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Vicco A, McCormack C, Pedrique B, Ribeiro I, Malavige GN, Dorigatti I. A scoping literature review of global dengue age-stratified seroprevalence data: estimating dengue force of infection in endemic countries. EBioMedicine 2024; 104:105134. [PMID: 38718682 PMCID: PMC11096825 DOI: 10.1016/j.ebiom.2024.105134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dengue poses a significant burden worldwide, and a more comprehensive understanding of the heterogeneity in the intensity of dengue transmission within endemic countries is necessary to evaluate the potential impact of public health interventions. METHODS This scoping literature review aimed to update a previous study of dengue transmission intensity by collating global age-stratified dengue seroprevalence data published in the Medline, Embase and Web of Science databases from 2014 to 2023. These data were then utilised to calibrate catalytic models and estimate the force of infection (FOI), which is the yearly per-capita risk of infection for a typical susceptible individual. FINDINGS We found a total of 66 new publications containing 219 age-stratified seroprevalence datasets across 30 endemic countries. Together with the previously available average FOI estimates, there are now more than 250 dengue average FOI estimates obtained from seroprevalence studies from across the world. INTERPRETATION The results show large heterogeneities in average dengue FOI both across and within countries. These new estimates can be used to inform ongoing modelling efforts to improve our understanding of the drivers of the heterogeneity in dengue transmission globally, which in turn can help inform the optimal implementation of public health interventions. FUNDING UK Medical Research Council, Wellcome Trust, Community Jameel, Drugs for Neglected Disease initiative (DNDi) funded by the French Development Agency, Médecins Sans Frontières International; Swiss Agency for Development and Cooperation and UK aid.
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Affiliation(s)
- Anna Vicco
- Department of Molecular Medicine, University of Padua, Padua, Italy; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Jameel Institute, Imperial College London, London, United Kingdom.
| | - Clare McCormack
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Jameel Institute, Imperial College London, London, United Kingdom
| | - Belen Pedrique
- Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
| | - Isabela Ribeiro
- Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
| | | | - Ilaria Dorigatti
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Jameel Institute, Imperial College London, London, United Kingdom.
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Indu PS, Anish TS, Chintha S, Libu GK, Tony L, Siju NS, Sreekumar E, Santhoshkumar A, Aravind R, Saradadevi KL, Sunija S, Johnson J, Anupriya MG, Mathew T, Reena KJ, Meenakshy V, Namitha P, Kumar NP, Kumari R, Mohamed AJ, Nagpal B, Sarkar S, Sadanandan R, Velayudhan R. The burden of dengue and force of infection among children in Kerala, India; seroprevalence estimates from Government of Kerala-WHO Dengue study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 22:100337. [PMID: 38482148 PMCID: PMC10934323 DOI: 10.1016/j.lansea.2023.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 11/09/2023] [Accepted: 11/22/2023] [Indexed: 04/21/2024]
Abstract
Background Dengue shows high geographic heterogeneity within and across endemic countries. In the context of increasing burden and predicted outbreaks due to climate change, understanding the heterogeneity will enable us to develop region specific targeted interventions, including vaccination. World Health Organisation (WHO) suggests standard methodologies to study the burden and heterogeneity at national and subnational levels. Regional studies with robust and standard methodology to capture heterogeneity are scarce. We estimated the seroprevalence of dengue in children aged 9-12 years and the force of infection in Kerala, India, from where Zika cases also have been reported recently. Methods We conducted a school-based cross-sectional survey in 38 clusters; selected by stratified random sampling, representing rural, urban, high burden and low-burden administrative units. Validation of Indirect IgG ELISA was done by Plaque Reduction Neutralization Test (PRNT90) using the local isolates of all four serotypes. Force of infection (FOI) was estimated using the WHO-FOI calculator. We conducted a follow-up survey among a subsample of seronegative children, to estimate the rate of sero-conversion. Results Among 5236 children tested, 1521 were positive for anti-dengue IgG antibody. The overall seroprevalence in the state was 29% (95% CI 24.1-33.9). The validity corrected seroprevalence was 30.9% in the overall sample, 46.9% in Thiruvananthapuram, 26.9% in Kozhikkode and 24.9% in Kollam. Age-specific seroprevalence increased with age; 25.7% at 9 years, 29.5% at 10 years, 30.9% at 11 years and 33.9% at 12 years. Seroprevalence varied widely across clusters (16.1%-71.4%). The estimated force of infection was 3.3/100 person-years and the seroconversion rate was 4.8/100 person-years. 90% of children who tested positive were not aware of dengue infection. All the four serotypes were identified in PRNT and 40% of positive samples had antibodies against multiple serotypes. Interpretation The study validates the WHO methodology for dengue serosurveys and confirms its feasibility in a community setting. The overall seroprevalence in the 9-12 year age group is low to moderate in Kerala; there are regional variations; high burden and low burden clusters co-exist in the same districts. The actual burden of dengue exceeds the reported numbers. Heterogeneity in prevalence, the high proportion of inapparent dengue and the hyperendemic situation suggest the need for region-specific and targeted interventions, including vaccination. Funding World Health Organization.
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Affiliation(s)
- Pillaveetil Sathyadas Indu
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Thekkumkara Surendran Anish
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Sujatha Chintha
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Gnanaseelan Kanakamma Libu
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Lawrence Tony
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Nalinakshan Sudha Siju
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Easwaran Sreekumar
- Molecular Virology Laboratory, Rajiv Gandhi Centre for Biotechnology (RGCB), Thiruvananthapuram, Kerala, India
- Institute of Advanced Virology (IAV), Bio 360 Life Sciences Park, Thonnakkal, Thiruvananthapuram, Kerala, India
| | - Asokan Santhoshkumar
- Department of Paediatrics, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | - Reghukumar Aravind
- Department of Infectious Diseases, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | | | | | | | | | | | | | | | - Premaletha Namitha
- Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala University of Health Sciences, India
| | | | | | | | | | | | | | - Raman Velayudhan
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
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3
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Anantharaj A, Agrawal T, Shashi PK, Tripathi A, Kumar P, Khan I, Pareek M, Singh B, Pattabiraman C, Kumar S, Pandey R, Chandele A, Lodha R, Whitehead SS, Medigeshi GR. Neutralizing antibodies from prior exposure to dengue virus negatively correlate with viremia on re-infection. COMMUNICATIONS MEDICINE 2023; 3:148. [PMID: 37857747 PMCID: PMC10587183 DOI: 10.1038/s43856-023-00378-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND India is hyperendemic to dengue and over 50% of adults are seropositive. There is limited information on the association between neutralizing antibody profiles from prior exposure and viral RNA levels during subsequent infection. METHODS Samples collected from patients with febrile illness was used to assess seropositivity by indirect ELISA. Dengue virus (DENV) RNA copy numbers were estimated by quantitative RT-PCR and serotype of the infecting DENV was determined by nested PCR. Focus reduction neutralizing antibody titer (FRNT) assay was established using Indian isolates to measure the levels of neutralizing antibodies and also to assess the cross-reactivity to related flaviviruses namely Zika virus (ZIKV), Japanese encephalitis virus (JEV) and West Nile virus (WNV). RESULTS In this cross-sectional study, we show that dengue seropositivity increased from 52% in the 0-15 years group to 89% in >45 years group. Antibody levels negatively correlate with dengue RNAemia on the day of sample collection and higher RNAemia is observed in primary dengue as compared to secondary dengue. The geometric mean FRNT50 titers for DENV-2 is significantly higher as compared to the other three DENV serotypes. We observe cross-reactivity with ZIKV and significantly lower or no neutralizing antibodies against JEV and WNV. The FRNT50 values for international isolates of DENV-1, DENV-3 and DENV-4 is significantly lower as compared to Indian isolates. CONCLUSIONS Majority of the adult population in India have neutralizing antibodies to all the four DENV serotypes which correlates with reduced RNAemia during subsequent infection suggesting that antibodies can be considered as a good correlate of protection.
