SARS-COv-2, influenza and other respiratory virus co-circulation during an outbreak in a rural health zone in Democratic Republic of Congo, 2024-2025.
10 affiliations
- 1National One Health Institute for Africa (INOHA), University of Kinshasa, Kinshasa, Democratic Republic of Congo. [email protected].
- 2MIVEGEC, University of Montpellier, IRD 224, CNRS 5290, Montpellier, France. [email protected].
- 3Department of Internal Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
- 4Faculty of Medicine, University of Bandundu, Bandundu, Democratic Republic of Congo.
- 5Department of Chemistry, Faculty of Agronomy, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
- 6Democratic Republic of Congo National Institute for Agronomic Study and Research (INERA), Kinshasa, Democratic Republic of Congo.
- 7National Institute of Public Health, Kinshasa, Democratic Republic of Congo.
- 8National Institute for Biomedical Research, Kinshasa, Democratic Republic of Congo.
- 9Microbiology Department, Kinshasa University Clinics, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
- 10MIVEGEC, University of Montpellier, IRD 224, CNRS 5290, Montpellier, France.
Abstract
Background
Little is known about the global impact of co-circulation and co-infection of COVID-19 and influenza in Democratic Republic of the Congo (DRC). This study aims at analyzing data on SARS-CoV-2, influenza and other respiratory viruses collected during an outbreak response in the rural Province of Panzi to advocate for the strengthening of respiratory virus surveillance systems.Methods
Routinely collected surveillance data were analyzed following a health alert of increases in acute respiratory infection (ARI) cases and deaths. Oropharyngeal and nasopharyngeal swabs were systematically collected and tested for influenza, SARS-CoV-2, and respiratory pathogens using multiplex RT-PCR. Statistical analysis included descriptive statistics and comparative tests (chi-square/Fisher's exact test and t-test or Welch test).Results
Routine surveillance data yielded a total of 5,781 suspected cases, including 108 deaths. Incidence rates peaked in 2025 for ARI (209 per 100,000 people) and for Influenza-Like Illness (approximately 250 per 100,000 people). Children under one year of age remained the most affected throughout the entire duration of the epidemic. A total of 115 biological samples (approximately 2% of suspected cases) were tested and 55 (47.8%) were positive for at least one respiratory pathogen. Influenza was detected in 30 cases (54.5%), SARS-CoV-2 in 15 cases (27.3%). Median patient age was 5 years (range 0.4-75 years), with 36.4% 1-<5 years. Eleven co-infections, meaning at least 2 virus detected in the same individual, were identified. Among them, co-infection of influenza with SARS-CoV-2 occurred in 2 cases (6.7%), with rhinovirus in 2 cases (6.7%), with parainfluenza type1/2 in 1 case (3.3%), with Bocavirus in 1 case (3.3%), and with adenovirus in 1 case (3.3%). Influenza A (H1N1) pdm09 was the sole circulating influenza subtype.Conclusion
This study documents the co-circulation and co-infection of respiratory viruses, particularly influenza and SARS-CoV-2, despite a small sampling size. These findings emphasize the need to strengthen routine surveillance of respiratory viruses to assess a robust knowledge of co-circulation of respiratory infections and also the clinical impact of the co-infections in DRC.
Related
- Notes from the Field: Outbreak of Ebola Disease Caused by Bundibugyo Virus — Democratic Republic of the Congo and Uganda, May 2026
- Nowcasting outbreak case and death counts from open-source reporting: a validation on the 2026 Ebola (Bundibugyo) outbreak in the Democratic Republic of the Congo
- Temporal and Phylodynamic analyses of the 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo
- One Health preparedness for Ebola disease caused by Bundibugyo virus: lessons from the 2026 outbreak centred in the Democratic Republic of the Congo.
- Filovirus Seroreactivity Beyond Virus-Specific Outbreak Regions in the Democratic Republic of the Congo, 2015-2023
BibTeX
@article{bokabo2026sarscov2,
title = {{SARS-COv-2, influenza and other respiratory virus co-circulation during an outbreak in a rural health zone in Democratic Republic of Congo, 2024-2025.}},
author = {Eric Bokabo and Hippolyte Situakibanza and Serge Mazamay and Roger Vumilia Kizungu and Mathias Mossoko and Edith Nkwembe and Hélène Broutin},
journal = {BMC infectious diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14152-2},
url = {https://europepmc.org/article/MED/42972532},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - SARS-COv-2, influenza and other respiratory virus co-circulation during an outbreak in a rural health zone in Democratic Republic of Congo, 2024-2025.
AU - Eric Bokabo
AU - Hippolyte Situakibanza
AU - Serge Mazamay
AU - Roger Vumilia Kizungu
AU - Mathias Mossoko
AU - Edith Nkwembe
AU - Hélène Broutin
PY - 2026
DA - 2026/08/05
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14152-2
UR - https://europepmc.org/article/MED/42972532
AB - Background Little is known about the global impact of co-circulation and co-infection of COVID-19 and influenza in Democratic Republic of the Congo (DRC). This study aims at analyzing data on SARS-CoV-2, influenza and other respiratory viruses collected during an outbreak response in the rural Province of Panzi to advocate for the strengthening of respiratory virus surveillance systems.Methods Routinely collected surveillance data were analyzed following a health alert of increases in acute respiratory infection (ARI) cases and deaths. Oropharyngeal and nasopharyngeal swabs were systematically collected and tested for influenza, SARS-CoV-2, and respiratory pathogens using multiplex RT-PCR. Statistical analysis included descriptive statistics and comparative tests (chi-square/Fisher's exact test and t-test or Welch test).Results Routine surveillance data yielded a total of 5,781 suspected cases, including 108 deaths. Incidence rates peaked in 2025 for ARI (209 per 100,000 people) and for Influenza-Like Illness (approximately 250 per 100,000 people). Children under one year of age remained the most affected throughout the entire duration of the epidemic. A total of 115 biological samples (approximately 2% of suspected cases) were tested and 55 (47.8%) were positive for at least one respiratory pathogen. Influenza was detected in 30 cases (54.5%), SARS-CoV-2 in 15 cases (27.3%). Median patient age was 5 years (range 0.4-75 years), with 36.4% 1-<5 years. Eleven co-infections, meaning at least 2 virus detected in the same individual, were identified. Among them, co-infection of influenza with SARS-CoV-2 occurred in 2 cases (6.7%), with rhinovirus in 2 cases (6.7%), with parainfluenza type1/2 in 1 case (3.3%), with Bocavirus in 1 case (3.3%), and with adenovirus in 1 case (3.3%). Influenza A (H1N1) pdm09 was the sole circulating influenza subtype.Conclusion This study documents the co-circulation and co-infection of respiratory viruses, particularly influenza and SARS-CoV-2, despite a small sampling size. These findings emphasize the need to strengthen routine surveillance of respiratory viruses to assess a robust knowledge of co-circulation of respiratory infections and also the clinical impact of the co-infections in DRC.
SN - 1471-2334
ER -