The study received the approval of the National Ethical Committee, authorisation n° 2013/03/086/L/CNERSH/SP) of Cameroon. Infants were enrolled only when their parent or guardian gave written proxy-consent. Older children, aged above 5 gave their assent before enrollment.

Parents and Participants were ensured of confidentiality, by attribution of codified identification numbers.

We enrolled children and infants consulting at the Centre Mère Enfant–CME in Yaoundé for fever. Children aged 6 months to 15 years, presenting with fever (axillary temperature above 37.5°C) were enrolled in the study. They were screened clinically and only those presenting with fever without known reasons (abscess, urinary infections, pulmonary infections…) were retained in the study.

A structured questionnaire (see S1 Study Questionnaire) was used to collect some relevant clinical and socio-demographic data. Three milliliters of blood were collected in an EDTA-tube from each child presenting with fever complaints. This study was carried out during the months of April to October 2015; which are rainy months with maximum transmission rate of both dengue and malaria, best for the breeding of their vectors (Anopheles and Aedes). The following tests were done:

Malaria was diagnosed using gold standard method (microscopic examination of giemsa stained thick and thin blood smears). Dengue was diagnosed using the SD Bioline NS1 Ag+Ab combo rapid test according to the manufacturer’s instructions (Standard Diagnostics, Inc) and with ELISA CAPTURE DENGUE IgM/IgG. In order to confirm current dengue infection, in case of NS1 positive test, primer specific amplification was carried out as previously described [1213]. HIV was diagnosed using rapid tests following the national algorithm for children aged more than 18 months (SD Bioline HIV-1/2 3.0 for the first test and Ora Quick Rapid HIV-1 Antibody Test for the second test on all samples). For younger children (less than 18 months) they were diagnosed using Roche amplicor DNA PCR version 1.5 according to the instructions from the manufacturer and as described by Nkenfou [14]. Hematological tests like CD4 count and full blood count were performed. Urine analysis was done using urine stick test as described by the manufacturer. Infants presented with positive urinary test were excluded from the study.

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