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Affiliation(s)
- Anbalagan Anantharaj
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Tanvi Agrawal
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Pooja Kumari Shashi
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Alok Tripathi
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Parveen Kumar
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Imran Khan
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Madhu Pareek
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Balwant Singh
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | | | - Saurabh Kumar
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India
| | - Rajesh Pandey
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) laboratory, Division of Immunology and Infectious Disease Biology, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Anmol Chandele
- ICGEB-Emory Vaccine Center, International Center for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Stephen S Whitehead
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Guruprasad R Medigeshi
- Bioassay laboratory and Clinical and Cellular Virology lab, Translational Health Science and Technology Institute, Faridabad, Haryana, India.
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Singh S, Alallah J, Amrit A, Maheshwari A, Boppana S. Neurological Manifestations of Perinatal Dengue. NEWBORN (CLARKSVILLE, MD.) 2023; 2:158-172. [PMID: 37559696 PMCID: PMC10411360 DOI: 10.5005/jp-journals-11002-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Dengue viruses (DENVs) are single-stranded RNA viruses belonging to the family Flaviviridae. There are four distinct antigenically related serotypes, DENVs types 1, 2, 3, and 4. These are all mosquito-borne human pathogens. Congenital dengue disease occurs when there is mother-to-fetus transmission of the virus and should be suspected in endemic regions in neonates presenting with fever, maculopapular rash, and thrombocytopenia. Although most of the infected infants remain asymptomatic, some can develop clinical manifestations such as sepsis-like illness, gastric bleeding, circulatory failure, and death. Neurological manifestations include intracerebral hemorrhages, neurological malformations, and acute focal/disseminated encephalitis/encephalomyelitis. Dengue NS1Ag, a highly conserved glycoprotein, can help the detection of cases in the viremic stage. We do not have proven specific therapies yet; management is largely supportive and is focused on close monitoring and maintaining adequate intravascular volume.
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Affiliation(s)
- Srijan Singh
- Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Jubara Alallah
- Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Astha Amrit
- Department of Neonatology, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Akhil Maheshwari
- Department of Pediatrics, Division of Neonatal Medicine, Louisiana State University – Shreveport, Shreveport, Louisiana; Global Newborn Society, Baltimore, Maryland, United States of America
| | - Suresh Boppana
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Field evaluation of rapid diagnostic tests to determine dengue serostatus in Timor-Leste. PLoS Negl Trop Dis 2022; 16:e0010877. [DOI: 10.1371/journal.pntd.0010877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/17/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022] Open
Abstract
The live attenuated tetravalent CYD-TDV vaccine (Dengvaxia) is effective but has scarcely been used due to safety concerns among seronegative recipients. Rapid diagnostic tests (RDTs) which can accurately determine individual dengue serostatus are needed for use in pre-vaccination screening. This study aimed to determine the performance of existing RDTs (which have been designed to detect levels of immunoglobulin G, IgG, associated with acute post-primary dengue) when repurposed for detection of previous dengue infection (where concentrations of IgG are typically lower). A convenience sample of four-hundred-and-six participants (including 217 children) were recruited in the community. Whole blood was collected by phlebotomy and tested using Bioline Dengue IgG/IgM (Abbott) and Standard Q Dengue IgM/IgG (SD Biosensor) RDTs in the field. Serum samples from the same individuals were also tested at National Health Laboratory. The Panbio indirect IgG ELISA was used as a reference test. Reference testing determined that 370 (91.1%) participants were dengue IgG seropositive. Both assays were highly specific (100.0%) but had low sensitivity (Bioline = 21.1% and Standard Q = 4.6%) when used in the field. Sensitivity was improved when RDTs were used under laboratory conditions, and when assays were allowed to run beyond manufacturer recommendations (and read at a delayed time-point), but specificity was reduced. Efforts to develop RDTs with high sensitivity and specificity for prior dengue infection which can be operationalised for pre-vaccination screening are ongoing. Performance of forthcoming candidate assays should be tested under field conditions with blood samples, as well as in the laboratory.
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Racherla RG, Katari SK, Mohan A, Amineni U, Badur M, Chaudhury A, Nagaraja M, Kodavala S, Kante M, Kalawat U. Molecular Characterization and Identification of Potential Inhibitors for 'E' Protein of Dengue Virus. Viruses 2022; 14:v14050940. [PMID: 35632682 PMCID: PMC9143040 DOI: 10.3390/v14050940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/14/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Dengue is an arthropod-borne acute febrile illness caused by Dengue Virus (DENV), a member of Flaviviridae. Severity of the infection ranges from mild self-limiting illness to severe life-threatening hemorrhagic fever (DHF) and dengue shock syndrome (DSS). To date, there is no specific antiviral therapy established to treat the infection. The current study reports the epidemiology of DENV infections and potential inhibitors of DENV 'E' protein. Among the various serotypes, DENV-2 serotype was observed more frequently, followed by DENV-4, DENV-1, and DENV-3. New variants of existing genotypes were observed in DENV-1, 2, and 4 serotypes. Predominantly, the severe form of dengue was attributable to DENV-2 infections, and the incidence was more common in males and pediatric populations. Both the incidence and the disease severity were more common among the residents of non-urban environments. Due to the predominantly self-limiting nature of primary dengue infection and folk medicine practices of non-urban populations, we observed a greater number of secondary dengue cases than primary dengue cases. Hemorrhagic manifestations were more in secondary dengue in particularly in the pediatric group. Through different computational methods, ligands RGBLD1, RGBLD2, RGBLD3, and RGBLD4 are proposed as potential inhibitors in silico against DENV-1, -2, -3, and -4 serotypes.
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Affiliation(s)
- Rishi Gowtham Racherla
- Department of Clinical Virology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India; (R.G.R.); (M.N.); (M.K.)
| | - Sudheer Kumar Katari
- Department of Bioinformatics, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India; (S.K.K.); (U.A.)
| | - Alladi Mohan
- Department of Medicine, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India;
| | - Umamaheswari Amineni
- Department of Bioinformatics, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India; (S.K.K.); (U.A.)
| | - Manohar Badur
- Department of Pediatrics, Sri Venkateswara Ramnarain Ruia Government General Hospital (SVRRGGH), Tirupati 517507, Andhra Pradesh, India;
| | - Abhijit Chaudhury
- Department of Microbiology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India;
| | - Mudhigeti Nagaraja
- Department of Clinical Virology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India; (R.G.R.); (M.N.); (M.K.)
| | - Sireesha Kodavala
- Department of Biotechnology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India;
| | - Meenakshi Kante
- Department of Clinical Virology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India; (R.G.R.); (M.N.); (M.K.)
| | - Usha Kalawat
- Department of Clinical Virology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati 517507, Andhra Pradesh, India; (R.G.R.); (M.N.); (M.K.)
- Correspondence:
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Harapan H, Panta K, Michie A, Ernst T, McCarthy S, Muhsin M, Safarianti S, Zanaria TM, Mudatsir M, Sasmono RT, Imrie A. Hyperendemic Dengue and Possible Zika Circulation in the Westernmost Region of the Indonesian Archipelago. Viruses 2022; 14:219. [PMID: 35215813 PMCID: PMC8875625 DOI: 10.3390/v14020219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/16/2022] [Accepted: 01/20/2022] [Indexed: 12/03/2022] Open
Abstract
The transmission of dengue and other medically important mosquito-borne viruses in the westernmost region of Indonesia is not well described. We assessed dengue and Zika virus seroprevalence in Aceh province, the westernmost area of the Indonesian archipelago. Serum samples collected from 199 randomly sampled healthy residents of Aceh Jaya in 2017 were analyzed for neutralizing antibodies by plaque reduction neutralization test (PRNT). Almost all study participants (198/199; 99.5%) presented with multitypic profiles of neutralizing antibodies to two or more DENV serotypes, indicating transmission of multiple DENV in the region prior to 2017. All residents were exposed to one or more DENV serotypes by the age of 30 years. The highest geometric mean titers were measured for DENV-4, followed by DENV-1, DENV-2 and DENV-3. Among a subset of 116 sera, 27 neutralized ZIKV with a high stringency (20 with PRNT90 > 10 and 7 with PRNT90 > 40). This study showed that DENV is hyperendemic in the westernmost region of the Indonesian archipelago and suggested that ZIKV may have circulated prior to 2017.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia; (H.H.); (M.M.)
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia; (K.P.); (A.M.); (T.E.); (S.M.)
| | - Kritu Panta
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia; (K.P.); (A.M.); (T.E.); (S.M.)
| | - Alice Michie
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia; (K.P.); (A.M.); (T.E.); (S.M.)
| | - Timo Ernst
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia; (K.P.); (A.M.); (T.E.); (S.M.)
| | - Suzi McCarthy
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia; (K.P.); (A.M.); (T.E.); (S.M.)
