougou (Burkina Faso): research and public health implications","volume":"5","author":"V Ridde","year":"2016","journal-title":"Infect Dis Poverty"},{"key":"pntd.0014494.ref021","author":"W H O, Regional Office for Africa"},{"key":"pntd.0014494.ref022","first-page":"230","article-title":"First introduction of dengue virus type 3 in Niger, 2022. IJID Reg. juin","volume":"7","author":"A Lagare","year":"2023"},{"key":"pntd.0014494.ref023","author":"W H O, Regional Office for Africa"},{"issue":"10425","key":"pntd.0014494.ref024","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/S0140-6736(23)02803-9","article-title":"Dengue epidemic in Burkina Faso: how can the response improve?","volume":"403","author":"O Manigart","year":"2024","journal-title":"Lancet"},{"key":"pntd.0014494.ref025","volume-title":"Epidemiological alert: Risk of dengue outbreaks due to the increased circulation of DENV-3 in the Americas region","author":"Pan American Health Organization\/World Health Organization","year":"2025"},{"key":"pntd.0014494.ref026","volume-title":"Epidemiological Bulletin, 26th edition","author":"WHO RO for S-EA","year":"2024"},{"issue":"1","key":"pntd.0014494.ref027","doi-asserted-by":"crossref","first-page":"2373308","DOI":"10.1080\/22221751.2024.2373308","article-title":"Genomic characterization of a reemerging Chikungunya outbreak in Kedougou, southeastern Senegal, 2023","volume":"13","author":"I Dieng","year":"2024","journal-title":"Emerg Microbes Infect"},{"issue":"6","key":"pntd.0014494.ref028","doi-asserted-by":"crossref","DOI":"10.1093\/jtm\/taaf002","article-title":"Cryptic circulation of chikungunya virus in C\u00f4te d\u2019Ivoire revealed by sentinel travellers, 2023-24","volume":"32","author":"L Pezzi","year":"2025","journal-title":"J Travel Med"},{"issue":"4","key":"pntd.0014494.ref029","doi-asserted-by":"crossref","first-page":"591","DOI":"10.3201\/eid1504.080664","article-title":"Concurrent chikungunya and dengue virus infections during simultaneous outbreaks, Gabon, 2007","volume":"15","author":"EM Leroy","year":"2009","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pntd.0014494.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ofid\/ofaa626","article-title":"Occurrence of 4 dengue virus serotypes and chikungunya virus in Kilombero Valley, Tanzania, during the dengue outbreak in 2018","volume":"8","author":"B Chipwaza","year":"2021","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"pntd.0014494.ref031","doi-asserted-by":"crossref","first-page":"53","DOI":"10.26719\/emhj.24.007","article-title":"Challenges and epidemiological implications of the first outbreak of dengue and chikungunya in Sudan","volume":"30","author":"SM Aljaily","year":"2024","journal-title":"East Mediterr Health J"},{"key":"pntd.0014494.ref032","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12936-016-1100-5","article-title":"Concurrent malaria and arbovirus infections in Kedougou, southeastern Senegal","volume":"15","author":"A Sow","year":"2016","journal-title":"Malar J"},{"issue":"10","key":"pntd.0014494.ref033","article-title":"Detection and serotyping of dengue viruses in febrile patients consulting at the New-Bell District Hospital in Douala, Cameroon","volume":"13","author":"FBS Yousseu","year":"2018","journal-title":"PLoS One"},{"issue":"3","key":"pntd.0014494.ref034","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/tmi.13721","article-title":"Aetiologies of acute undifferentiated febrile illness at the emergency ward of the University of Gondar Hospital, Ethiopia","volume":"27","author":"Y Akelew","year":"2022","journal-title":"Trop Med Int Health"},{"issue":"1","key":"pntd.0014494.ref035","doi-asserted-by":"crossref","first-page":"6735","DOI":"10.1038\/s41467-021-26707-9","article-title":"Model-based assessment of Chikungunya and O\u2019nyong-nyong virus circulation in Mali in a serological cross-reactivity context","volume":"12","author":"N Hoz\u00e9","year":"2021","journal-title":"Nat Commun"},{"issue":"2","key":"pntd.0014494.ref036","doi-asserted-by":"crossref","first-page":"344","DOI":"10.4269\/ajtmh.24-0785","article-title":"Fatal Outcome in a Pregnant Woman with HELLP Syndrome and Dengue","volume":"113","author":"PA Garavito-P\u00e9rez","year":"2025","journal-title":"Am J Trop Med Hyg"},{"issue":"8","key":"pntd.0014494.ref037","article-title":"Dengue fever in a sickle cell-positive pregnant woman: a case report","volume":"16","author":"LS Reddy","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"pntd.0014494.ref038","doi-asserted-by":"crossref","DOI":"10.1093\/jtm\/tay136","article-title":"Risk of severe dengue is higher in patients with sickle cell disease: a scoping review","volume":"26","author":"A Wilder-Smith","year":"2019","journal-title":"J Travel Med"},{"key":"pntd.0014494.ref039","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ejogrb.2021.04.035","article-title":"Dengue in pregnancy: review article","volume":"261","author":"V Mulik","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"6","key":"pntd.0014494.ref040","doi-asserted-by":"crossref","DOI":"10.1002\/jmv.28853","article-title":"Genomic diversity of mpox virus in Paris area (France) during the 2022 outbreak","volume":"95","author":"G Piorkowski","year":"2023","journal-title":"J Med Virol"},{"issue":"67","key":"pntd.0014494.ref041","doi-asserted-by":"crossref","first-page":"3773","DOI":"10.21105\/joss.03773","article-title":"Nextclade: clade assignment, mutation calling and quality control for viral genomes","volume":"6","author":"I Aksamentov","year":"2021","journal-title":"JOSS"},{"issue":"5","key":"pntd.0014494.ref042","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007231","article-title":"A computational method for the identification of Dengue, Zika and Chikungunya virus species and genotypes","volume":"13","author":"V Fonseca","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0014494.ref043","doi-asserted-by":"crossref","DOI":"10.1093\/ve\/vey016","article-title":"Bayesian phylogenetic and phylodynamic data integration using BEAST 1.10","volume":"4","author":"MA Suchard","year":"2018","journal-title":"Virus Evol"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0014494","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T17:50:22Z","timestamp":1784051422000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0014494"}},"subtitle":[],"editor":[{"given":"Katie","family":"Anders","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0014494","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]}}}