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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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Nimavat N, Hasan MM, Charmode S, Mandala G, Parmar GR, Bhangu R, Khan I, Singh S, Agrawal A, Shah A, Sachdeva V. COVID-19 pandemic effects on the distribution of healthcare services in India: A systematic review. World J Virol 2022; 11:186-197. [PMID: 36159611 PMCID: PMC9372784 DOI: 10.5501/wjv.v11.i4.186] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/19/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has brought fundamental changes to our problems and priorities, especially those related to the healthcare sector. India was one of the countries severely affected by the harsh consequences of the COVID-19 pandemic.
AIM To understand the challenges faced by the healthcare system during a pandemic.
METHODS The literature search for this review was conducted using PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. We also used Reference Citation Analysis (RCA) to search and improve the results. We focused on the published scientific articles concerned with two major vital areas: (1) The Indian healthcare system; and (2) COVID-19 pandemic effects on the Indian healthcare system.
RESULTS The Indian healthcare system was suffering even before the pandemic. The pandemic has further stretched the healthcare services in India. The main obstacle in the healthcare system was to combat the rising number of communicable as well as noncommunicable diseases. Besides the pandemic measures, there was a diversion of focus of the already established healthcare services away from the chronic conditions and vaccinations. The disruption of the vaccination services may have more severe short and long-term consequences than the pandemic’s adverse effects.
CONCLUSION Severely restricted resources limited the interaction of the Indian healthcare system with the COVID-19 pandemic. Re-establishment of primary healthcare services, maternal and child health services, noncommunicable diseases programs, National Tuberculosis Elimination Program, etc. are important to prevent serious long-term consequences of this pandemic.
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Affiliation(s)
- Nirav Nimavat
- Department of Community Medicine, Dr. Kiran C Patel Medical College and Research Institute, Bharuch 392001, India
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Tangail 1902, Bangladesh
| | - Sundip Charmode
- Department of Anatomy, All India Institute of Medical Sciences, Rajkot 360006, Gujarat, India
| | - Gowthamm Mandala
- Independent Researcher, Centre Groove High School, Greenwood, IN 46143, United States
| | | | - Ranvir Bhangu
- Department of Medical, Caribbean Medical University, Des Plaines, IL 60018, United States
| | - Israr Khan
- Shifa International Hospital, Islamabad 999010, Pakistan
| | - Shruti Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Patna 801507, India
| | - Amit Agrawal
- Department of Paediatrics, Gandhi Medical College, Bhopal 462001, India
| | - Ashish Shah
- Department of Pharmacy, Sumandeep Vidyapeeth, Vadodara 391760, India
| | - Vishi Sachdeva
- Department of Medical, Adesh Institute of Medical Sciences and Research, Bathinda 151009, India
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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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Mendoza-Cano O, Rincón-Avalos P, Watson V, Khouakhi A, la Cruz JLD, Ruiz-Montero AP, Nava-Garibaldi CM, Lopez-Rojas M, Murillo-Zamora E. The Burden of Dengue in Children by Calculating Spatial Temperature: A Methodological Approach Using Remote Sensing Techniques. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4230. [PMID: 33923602 PMCID: PMC8073896 DOI: 10.3390/ijerph18084230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Dengue fever is one of the most important arboviral diseases. Surface temperature versus dengue burden in tropical environments can provide valuable information that can be adapted in future measurements to improve health policies. METHODS A methodological approach using Daymet-V3 provided estimates of daily weather parameters. A Python code developed by us extracted the median temperature from the urban regions of Colima State (207.3 km2) in Mexico. JointPoint regression models computed the mean temperature-adjusted average annual percentage of change (AAPC) in disability-adjusted life years (DALY) rates (per 100,000) due to dengue in Colima State among school-aged (5-14 years old) children. RESULTS Primary outcomes were average temperature in urban areas and cumulative dengue burden in DALYs in the school-aged population. A model from 1990 to 2017 medium surface temperature with DALY rates was performed. The increase in DALYs rate was 64% (95% CI, 44-87%), and it seemed to depend on the 2000-2009 estimates (AAPC = 185%, 95% CI 18-588). CONCLUSION From our knowledge, this is the first study to evaluate surface temperature and to model it through an extensive period with health economics calculations in a specific subset of the Latin-American endemic population for dengue epidemics.
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Affiliation(s)
- Oliver Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Col. Jardines del Llano, Coquimatlán 28400, Colima, Mexico; (P.R.-A.); (J.L.-d.l.C.); (A.P.R.-M.); (M.L.-R.)
| | - Pedro Rincón-Avalos
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Col. Jardines del Llano, Coquimatlán 28400, Colima, Mexico; (P.R.-A.); (J.L.-d.l.C.); (A.P.R.-M.); (M.L.-R.)
| | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK;
| | - Abdou Khouakhi
- School of Water, Energy and Environment, Centre for Environmental and Agricultural Informatics, Cranfield University, Cranfield MK43 0AL, UK;
| | - Jesús López-de la Cruz
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Col. Jardines del Llano, Coquimatlán 28400, Colima, Mexico; (P.R.-A.); (J.L.-d.l.C.); (A.P.R.-M.); (M.L.-R.)
| | - Angelica Patricia Ruiz-Montero
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Col. Jardines del Llano, Coquimatlán 28400, Colima, Mexico; (P.R.-A.); (J.L.-d.l.C.); (A.P.R.-M.); (M.L.-R.)
| | - Cynthia Monique Nava-Garibaldi
- Department of Civil and Environmental Engineering, University of Wisconsin-Madison, 1415 Engineering Dr, Madison, WI 53706, USA;
| | - Mario Lopez-Rojas
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Col. Jardines del Llano, Coquimatlán 28400, Colima, Mexico; (P.R.-A.); (J.L.-d.l.C.); (A.P.R.-M.); (M.L.-R.)
| | - Efrén Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Av. Javier Mina 301, Col. Centro, Colima 28000, Colima, Mexico
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