- Pathwest Laboratory Medicine, Nedlands, WA 6009, Australia
| | - Muhsin Muhsin
- Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia;
- Department of Parasitology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia; (S.S.); (T.M.Z.)
| | - Safarianti Safarianti
- Department of Parasitology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia; (S.S.); (T.M.Z.)
| | - Tjut Mariam Zanaria
- Department of Parasitology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia; (S.S.); (T.M.Z.)
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia; (H.H.); (M.M.)
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - R. Tedjo Sasmono
- Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia;
| | - Allison Imrie
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia; (K.P.); (A.M.); (T.E.); (S.M.)
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Nealon J, Bouckenooghe A, Cortes M, Coudeville L, Frago C, Macina D, Tam CC. Dengue Endemicity, Force of Infection, and Variation in Transmission Intensity in 13 Endemic Countries. J Infect Dis 2022; 225:75-83. [PMID: 32211772 PMCID: PMC8730486 DOI: 10.1093/infdis/jiaa132] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/19/2020] [Indexed: 01/06/2023] Open
Abstract
Dengue endemicity varies but comparative, multicountry data are extremely limited. An improved understanding is needed to prioritize prevention, including vaccination, which is currently recommended only under specific epidemiological conditions. We used serological study data from 46 geographical sites in 13 countries to estimate dengue force of infection (FOI, the proportion of children seroconverting per year) under assumptions of either age-constant or age-varying FOI, and the age at which 50% and 80% of children had been infected. After exclusions, 13 661 subjects were included. Estimated constant FOI varied widely, from 1.7% (Singapore) to 24.1% (the Philippines). In the site-level analysis 44 sites (96%) reached 50% seroconversion and 35 sites (75%) reached 80% seroconversion by age 18 years, with significant heterogeneity. These findings confirm that children living in dengue-endemic countries receive intense early dengue exposure, increasing risk of secondary infection, and imply serosurveys at fine spatial resolutions are needed to inform vaccination campaigns.
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Affiliation(s)
- Joshua Nealon
- Vaccines Epidemiology and Modeling, Sanofi Pasteur, Lyon, France
| | | | | | | | - Carina Frago
- Global Clinical Sciences, Sanofi Pasteur, Singapore, Singapore
| | - Denis Macina
- Vaccines Epidemiology and Modeling, Sanofi Pasteur, Lyon, France
| | - Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore.,London School of Hygiene and Tropical Medicine, London, United Kingdom
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Lim JK, Carabali M, Edwards T, Barro A, Lee JS, Dahourou D, Lee KS, Nikiema T, Shin MY, Bonnet E, Kagone T, Kaba L, Namkung S, Somé PA, Yang JS, Ridde V, Yoon IK, Alexander N, Seydou Y. Estimating the Force of Infection for Dengue Virus Using Repeated Serosurveys, Ouagadougou, Burkina Faso. Emerg Infect Dis 2021; 27:130-139. [PMID: 33350906 PMCID: PMC7774580 DOI: 10.3201/eid2701.191650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Because of limited data on dengue virus in Burkina Faso, we conducted 4 consecutive age-stratified longitudinal serologic surveys, ≈6 months apart, among persons 1–55 years of age, during June 2015–March 2017, which included a 2016 outbreak. The seroconversion rate before the serosurvey enrollment was estimated by binomial regression, taking age as the duration of exposure, and assuming constant force of infection (FOI) over age and calendar time. We calculated FOI between consecutive surveys and rate ratios for potentially associated characteristics based on seroconversion using the duration of intervals. Among 2,897 persons at enrollment, 66.3% were IgG-positive, and estimated annual FOI was 5.95%. Of 1,269 enrollees participating in all 4 serosurveys, 438 were IgG-negative at enrollment. The annualized FOI ranged from 10% to 20% (during the 2016 outbreak). Overall, we observed high FOI for dengue. These results could support decision-making about control and preventive measures for dengue.
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Rai P, Kille S, Kotian A, Kumar BK, Deekshit VK, Ramakrishna MS, Karunasagar I, Karunasagar I. Molecular investigation of the dengue outbreak in Karnataka, South India, reveals co-circulation of all four dengue virus serotypes. INFECTION GENETICS AND EVOLUTION 2021; 92:104880. [PMID: 33905893 DOI: 10.1016/j.meegid.2021.104880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/20/2022]
Abstract
The growing incidence of dengue outbreaks in the state of Karnataka prompted us to study the circulating dengue virus (DENV) and their proportion among the suspected cases of dengue patients during the disease outbreak at Mysuru district of Southern India. The presence of the DENV in a patient's serum sample was identified by RT-PCR using previously published primer pairs targeting CprM gene. DENV serotyping was carried out by semi-nested multiplex PCR using serotype-specific primers and nucleotide sequencing. Three hundred fifty-five samples of serum from suspected dengue cases were collected, and 203 samples (57.18%) were found positives. In 2016, DENV-4 (97.87%) was found to be the most dominant DENV serotype either alone or as co-infection, followed by DENV-2 (8.51%) and DENV-3 (4.25%). In 47 positive cases, co-infection with more than one serotype was detected in 4 cases (8.51%). The analysis of the dengue cases in 2017, DENV-4 was dominating serotype (33.97%), followed by the emergence of DENV-2 (32.05%), DENV-3 (25.64%), and DENV-1 (25.00%). Our study also reports the circulation of all four DENV serotypes in the Mysuru district of Southern India, with concurrent infections rate of 16.66% in 2017. The present study provides information regarding the genetic variation among the circulating DENV serotype in an Indian state of Karnataka. The need for the studying genetic diversity of DENV will be useful during the continuous monitoring for disease burden as well as the development of appropriate prophylactic measures to control the spread of dengue infection.
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Affiliation(s)
- Praveen Rai
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India.
| | - Sonam Kille
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India
| | - Akshatha Kotian
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India
| | - Ballamoole Krishna Kumar
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India
| | - Vijaya Kumar Deekshit
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India
| | - Mysore Shivalingappa Ramakrishna
- 306/A, 3(rd) Stage Main, 9(th) Cross A-1BLOCK Vijay Nagar, 3(rd) Stage, Behind Clear medi Radiant Hospital, Mysuru 570030, Karnataka, India
| | - Indrani Karunasagar
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India
| | - Iddya Karunasagar
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research (NUCSER), Division of Infectious Diseases, Deralakatte, Mangaluru 575018, Karnataka, India
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Hussain W, Shaikh M, Hanif M, Ashfaq M, Ahmed H, Nisa BU. Pattern and Outcome of Dengue Fever in a Pediatric Tertiary Hospital: A Retrospective Report. Cureus 2021; 13:e14164. [PMID: 33936876 PMCID: PMC8080948 DOI: 10.7759/cureus.14164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction For Pakistan, dengue has been established as a public health problem. With superimposed factors such as poor socioeconomic conditions, limited public health awareness, poor hygiene, and sanitation conditions, the situation has become more severe and complications have become frequent. Almost 90% of all infections occur in children of age less than 18 years. This is a three-year retrospective report of dengue fever in Southern Pakistan. Methods In this retrospective analysis, all records of patients admitted to the National Institute of Child Health, Karachi, from May 1, 2016, till April 30, 2019, diagnosed with dengue fever were recruited. Their demographic, clinical, and biochemical records were assessed. The outcome was also recorded. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) for Windows version 20.0 (IBM Corp., Chicago). Results Among 93 cases of dengue fever, there were 71 (76.3%) male and 22 (23.7%) female children. Their mean age was 5.7 ± 3.07 years. The mean duration from onset of disease to hospitalization was 4.2 ± 2.1 days. The mean platelet count was 47391.30 ± 41370.61 x 109/L. Fever (100%) and abdominal pain (35.5%) were common presentations. Bleeding episodes were seen in 31% of children, rash in 15%, disseminated intravascular coagulation in 3%, and 1% developed pleural effusion. There were no mortalities; 87 (93.5%) were discharged and six (6.5%) children left against medical advice. Conclusion Fever, abdominal pain, bleeding episodes, and rash were common presentations. Hematological, hepatological, neurological, and pleural complications were not uncommon. The outcome of the disease was adequate and there were no mortalities.
