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Salim KU, Álvarez FS, Chan-Golston AM, Naughton CC, Cisneros R, Joyce A. Socioeconomic and environmental factors associated with dengue fever incidence in Guatemala: Rising temperatures increase dengue risk. PLoS One 2024; 19:e0308271. [PMID: 39088578 PMCID: PMC11293734 DOI: 10.1371/journal.pone.0308271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 07/15/2024] [Indexed: 08/03/2024] Open
Abstract
Dengue fever is a mosquito-borne illness that infects 390 million people annually. Dengue outbreaks in Guatemala have been occurring more often and at increased rates since the first dengue outbreak in Guatemala in the 1970s. This study will examine environmental and socioeconomic factors associated with dengue in Guatemala at the municipality (county) level. Socioeconomic factors included population density, Mayan population, economic activity, and attending school. Environmental factors included average minimum annual temperature and annual precipitation. The relationship between environmental and socioeconomic variables and dengue fever incidence was initially evaluated through univariate zero-inflated negative binomial models, and then again through three zero-inflated multivariate negative binomial regression models. For all three models, elevation was considered a predictor of zero-inflation. In the combined model, there was a positive relationship between minimum temperature, economic activity and dengue fever incidence, and a negative relationship between population density, Mayan population and dengue fever. Predicted rates of dengue fever incidence and adjusted confidence intervals were calculated after increasing minimum yearly temperature by 1°C and 2°C. The three municipalities with the highest minimum yearly temperature (El Estor, Iztapa, and Panzós) and the municipality of Guatemala, all had an increase in the magnitude of the risk of dengue fever incidence following 1°C and 2°C increase in temperature. This research suggests that these socioeconomic and environmental factors are associated with risk of dengue in Guatemala. The predicted rates of dengue fever also highlight the potential effect that climate change in the form of increasing temperature can have on dengue in Guatemala.
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Affiliation(s)
- Kasem U. Salim
- Public Health, University of California Merced, Merced, CA, United States of America
| | | | - Alec M. Chan-Golston
- Public Health, University of California Merced, Merced, CA, United States of America
| | - Colleen C. Naughton
- Civil and Environmental Engineering, University of California Merced, Merced, CA, United States of America
| | - Ricardo Cisneros
- Public Health, University of California Merced, Merced, CA, United States of America
| | - Andrea Joyce
- Public Health, University of California Merced, Merced, CA, United States of America
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Zúniga-Gutiérrez M, Meléndez M, Montoya SSR, Escobar HAF, López J, Paz S, Sauceda-Acosta D. Dengue Burden and Factors Influencing Severity in Honduras: A Descriptive and Analytical Study. Rev Soc Bras Med Trop 2024; 57:e004072024. [PMID: 38896654 PMCID: PMC11178375 DOI: 10.1590/0037-8682-0594-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/09/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Dengue is a disease that accounts for a major morbidity and mortality in Honduras. METHODS This descriptive study used an analytical component based on the data from the National Virology Laboratory between 2016-2022. Ordinal logistic regression was used to identify the factors associated with the classification of dengue without warning signs (DWOS), dengue with warning signs (DWS), and severe dengue (SD). RESULTS Overall, 14,687 dengue cases were included; 50.1% had DWOS, 36.5% had DWS, and 13.4% had SD. Patients that were more associated with a higher probability of DWS and SD were patients in the age groups 1-4 years (DWS OR 1.61; 95%CI:1.33-1.94), (SD OR 1.52; 95% CI:1.26-1.84), 5-9 years (DWS OR 2.01; 95% CI:1.68-2.40), (SD OR 2.00; 95% CI:1.67-2.40), and 10-19 years (DWS OR 1.55; 95% CI:1.30-1.85) (SD OR 1.57; 95% CI:1.31-1.88). The departments that were associated with a higher probability of DWS and SD were La Paz (OR 6.35; 95% CI:3.53-11.42), (OR 10.94; 95% CI:5.96-20.08), Copán (OR 6.94; 95% CI:5.05-9.53) (OR 7.33; 95% CI: 5.35-10.03), Valle (OR 5.22; 95% CI:1.25-21.82) (OR 10.71; 95% CI:2.21-51.88). CONCLUSIONS During the study period, dengue presented endemic behavior, with peaks consistent with the last two epidemics in Honduras in 2015 and 2019. The main factors associated with dengue severity were age< 19 years, male sex, and being from La Paz, Copán, or Valle.