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Affiliation(s)
- Wajid Hussain
- Pediatrics and Child Health, Jinnah Sindh Medical University, Karachi, PAK
| | - Mehmood Shaikh
- Neonatal Intensive Care Unit, Jinnah Sindh Medical University, Karachi, PAK
| | - Muhammad Hanif
- Neonatal Intensive Care Unit, Jinnah Sindh Medical University, Karachi, PAK
| | - Muhammad Ashfaq
- Pediatrics and Child Health, Jinnah Sindh Medical University, Karachi, PAK
| | - Habib Ahmed
- Pediatrics and Child Health, Jinnah Sindh Medical University, Karachi, PAK
| | - Bader-U- Nisa
- Pediatrics and Child Health, Jinnah Sindh Medical University, Karachi, PAK
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Cattarino L, Rodriguez-Barraquer I, Imai N, Cummings DAT, Ferguson NM. Mapping global variation in dengue transmission intensity. Sci Transl Med 2020; 12:12/528/eaax4144. [PMID: 31996463 DOI: 10.1126/scitranslmed.aax4144] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 09/12/2019] [Accepted: 01/02/2020] [Indexed: 12/28/2022]
Abstract
Intervention planning for dengue requires reliable estimates of dengue transmission intensity. However, current maps of dengue risk provide estimates of disease burden or the boundaries of endemicity rather than transmission intensity. We therefore developed a global high-resolution map of dengue transmission intensity by fitting environmentally driven geospatial models to geolocated force of infection estimates derived from cross-sectional serological surveys and routine case surveillance data. We assessed the impact of interventions on dengue transmission and disease using Wolbachia-infected mosquitoes and the Sanofi-Pasteur vaccine as specific examples. We predicted high transmission intensity in all continents straddling the tropics, with hot spots in South America (Colombia, Venezuela, and Brazil), Africa (western and central African countries), and Southeast Asia (Thailand, Indonesia, and the Philippines). We estimated that 105 [95% confidence interval (CI), 95 to 114] million dengue infections occur each year with 51 (95% CI, 32 to 66) million febrile disease cases. Our analysis suggests that transmission-blocking interventions such as Wolbachia, even at intermediate efficacy (50% transmission reduction), might reduce global annual disease incidence by up to 90%. The Sanofi-Pasteur vaccine, targeting only seropositive recipients, might reduce global annual disease incidence by 20 to 30%, with the greatest impact in high-transmission settings. The transmission intensity map presented here, and made available for download, may help further assessment of the impact of dengue control interventions and prioritization of global public health efforts.
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Affiliation(s)
- Lorenzo Cattarino
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
| | | | - Natsuko Imai
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Derek A T Cummings
- Department of Biology and Emerging Pathogens Institute, University of Florida, P. O. Box 100009, Gainesville, FL 32610, USA
| | - Neil M Ferguson
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
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13
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Bhavsar A, Tam CC, Garg S, Jammy GR, Taurel AF, Chong SN, Nealon J. Estimated dengue force of infection and burden of primary infections among Indian children. BMC Public Health 2019; 19:1116. [PMID: 31412836 PMCID: PMC6694619 DOI: 10.1186/s12889-019-7432-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/01/2019] [Indexed: 12/17/2022] Open
Abstract
Background Comprehensive, age-stratified dengue surveillance data are unavailable from India and many more dengue cases occur than are reported. Additional information on dengue transmission dynamics can inform understanding of disease endemicity and infection risk. Methods Using age-stratified dengue IgG seroprevalence data from 2556 Indian children aged 5–10 years, we estimated annual force of infection (FOI) at each of 6 sites using a binomial regression model. We estimated the ages by which 50 and 70% of children were first infected; and predicted seroprevalence in children aged 1–10 years assuming constant force-of-infection. Applying these infection rates to national census data, we then calculated the number of primary dengue infections occurring, annually, in Indian children. Results Annual force-of-infection at all sites combined was 11.9% (95% CI 8.8–16.2), varying across sites from 3.5% (95% CI 2.8–4.4) to 21.2% (95% CI 18.4–24.5). Overall, 50 and 70% of children were infected by 5.8 (95% CI 4.3–7.9) and 10.1 (95% CI 7.4–13.7) years respectively. In all sites except Kalyani, > 70% of children had been infected before their 11th birthday, and goodness-of-fit statistics indicated a relatively constant force-of-infection over time except at two sites (Wardha and Hyderabad). Nationwide, we estimated 17,013,527 children (95% CI: 14,518,438- 19,218,733), equivalent to 6.5% of children aged < 11 years, experience their first infection annually. Conclusions Dengue force-of-infection in India is comparable to other highly endemic countries. Significant variation across sites exists, likely reflecting local epidemiological variation. The number of annual primary infections is indicative of a significant, under-reported burden of secondary infections and symptomatic episodes. Trial registration Registered retrospectively with clinicaltrials.gov (NCT01477671; 18/11/2011) and clinical trials registry of India (ctri.nic.in; CTRI/2011/12/002243; 15/12/2011). Date of enrollment of 1st subject: 22/9/2011. Electronic supplementary material The online version of this article (10.1186/s12889-019-7432-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amit Bhavsar
- Sanofi Pasteur- India, Mumbai, India.,Present address: GSK Biologicals, Rixensart, Belgium
| | - Clarence C Tam
- Present address: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,London School of Hygiene & Tropical Medicine, London, UK
| | - Suneela Garg
- Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, Delhi, 10002, India
| | - Guru Rajesh Jammy
- SHARE INDIA - Mediciti Institute of Medical Sciences, Hyderabad, India
| | - Anne-Frieda Taurel
- Sanofi Pasteur- Singapore, Asia & JPAC, 38 Beach Road # 18-11, South Beach Tower, Singapore, 189767, Singapore
| | - Sher-Ney Chong
- Present address: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Sanofi Pasteur- Singapore, Asia & JPAC, 38 Beach Road # 18-11, South Beach Tower, Singapore, 189767, Singapore
| | - Joshua Nealon
- Sanofi Pasteur- Singapore, Asia & JPAC, 38 Beach Road # 18-11, South Beach Tower, Singapore, 189767, Singapore.
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14
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Murhekar MV, Kamaraj P, Kumar MS, Khan SA, Allam RR, Barde P, Dwibedi B, Kanungo S, Mohan U, Mohanty SS, Roy S, Sagar V, Savargaonkar D, Tandale BV, Topno RK, Sapkal G, Kumar CPG, Sabarinathan R, Kumar VS, Bitragunta S, Grover GS, Lakshmi PVM, Mishra CM, Sadhukhan P, Sahoo PK, Singh SK, Yadav CP, Bhagat A, Srivastava R, Dinesh ER, Karunakaran T, Govindhasamy C, Rajasekar TD, Jeyakumar A, Suresh A, Augustine D, Kumar PA, Kumar R, Dutta S, Toteja GS, Gupta N, Mehendale SM. Burden of dengue infection in India, 2017: a cross-sectional population based serosurvey. LANCET GLOBAL HEALTH 2019; 7:e1065-e1073. [PMID: 31201130 DOI: 10.1016/s2214-109x(19)30250-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/03/2019] [Accepted: 05/01/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The burden of dengue virus (DENV) infection across geographical regions of India is poorly quantified. We estimated the age-specific seroprevalence, force of infection, and number of infections in India. METHODS We did a community-based survey in 240 clusters (118 rural, 122 urban), selected from 60 districts of 15 Indian states from five geographical regions. We enumerated each cluster, randomly selected (with an Andriod application developed specifically for the survey) 25 individuals from age groups of 5-8 years, 9-17 years, and 18-45 years, and sampled a minimum of 11 individuals from each age group (all the 25 randomly selected individuals in each age group were visited in their houses and individuals who consented for the survey were included in the study). Age was the only inclusion criterion; for the purpose of enumeration, individuals residing in the household for more than 6 months were included. Sera were tested centrally by a laboratory team of scientific and technical staff for IgG antibodies against the DENV with the use of indirect ELISA. We calculated age group specific seroprevalence and constructed catalytic models to estimate force of infection. FINDINGS From June 19, 2017, to April 12, 2018, we randomly selected 17 930 individuals from three age groups. Of these, blood samples were collected and tested for 12 300 individuals (5-8 years, n=4059; 9-17 years, n=4265; 18-45 years, n=3976). The overall seroprevalence of DENV infection in India was 48·7% (95% CI 43·5-54·0), increasing from 28·3% (21·5-36·2) among children aged 5-8 years to 41·0% (32·4-50·1) among children aged 9-17 years and 56·2% (49·0-63·1) among individuals aged between 18-45 years. The seroprevalence was high in the southern (76·9% [69·1-83·2]), western (62·3% [55·3-68·8]), and northern (60·3% [49·3-70·5]) regions. The estimated number of primary DENV infections with the constant force of infection model was 12 991 357 (12 825 128-13 130 258) and for the age-dependent force of infection model was 8 655 425 (7 243 630-9 545 052) among individuals aged 5-45 years from 30 Indian states in 2017. INTERPRETATION The burden of dengue infection in India was heterogeneous, with evidence of high transmission in northern, western, and southern regions. The survey findings will be useful in making informed decisions about introduction of upcoming dengue vaccines in India. FUNDING Indian Council of Medical Research.
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Affiliation(s)
- Manoj V Murhekar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India.
| | - P Kamaraj
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | | | - Siraj Ahmed Khan
- ICMR-Regional Medical Research Centre, Northeast Region, Dibrugarh, India
| | | | - Pradip Barde
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | | | - Suman Kanungo
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Uday Mohan
- King George's Medical University, Lucknow, India
| | | | - Subarna Roy
- ICMR-National Institute of Traditional Medicine, Belagavi, India
| | - Vivek Sagar
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Roshan Kamal Topno
- ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | - C P Girish Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - R Sabarinathan
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - Velusamy Saravana Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | | | | | - P V M Lakshmi
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Provash Sadhukhan
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - S K Singh
- King George's Medical University, Lucknow, India
| | | | - Asha Bhagat
- ICMR-National Institute of Virology, Pune, India
| | | | - E Ramya Dinesh
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - T Karunakaran
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - C Govindhasamy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - T Daniel Rajasekar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A Jeyakumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A Suresh
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - D Augustine
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - P Ashok Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - Rajesh Kumar
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - G S Toteja
- ICMR-Desert Medicine Research Centre, Jodhpur, India
| | - Nivedita Gupta
- Epidemiology and Communicable Diseases Division, ICMR, New Delhi, India
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The value of seroprevalence data as surveillance tool for Lyme borreliosis in the general population: the experience of Belgium. BMC Public Health 2019; 19:597. [PMID: 31101034 PMCID: PMC6525443 DOI: 10.1186/s12889-019-6914-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 04/29/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Serological surveillance, based on the measurement of the presence of specific antibodies in a given population, can be used in addition to traditional and routine disease surveillance methods. The added value of this has been largely documented for vaccine-preventable diseases, but to a lesser extent for vector-borne diseases. This study aimed to evaluate the utility of seroprevalence data as additional source of information on the epidemiology of Lyme borreliosis in Belgium. METHODS In total, 3215 residual blood samples collected in 2013-2015 were analysed with Liaison® Borrelia IgG kit (DiaSorin S.p.A, Saluggia, Italy). Positive and equivocal results were further examined with immunoblotting (recomLine Borrelia IgG kit, Mikrogen, Neuried, Germany). Crude prevalence estimates of equivocal and seropositive results were calculated and further adjusted accounting for clustered sampling and standardized for age, sex and population per province, according to the Belgian population structure in 2014. The effect of age, sex and region on seropositivity was assessed using log-binomial regression. RESULTS The overall weighted national seroprevalence for Borrelia burgdorferi sensu lato, adjusted for clustered sampling, age, sex and province was 1.06% (95%CI 0.67-1.67). Although not statistically significant, the highest prevalences were observed in men and in those younger than 15 years or older than 59 years of age. At provincial level, the seroprevalence estimates do not follow the geographical distribution of tick bites and diagnoses of Lyme borreliosis as detected through other surveillance systems. CONCLUSIONS Although the use of residual samples for seroprevalence estimates has several advantages, it seems to be a limited tool for serological surveillance of Lyme borreliosis in Belgium, other than follow-up of trends if repeated over time. A population-based sampling strategy might provide a more representative nationwide sample, but would be very time intensive and expensive. Seroprevalence studies within risk groups or risk areas in Belgium could provide a useful alternative approach to complement routine surveillance data of Lyme borreliosis.
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Shah PS, Alagarasu K, Karad S, Deoshatwar A, Jadhav SM, Raut T, Singh A, Dayaraj C, Padbidri VS. Seroprevalence and incidence of primary dengue infections among children in a rural region of Maharashtra, Western India. BMC Infect Dis 2019; 19:296. [PMID: 30940086 PMCID: PMC6444844 DOI: 10.1186/s12879-019-3937-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 03/25/2019] [Indexed: 12/30/2022] Open
Abstract
Background Dengue infections have become a huge threat to public health systems in developing countries. Data on seroprevalence and incidence of dengue infections are lacking from rural regions of India. The objective of present study was to investigate the seroprevalence and incidence of dengue infection utilizing repeated serosurveys from a rural region of Maharashtra, Western India. Methods In the present study, 819 children between ages 5 to 15 years from 21 villages in Pune District of Maharashtra, India were sampled in 2014 and 2016. The sera were tested for the presence of dengue specific IgG using an indirect IgG ELISA kit. Results Overall seroprevalence of dengue was 15.3% (95% confidence intervals (CI) 12.9–17.8%) in 2014 and 20.5% (95% CI 17.8–23.4%) in 2016. Among the 694 children who were seronegative at baseline (2014), 78 seroconverted. Overall incidence rate of primary dengue was 54.2 infections/1000 children years (95% CI 43.0–67.3). Incidence of primary dengue infection was higher in children from urbanized villages compared to rural villages (Incidence rate ratio (IRR) 2.6 (95% CI 1.3–5.2)). In rural villages, incidence of primary dengue infection was higher in children aged 10 years or above as compared to those aged below 10 years (IRR 9.75 (95% CI 1.21–77.9). Conclusions The study provides the incidence rates of primary dengue infections from a rural region of India. More multi centric studies investigating the incidence of dengue will provide accurate estimate of incidence of dengue and help formulate well directed policies. The results also suggest that urbanization and transitions in demographic settings might favour dengue outbreaks in rural regions and these regions need to be targeted for vector control measures.
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Affiliation(s)
- Paresh S Shah
- Dengue/Chikungunya Group, ICMR- National Institute of Virology, Pune, 411001, India.
| | - Kalichamy Alagarasu
- Dengue/Chikungunya Group, ICMR- National Institute of Virology, Pune, 411001, India
| | - Shivaji Karad
- KEM Hospital and Research Centre, Pune, 411001, India
| | - Avinash Deoshatwar
- Epidemiology Group, ICMR- National Institute of Virology, Pune, 411001, India
| | - Santosh M Jadhav
- Bioinformatics Group, ICMR- National Institute of Virology, Pune, 411001, India
| | - Tushar Raut
- Dengue/Chikungunya Group, ICMR- National Institute of Virology, Pune, 411001, India
| | - Anand Singh
- Dengue/Chikungunya Group, ICMR- National Institute of Virology, Pune, 411001, India
| | - Cecilia Dayaraj
- Dengue/Chikungunya Group, ICMR- National Institute of Virology, Pune, 411001, India
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17
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Analysis of dengue specific memory B cells, neutralizing antibodies and binding antibodies in healthy adults from India. Int J Infect Dis 2019; 84S:S57-S63. [PMID: 30658170 DOI: 10.1016/j.ijid.2019.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The Indian population is facing highest dengue burden worldwide supporting an urgent need for vaccines. For vaccine introduction, evaluation and interpretation it is important to gain a critical understanding of immune memory induced by natural exposure. However, immune memory to dengue remains poorly characterized in this region. METHODS We enumerated levels of dengue specific memory B cells (MBC), neutralizing (NT) and binding antibodies in healthy adults (n=70) from New Delhi. RESULTS NT-antibodies, binding antibodies and MBC were detectable in 86%, 86.56% and 81.63% of the subjects respectively. Among the neutralizing positive subjects, 58%, 27%, 5% and 10% neutralized all four, any three, any two and any one dengue serotypes respectively. The presence of the neutralizing antibodies was associated with the presence of the MBC and binding antibodies. However, a massive interindividual variation was observed in the levels of the neutralizing antibodies (range, <1:50-1:30,264), binding antibodies (range, 1:3,000-1:134,000,) as well as the MBC (range=0.006%-5.05%). CONCLUSION These results indicate that a vast majority of the adults are immune to multiple dengue serotypes and show massive interindividual variation in neutralizing/binding antibodies and MBCs - emphasizing the importance of monitoring multiple parameters of immune memory in order to properly plan, evaluate and interpret dengue vaccines.