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Affiliation(s)
- Melba Zúniga-Gutiérrez
- Universidad Nacional Autónoma de Honduras, Research Institute in
Medical Sciences and Right to Health, Epidemiology Postgraduate Program Tegucigalpa,
Honduras
| | - Marlon Meléndez
- Universidad Nacional Autónoma de Honduras, Epidemiology Postgraduate
Program. Tegucigalpa, Honduras
| | | | | | - Jorge López
- Universidad Nacional Autónoma de Honduras, Demography and
Development Postgraduate Program. Tegucigalpa, Honduras
| | - Sandra Paz
- Ministry of Health, Health Surveillance Unit, National Virology
Laboratory. Tegucigalpa, Honduras
| | - Dilcia Sauceda-Acosta
- Universidad Nacional Autónoma de Honduras, Research Institute in
Medical Sciences and Right to Health, Epidemiology Postgraduate Program Tegucigalpa,
Honduras
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Lessa CLS, Hodel KVS, Gonçalves MDS, Machado BAS. Dengue as a Disease Threatening Global Health: A Narrative Review Focusing on Latin America and Brazil. Trop Med Infect Dis 2023; 8:tropicalmed8050241. [PMID: 37235289 DOI: 10.3390/tropicalmed8050241] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Arboviruses constitute the largest known group of viruses. These viruses are the etiological agents of pathologies known as arboviruses, with dengue being one of the most prevalent. Dengue has resulted in important socioeconomic burdens placed on different countries around the world, including those in Latin America, especially Brazil. Thus, this work intends to carry out a narrative-based review of the literature, conducted using a study of the secondary data developed through a survey of scientific literature databases, and to present the situation of dengue, particularly its distribution in these localities. Our findings from the literature demonstrate the difficulties that managers face in controlling the spread of and planning a response against dengue, pointing to the high cost of the disease for public coffers, rendering the resources that are already limited even scarcer. This can be associated with the different factors that affect the spread of the disease, including ecological, environmental, and social factors. Thus, in order to combat the disease, it is expected that targeted and properly coordinated public policies need to be adopted not only in specific localities, but also globally.
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Affiliation(s)
- Carlos Letacio Silveira Lessa
- Postgraduate Program in Industrial Management and Technology, SENAI CIMATEC University Center, Salvador 41650-010, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, Brazil
| | - Katharine Valéria Saraiva Hodel
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Brazil
| | - Marilda de Souza Gonçalves
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, Brazil
- Anemia Research Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia, Salvador 40170-115, Brazil
| | - Bruna Aparecida Souza Machado
- Postgraduate Program in Industrial Management and Technology, SENAI CIMATEC University Center, Salvador 41650-010, Brazil
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), SENAI CIMATEC University Center, Salvador 41650-010, Brazil
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Lamb MM, Paniagua-Avila A, Zacarias A, Rojop N, Chacon A, Natrajan MS, Waggoner JJ, Lopez MR, Cordon-Rosales C, Huleatt JW, Bonaparte MI, Asturias EJ, Olson D. Repeated Rapid Active Sampling Surveys Demonstrated a Rapidly Changing Zika Seroprevalence among Children in a Rural Dengue-endemic Region in Southwest Guatemala during the Zika Epidemic (2015-2016). Am J Trop Med Hyg 2022; 107:1099-1106. [PMID: 36252798 PMCID: PMC9709015 DOI: 10.4269/ajtmh.22-0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/08/2022] [Indexed: 11/07/2022] Open
Abstract
Although Central America is largely dengue virus (DENV)-endemic, the 2015-2016 Zika virus (ZIKV) pandemic brought new urgency to develop surveillance approaches capable of characterizing the rapidly changing disease burden in resource-limited settings. We conducted a pediatric DENV surveillance study in rural Guatemala, including serial cross-sectional surveys from April through September 2015 (Survey 1), in October-November 2015 (Survey 2), and January-February 2016 (Survey 3). Serum underwent DENV IgM MAC ELISA and polymerase chain reaction testing. Using banked specimens from Surveys 2 and 3, we expanded testing to include DENV 1-4 and ZIKV microneutralization (MN50), DENV NS1 IgG ELISA, and ZIKV anti-NS1 antibody Blockage of Binding (BoB) ELISA testing. Demographic risk factors for ZIKV BoB positivity were explored using multivariable generalized linear regression models. Of Survey 2 and 3 samples available (N = 382), DENV seroprevalence slightly increased (+1%-10% depending on the assay) during the surveillance period and increased with age. In contrast, ZIKV seroprevalence consistently increased over the 3-month period, including from 6% to 34% (P < 0.0001) and 10%-37% (P < 0.0001) using the MN50 ≥100 and BoB ELISA assays, respectively. Independent risk factors for ZIKV seropositivity included older age (prevalence ratio (PR)/year = 1.12, 95% confidence interval (CI) = 1.07-1.17) and primary caregiver literacy (PR = 2.80, CI = 1.30-6.06). Rapid active surveillance (RAS) surveys demonstrated a nearly 30% increase in ZIKV prevalence and a slight (≤ 10%) increase in DENV seroprevalence from October to November 2015 to January to February 2016 in rural southwest Guatemala, regardless of serologic assay used. RAS surveys may be a useful "off-the-shelf" tool to characterize arboviruses and other emerging pathogens rapidly in resource-limited settings.