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18
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Racherla RG, Pamireddy ML, Mohan A, Mudhigeti N, Mahalakshmi PA, Nallapireddy U, Kalawat U. Co-circulation of four dengue serotypes at South Eastern Andhra Pradesh, India: A prospective study. Indian J Med Microbiol 2018; 36:236-240. [PMID: 30084417 DOI: 10.4103/ijmm.ijmm_18_109] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Dengue is one of the most important mosquito-borne viral diseases in the world. The emergence and spread of four dengue viruses (DENVs) (serotypes) represent a global pandemic. The four distinct serotypes are, namely, DENV-1, DENV-2, DENV-3 and DENV-4. Very few dengue serotyping studies have been reported from Andhra Pradesh. In this context, the present study focuses on the circulating serotypes of dengue in South-Eastern Andhra Pradesh. Methodology Study was done at Sri Venkateswara Institute of Medical Sciences, a teaching hospital in Tirupati, Andhra Pradesh. Acute phase dengue serum samples were collected and tested for NS1 antigen and anti-human IgM antibodies by enzyme-linked immunosorbent assay (ELISA). NS1-positive samples were further serotyped by reverse transcriptase real-time polymerase chain reaction (rRT-PCR). Results A total of 398 serum samples were received from clinically suspected dengue fever cases. Of these, 150 (37.7%) samples were positive for NS1 and/or IgM ELISA. The 96 NS1 antigen-positive samples were further processed for serotyping, of which 36 were negative by rRT-PCR. DENV-2 (41%) was the predominant serotype, followed by DENV-4 (37%), DENV-3 (12%) and DENV-1 (10%) in descending order. Conclusion This study reports the all four dengue serotypes' co-circulation. This is the first report from South Eastern Andhra Pradesh. Amongst four, DENV-2 was predominant followed by DENV-4. The information of predominant serotypes can guide in forecasting dengue outbreaks and improving control measures of vectors thus may be helpful in the prevention of outbreaks.
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Affiliation(s)
- Rishi Gowtham Racherla
- Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Madhavi Latha Pamireddy
- Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Alladi Mohan
- Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Nagaraja Mudhigeti
- Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | | | - Umapathi Nallapireddy
- Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Usha Kalawat
- Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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Pavía-Ruz N, Barrera-Fuentes GA, Villanueva-Jorge S, Che-Mendoza A, Campuzano-Rincón JC, Manrique-Saide P, Rojas DP, Vazquez-Prokopec GM, Halloran ME, Longini IM, Gómez-Dantés H. Dengue seroprevalence in a cohort of schoolchildren and their siblings in Yucatan, Mexico (2015-2016). PLoS Negl Trop Dis 2018; 12:e0006748. [PMID: 30462654 PMCID: PMC6248890 DOI: 10.1371/journal.pntd.0006748] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/12/2018] [Indexed: 12/27/2022] Open
Abstract
Background The implementation of vector control interventions and potential introduction new tools requires baseline data to evaluate their direct and indirect effects. The objective of the study is to present the seroprevalence of dengue infection in a cohort of children 0 to 15 years old followed during 2015 to 2016, the risk factors and the role of enhanced surveillance strategies in three urban sites (Merida, Ticul and Progreso) in Yucatan, Mexico. Methods A cohort of school children and their family members was randomly selected in three urban areas with different demographic, social conditions and levels of transmission. We included results from 1,844 children aged 0 to 15 years. Serum samples were tested for IgG, NS1 and IgM. Enhanced surveillance strategies were established in schools (absenteeism) and cohort families (toll-free number). Results Seroprevalence in children 0 to 15 years old was 46.8 (CI 95% 44.1–49.6) with no difference by sex except in Ticul. Prevalence increased with age and was significantly lower in 0 to 5 years old (26.9%, 95% CI:18.4–35.4) compared with 6 to 8 years old (43.9%, 95% CI:40.1–47.7) and 9 to 15 years old (61.4%, 95% CI:58.0–64.8). Sharing the domestic space with other families increased the risk 1.7 times over the individual families that own or rented their house, while risk was significantly higher when kitchen and bathroom were outside. Complete protection with screens in doors and windows decreased risk of infection. Seroprevalence was significantly higher in the medium and high risk areas. Conclusions The prevalence of antibodies in children 0 to 15 years in three urban settings in the state of Yucatan describe the high exposure and the heterogenous transmission of dengue virus by risk areas and between schools in the study sites. The enhanced surveillance strategy was useful to improve detection of dengue cases with the coincident transmission of chikungunya and Zika viruses. Dengue is a major public health problem in Latin America. Its transmission is highly heterogeneous, and its burden varies by geographic region, age group affected, serotype and other factors. While surveillance of dengue in the region has improved, several limitations remain, including under detection, misdiagnosis and the complexity of controlling a vector that has adapted to human dwellings in tropical and subtropical urban contexts. Prospective studies have become crucial to understand the transmission of dengue in urban environments and assess the impact of control strategies, such as the introduction of a dengue vaccine or additional vector control interventions. Our findings provide epidemiological data regarding the serological profile and risk factors for dengue infections in a cohort of children 0 to 15 years old in an endemic state in Mexico and confirmed the high exposure in these age groups. Likewise, enhanced and passive surveillance of cases gave us the opportunity to measure the behavior of dengue activity during chikungunya and Zika viruses’ arrival, which we believe will contribute to improve the design of surveillance and control strategies.
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Affiliation(s)
- Norma Pavía-Ruz
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | | | - Salha Villanueva-Jorge
- Laboratorio Estatal de Salud Pública y Referencia Epidemiológica, Servicios de Salud de Yucatán, Merida, Yucatan, Mexico
| | - Azael Che-Mendoza
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | | | - Pablo Manrique-Saide
- Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | - Diana Patricia Rojas
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States of America
- Center for Inference and Dynamics of Infectious Diseases, Seattle, Washington, United States of America
| | | | - M. Elizabeth Halloran
- Center for Inference and Dynamics of Infectious Diseases, Seattle, Washington, United States of America
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Ira M. Longini
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States of America
- Center for Inference and Dynamics of Infectious Diseases, Seattle, Washington, United States of America
| | - Héctor Gómez-Dantés
- Center for Health Systems Research, National Institute of Public Health, Mexico City, Mexico
- * E-mail:
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Mishra AC, Arankalle VA, Gadhave SA, Mahadik PH, Shrivastava S, Bhutkar M, Vaidya VM. Stratified sero-prevalence revealed overall high disease burden of dengue but suboptimal immunity in younger age groups in Pune, India. PLoS Negl Trop Dis 2018; 12:e0006657. [PMID: 30080850 PMCID: PMC6095695 DOI: 10.1371/journal.pntd.0006657] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 08/16/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In India, dengue disease is emerging as the most important vector borne public health problem due to rapid and unplanned urbanization, high human density and week management of the disease. Clinical cases are grossly underreported and not much information is available on prevalence and incidence of the disease. METHODOLOGY A cross sectional, stratified, facility based, multistage cluster sampling was conducted between May 4 and June 27, 2017 in Pune city. A total of 1,434 participants were enrolled. The serum samples were tested for detection of historical dengue IgG antibodies by ELISA using the commercial Panbio Dengue IgG Indirect ELISA kit. Anti-dengue IgG-capture Panbio ELISA was used for detection of high titered antibodies to detect recent secondary infection. We used this data to estimate key transmission parameters like force of infection and basic reproductive number. A subset of 120 indirect ELISA positive samples was also tested for Plaque Reduction Neutralizing Antibodies for determining serotype-specific prevalence. FINDINGS Overall, 81% participants were infected with dengue virus (DENV) at least once if not more. The positivity was significantly different in different age groups. All the adults above 70 years were positive for DENV antibodies. Over 69% participants were positive for neutralizing antibodies against all 4 serotypes suggesting intense transmission of all DENV serotypes in Pune. Age-specific seroprevalence was consistent with long-term, endemic circulation of DENV. There was an increasing trend with age, from 21.6% among <36 months to 59.4% in age group 10-12 years. We estimate that 8.68% of the susceptible population gets infected by DENV each year resulting into more than 3,00,000 infections and about 47,000 to 59,000 cases per year. This transmission intensity is similar to that reported from other known hyper-endemic settings in Southeast Asia and the Americas but significantly lower than report from Chennai. CONCLUSIONS Our study suggests that Pune city has high disease burden, all 4 serotypes are circulating, significant spatial heterogeneity in seroprevalence and suboptimal immunity in younger age groups. This would allow informed decisions to be made on management of dengue and introduction of upcoming dengue vaccines in the city.
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Affiliation(s)
- Akhilesh C. Mishra
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
| | - Vidya A. Arankalle
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
| | - Swapnil A. Gadhave
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
| | - Pritam H. Mahadik
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
| | - Shubham Shrivastava
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
| | - Mandar Bhutkar
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
| | - Varsha M. Vaidya
- Department Community Medicine, Medical College, Bharati Vidyapeeth (Deemed to be University), Katraj, Pune, India
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Fritzell C, Rousset D, Adde A, Kazanji M, Van Kerkhove MD, Flamand C. Current challenges and implications for dengue, chikungunya and Zika seroprevalence studies worldwide: A scoping review. PLoS Negl Trop Dis 2018; 12:e0006533. [PMID: 30011271 PMCID: PMC6062120 DOI: 10.1371/journal.pntd.0006533] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/26/2018] [Accepted: 05/16/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Arboviral infections are a public health concern and an escalating problem worldwide. Estimating the burden of these diseases represents a major challenge that is complicated by the large number of unapparent infections, especially those of dengue fever. Serological surveys are thus required to identify the distribution of these diseases and measure their impact. Therefore, we undertook a scoping review of the literature to describe and summarize epidemiological practices, findings and insights related to seroprevalence studies of dengue, chikungunya and Zika virus, which have rapidly expanded across the globe in recent years. METHODOLOGY/PRINCIPAL FINDINGS Relevant studies were retrieved through a literature search of MEDLINE, WHOLIS, Lilacs, SciELO and Scopus (2000 to 2018). In total, 1389 publications were identified. Studies addressing the seroprevalence of dengue, chikungunya and/or Zika written in English or French and meeting the inclusion and exclusion criteria were included. In total, 147 studies were included, from which 185 data points were retrieved, as some studies used several different samples. Most of the studies were exclusively conducted on dengue (66.5%), but 16% were exclusively conducted on chikungunya, and 7 were exclusively conducted on Zika; the remainder were conducted on multiple arboviruses. A wide range of designs were applied, but most studies were conducted in the general population (39%) and in households (41%). Although several assays were used, enzyme-linked immunosorbent assays (ELISAs) were the predominant test used (77%). The temporal distribution of chikungunya studies followed the virus during its rapid expansion since 2004. The results revealed heterogeneity of arboviruses seroprevalence between continents and within a given country for dengue, chikungunya and Zika viruses, ranging from 0 to 100%, 76% and 73% respectively. CONCLUSIONS/SIGNIFICANCE Serological surveys provide the most direct measurement for defining the immunity landscape for infectious diseases, but the methodology remains difficult to implement. Overall, dengue, chikungunya and Zika serosurveys followed the expansion of these arboviruses, but there remain gaps in their geographic distribution. This review addresses the challenges for researchers regarding study design biases. Moreover, the development of reliable, rapid and affordable diagnosis tools represents a significant issue concerning the ability of seroprevalence surveys to differentiate infections when multiple viruses co-circulate.
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Affiliation(s)
- Camille Fritzell
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Dominique Rousset
- National Reference Laboratory for Arboviruses, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Antoine Adde
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Mirdad Kazanji
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | | | - Claude Flamand
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana
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Ganeshkumar P, Murhekar MV, Poornima V, Saravanakumar V, Sukumaran K, Anandaselvasankar A, John D, Mehendale SM. Dengue infection in India: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006618. [PMID: 30011275 PMCID: PMC6078327 DOI: 10.1371/journal.pntd.0006618] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 08/06/2018] [Accepted: 06/19/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Dengue is the most extensively spread mosquito-borne disease; endemic in more than 100 countries. Information about dengue disease burden, its prevalence, incidence and geographic distribution is critical in planning appropriate control measures against dengue fever. We conducted a systematic review and meta-analysis of dengue fever in India. METHODS We searched for studies published until 2017 reporting the incidence, the prevalence or case fatality of dengue in India. Our primary outcomes were (a) prevalence of laboratory confirmed dengue infection among clinically suspected patients, (b) seroprevalence in the general population and (c) case fatality ratio among laboratory confirmed dengue patients. We used binomial-normal mixed effects regression model to estimate the pooled proportion of dengue infections. Forest plots were used to display pooled estimates. The metafor package of R software was used to conduct meta-analysis. RESULTS Of the 2285 identified articles on dengue, we included 233 in the analysis wherein 180 reported prevalence of laboratory confirmed dengue infection, seven reported seroprevalence as evidenced by IgG or neutralizing antibodies against dengue and 77 reported case fatality. The overall estimate of the prevalence of laboratory confirmed dengue infection among clinically suspected patients was 38.3% (95% CI: 34.8%-41.8%). The pooled estimate of dengue seroprevalence in the general population and CFR among laboratory confirmed patients was 56.9% (95% CI: 37.5-74.4) and 2.6% (95% CI: 2-3.4) respectively. There was significant heterogeneity in reported outcomes (p-values<0.001). CONCLUSIONS Identified gaps in the understanding of dengue epidemiology in India emphasize the need to initiate community-based cohort studies representing different geographic regions to generate reliable estimates of age-specific incidence of dengue and studies to generate dengue seroprevalence data in the country.
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Affiliation(s)
| | - Manoj V. Murhekar
- Department of Epidemiology, National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Veeraraghavadoss Poornima
- School of Public Health, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Velusamy Saravanakumar
- Department of Epidemiology, National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Krishnendu Sukumaran
- School of Public Health, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Anandan Anandaselvasankar
- School of Public Health, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Denny John
- Campbell Collaboration, New Delhi, India
| | - Sanjay M. Mehendale
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Yuan B, Nishiura H. Estimating the actual importation risk of dengue virus infection among Japanese travelers. PLoS One 2018; 13:e0198734. [PMID: 29924819 PMCID: PMC6010241 DOI: 10.1371/journal.pone.0198734] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/24/2018] [Indexed: 12/27/2022] Open
Abstract
Background Frequent international travel facilitates the global spread of dengue fever. Japan has experienced an increasing number of imported case notifications of dengue virus (DENV) infection, mostly arising from Japanese travelers visiting South and Southeast Asian countries. This has led an autochthonous dengue outbreak in 2014 in Japan. The present study aimed to infer the risk of DENV infection among Japanese travelers to Asian countries, thereby obtaining an actual estimate of the number of DENV infections among travelers. Methodology/Principal findings For eight destination countries (Indonesia, Philippines, Thailand, India, Malaysia, Vietnam, Sri Lanka, and Singapore), we collected age-dependent seroepidemiological data. We also retrieved the number of imported cases, who were notified to the Japanese government, as well as the total number of travelers to each destination. Using a mathematical model, we estimated the force of infection in each destination country with seroepidemiological data while jointly inferring the reporting coverage of DENV infections among Japanese travelers from datasets of imported cases and travelers. Assuming that travelers had a risk of infection that was identical to that of the local population during travel, the reporting coverage of dengue appeared to range from 0.6% to 4.3%. The risk of infection per journey ranged from 0.02% to 0.44%. Conclusions/Significance We found that the actual number of imported cases of DENV infection among Japanese travelers could be more than 20 times the notified number of imported cases. This finding may be attributed to the substantial proportion of asymptomatic and under-ascertained infections.