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Affiliation(s)
- Molly M. Lamb
- Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, Colorado
| | - Alejandra Paniagua-Avila
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, FUNSALUD, Coatepeque, Quetzaltenango, Guatemala
| | - Alma Zacarias
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, FUNSALUD, Coatepeque, Quetzaltenango, Guatemala
| | - Neudy Rojop
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, FUNSALUD, Coatepeque, Quetzaltenango, Guatemala
| | - Andrea Chacon
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, FUNSALUD, Coatepeque, Quetzaltenango, Guatemala
| | - Muktha S. Natrajan
- Emory University Department of Medicine, Division of Infectious Diseases, Atlanta, Georgia
| | - Jesse J. Waggoner
- Emory University Department of Medicine, Division of Infectious Diseases, Atlanta, Georgia
| | - Maria Renee Lopez
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Celia Cordon-Rosales
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | | | - Edwin J. Asturias
- Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, Colorado
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Daniel Olson
- Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, Colorado
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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Izmirly AM, Pelletier AN, Connors J, Taramangalam B, Alturki SO, Gordon EA, Alturki SO, Mell JC, Swaminathan G, Karthik V, Kutzler MA, Kallas EG, Sekaly RP, Haddad EK. Pre-vaccination frequency of circulatory Tfh is associated with robust immune response to TV003 dengue vaccine. PLoS Pathog 2022; 18:e1009903. [PMID: 35061851 PMCID: PMC8809550 DOI: 10.1371/journal.ppat.1009903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/02/2022] [Accepted: 01/06/2022] [Indexed: 11/19/2022] Open
Abstract
It has been estimated that more than 390 million people are infected with Dengue virus every year; around 96 millions of these infections result in clinical pathologies. To date, there is only one licensed viral vector-based Dengue virus vaccine CYD-TDV approved for use in dengue endemic areas. While initially approved for administration independent of serostatus, the current guidance only recommends the use of this vaccine for seropositive individuals. Therefore, there is a critical need for investigating the influence of Dengue virus serostatus and immunological mechanisms that influence vaccine outcome. Here, we provide comprehensive evaluation of sero-status and host immune factors that correlate with robust immune responses to a Dengue virus vector based tetravalent vaccine (TV003) in a Phase II clinical cohort of human participants. We observed that sero-positive individuals demonstrate a much stronger immune response to the TV003 vaccine. Our multi-layered immune profiling revealed that sero-positive subjects have increased baseline/pre-vaccination frequencies of circulating T follicular helper (cTfh) cells and the Tfh related chemokine CXCL13/BLC. Importantly, this baseline/pre-vaccination cTfh profile correlated with the vaccinees' ability to launch neutralizing antibody response against all four sero-types of Dengue virus, an important endpoint for Dengue vaccine clinical trials. Overall, we provide novel insights into the favorable cTfh related immune status that persists in Dengue virus sero-positive individuals that correlate with their ability to mount robust vaccine specific immune responses. Such detailed interrogation of cTfh cell biology in the context of clinical vaccinology will help uncover mechanisms and targets for favorable immuno-modulatory agents.
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Affiliation(s)
- Abdullah M. Izmirly
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | | | - Jennifer Connors
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Bhavani Taramangalam
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Sawsan O. Alturki
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Emma A. Gordon
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Sana O. Alturki
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Joshua C. Mell
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Gokul Swaminathan
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- Department of Vaccine Innovation, Boehringer Ingelheim, Lyon, France
| | - Vivin Karthik
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Michele A. Kutzler
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Esper G. Kallas
- Department of Infectious and Parasitic Diseases, University of São Paulo, Sao Paulo, Brazil
| | - Rafick-Pierre Sekaly
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Elias K. Haddad
- Department of Medicine and Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
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