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Affiliation(s)
- Baoyin Yuan
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroshi Nishiura
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- * E-mail:
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Orellano P, Vezzani D, Quaranta N, Reynoso J, Salomón OD. Estimation of expected dengue seroprevalence from passive epidemiological surveillance systems in selected areas of Argentina: A proxy to evaluate the applicability of dengue vaccination. Vaccine 2018; 36:979-985. [PMID: 29331246 DOI: 10.1016/j.vaccine.2018.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 01/02/2018] [Accepted: 01/04/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Current recommendations about dengue vaccination by the World Health Organization depend on seroprevalence levels and serological status in populations and individuals. However, seroprevalence estimation may be difficult due to a diversity of factors. Thus, estimation through models using data from epidemiological surveillance systems could be an alternative procedure to achieve this goal. OBJECTIVE To estimate the expected dengue seroprevalence in children of selected areas in Argentina, using a simple model based on data from passive epidemiological surveillance systems. METHODS A Markov model using a simulated cohort of individuals from age 0 to 9 years was developed. Parameters regarding the reported annual incidence of dengue, proportion of inapparent cases, and expansion factors for outpatient and hospitalized cases were considered as transition probabilities. The proportion of immune population at 9 years of age was taken as a proxy of the expected seroprevalence, considering this age as targeted for vaccination. The model was used to evaluate the expected seroprevalence in Misiones and Salta provinces and in Buenos Aires city, three settings showing different climatic favorability for dengue. RESULTS The estimates of the seroprevalence for the group of 9-year-old children for Misiones was 79% (95%CI:46-100%), and for Salta 22% (95%CI:14-30%), both located in northeastern and northwestern Argentina, respectively. Buenos Aires city, from central Argentina, showed a likely seroprevalence of 7% (95%CI: 3-11%). According to the deterministic sensitivity analyses, the parameter showing the highest influence on these results was the probability of inapparent cases. CONCLUSIONS This model allowed the estimation of dengue seroprevalence in settings where this information is not available. Particularly for Misiones, the expected seroprevalence was higher than 70% in a wide range of scenarios, thus in this province a vaccination strategy directed to seropositive children of >9 years should be analyzed, including further considerations as safety, cost-effectiveness, and budget impact.
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Affiliation(s)
- Pablo Orellano
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Universidad Tecnológica Nacional, Facultad Regional San Nicolás, San Nicolás, Argentina.
| | - Darío Vezzani
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Instituto Multidisciplinario sobre Ecosistemas y Desarrollo Sustentable, Facultad de Cs Exactas, UNICEN, Tandil, Argentina
| | - Nancy Quaranta
- Universidad Tecnológica Nacional, Facultad Regional San Nicolás, San Nicolás, Argentina; Comisión de Investigaciones Científicas de la Provincia de Buenos Aires, Argentina
| | - Julieta Reynoso
- Hospital Interzonal General de Agudos "San Felipe", San Nicolás, Argentina
| | - Oscar Daniel Salomón
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud de la Nación, Puerto Iguazú, Argentina
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Kenneson A, Beltrán-Ayala E, Borbor-Cordova MJ, Polhemus ME, Ryan SJ, Endy TP, Stewart-Ibarra AM. Social-ecological factors and preventive actions decrease the risk of dengue infection at the household-level: Results from a prospective dengue surveillance study in Machala, Ecuador. PLoS Negl Trop Dis 2017; 11:e0006150. [PMID: 29253873 PMCID: PMC5771672 DOI: 10.1371/journal.pntd.0006150] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 01/17/2018] [Accepted: 12/03/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In Ecuador, dengue virus (DENV) infections transmitted by the Aedes aegypti mosquito are among the greatest public health concerns in urban coastal communities. Community- and household-level vector control is the principal means of controlling disease outbreaks. This study aimed to assess the impact of knowledge, attitudes, and practices (KAPs) and social-ecological factors on the presence or absence of DENV infections in the household. METHODS In 2014 and 2015, individuals with DENV infections from sentinel clinics in Machala, Ecuador, were invited to participate in the study, as well as members of their household and members of four neighboring households located within 200 meters. We conducted diagnostic testing for DENV on all study participants; we surveyed heads of households (HOHs) regarding demographics, housing conditions and KAPs. We compared KAPs and social-ecological factors between households with (n = 139) versus without (n = 80) DENV infections, using bivariate analyses and multivariate logistic regression models with and without interactions. RESULTS Significant risk factors in multivariate models included proximity to abandoned properties, interruptions in piped water, and shaded patios (p<0.05). Significant protective factors included the use of mosquito bed nets, fumigation inside the home, and piped water inside the home (p<0.05). In bivariate analyses (but not multivariate modeling), DENV infections were positively associated with HOHs who were male, employed, and of younger age than households without infections (p<0.05). DENV infections were not associated with knowledge, attitude, or reported barriers to prevention activities. DISCUSSION Specific actions that can be considered to decrease the risk of DENV infections in the household include targeting vector control in highly shaded properties, fumigating inside the home, and use of mosquito bed nets. Community-level interventions include cleanup of abandoned properties, daily garbage collection, and reliable piped water inside houses. These findings can inform interventions to reduce the risk of other diseases transmitted by the Ae. aegypti mosquito, such as chikungunya and Zika fever.
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Affiliation(s)
- Aileen Kenneson
- Center for Global Health & Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, United States of America
| | - Efraín Beltrán-Ayala
- Facultad de Medicina, Universidad Técnica de Machala, Machala, El Oro Province, Ecuador
| | - Mercy J. Borbor-Cordova
- Facultad de Ingeniería Marítima, Ciencias Biológicas, Oceánicas y Recursos Naturales, Escuela Superior Politecnica del Litoral (ESPOL), Guayaquil, Ecuador
| | - Mark E. Polhemus
- Center for Global Health & Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, United States of America
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States of America
| | - Sadie J. Ryan
- Center for Global Health & Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, United States of America
- Department of Geography, University of Florida, Gainesville, FL, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States of America
- College of Life Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Timothy P. Endy
- Center for Global Health & Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, United States of America
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States of America
- Department of Microbiology & Immunology, SUNY Upstate Medical University, Syracuse, NY, United States of America
| | - Anna M. Stewart-Ibarra
- Center for Global Health & Translational Sciences, SUNY Upstate Medical University, Syracuse, NY, United States of America
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States of America
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Co-circulation and co-infections of all dengue virus serotypes in Hyderabad, India 2014. Epidemiol Infect 2017; 145:2563-2574. [DOI: 10.1017/s0950268817001479] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
SUMMARYThe burden of dengue virus infections increased globally during recent years. Though India is considered as dengue hyper-endemic country, limited data are available on disease epidemiology. The present study includes molecular characterization of dengue virus strains occurred in Hyderabad, India, during the year 2014. A total of 120 febrile cases were recruited for this study, which includes only children and 41 were serologically confirmed for dengue positive infections using non-structural (NS1) and/or IgG/IgM ELISA tests. RT-PCR, nucleotide sequencing and evolutionary analyses were carried out to identify the circulating serotypes/genotypes. The data indicated a high percent of severe dengue (63%) in primary infections. Simultaneous circulation of all four serotypes and co-infections were observed for the first time in Hyderabad, India. In total, 15 patients were co-infected with more than one dengue serotype and 12 (80%) of them had severe dengue. One of the striking findings of the present study is the identification of serotype Den-1 as the first report from this region and this strain showed close relatedness to the Thailand 1980 strains but not to any of the strains reported from India until now. Phylogenetically, all four strains of the present study showed close relatedness to the strains, which are reported to be high virulent.
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Carabali M, Lim JK, Velez DC, Trujillo A, Egurrola J, Lee KS, Kaufman JS, DaSilva LJ, Velez ID, Osorio JE. Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction. Int J Infect Dis 2017; 58:27-36. [PMID: 28284914 PMCID: PMC5421161 DOI: 10.1016/j.ijid.2017.02.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction. METHODS A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years. RESULTS A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n=1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3-10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent. CONCLUSIONS These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.
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Affiliation(s)
- Mabel Carabali
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
| | - Jacqueline Kyungah Lim
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Diana Carolina Velez
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Andrea Trujillo
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Jorge Egurrola
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Kang Sung Lee
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Luiz Jacinto DaSilva
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Ivan Dario Velez
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Jorge E Osorio
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia; Department of Pathobiological Sciences, University of Wisconsin, Madison, Wisconsin, USA
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