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Anderson KB, Stewart-Ibarra AM, Buddhari D, Beltran Ayala EF, Sippy RJ, Iamsirithaworn S, Ryan SJ, Fernandez S, Jarman RG, Thomas SJ, Endy TP. Key Findings and Comparisons From Analogous Case-Cluster Studies for Dengue Virus Infection Conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand. Front Public Health 2020; 8:2. [PMID: 32117847 PMCID: PMC7028768 DOI: 10.3389/fpubh.2020.00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/03/2020] [Indexed: 11/21/2022] Open
Abstract
Dengue viruses (DENV) pose a significant and increasing threat to human health across broad regions of the globe. Currently, prevention, control, and treatment strategies are limited. Promising interventions are on the horizon, including multiple vaccine candidates under development and a renewed and innovative focus on controlling the vector, Aedes aegypti. However, significant gaps persist in our understanding of the similarities and differences in DENV epidemiology across regions of potential implementation and evaluation. In this manuscript, we highlight and compare findings from two analogous cluster-based studies for DENV transmission and pathogenesis conducted in Thailand and Ecuador to identify key features and questions for further pursuit. Despite a remarkably similar incidence of DENV infection among enrolled neighborhood contacts at the two sites, we note a higher occurrence of secondary infection and severe illness in Thailand compared to Ecuador. A higher force of infection in Thailand, defined as the incidence of infection among susceptible individuals, is suggested by the higher number of captured Aedes mosquitoes per household, the increasing proportion of asymptomatic infections with advancing age, and the high proportion of infections identified as secondary-type infections by serology. These observations should be confirmed in long-term, parallel prospective cohort studies conducted across regions, which would advantageously permit characterization of baseline immune status (susceptibility) and contemporaneous assessment of risks and risk factors for dengue illness.
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Affiliation(s)
- Kathryn B Anderson
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Armed Forces Research Institute of Medical Science, Bangkok, Thailand.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Anna M Stewart-Ibarra
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Montevideo, Inter-American Institute for Global Change Research (IAI), Montevideo, Uruguay
| | - Darunee Buddhari
- Armed Forces Research Institute of Medical Science, Bangkok, Thailand
| | | | - Rachel J Sippy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Geography, University of Florida, Gainesville, FL, United States
| | | | - Sadie J Ryan
- Department of Geography, University of Florida, Gainesville, FL, United States.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Stefan Fernandez
- Armed Forces Research Institute of Medical Science, Bangkok, Thailand
| | - Richard G Jarman
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Stephen J Thomas
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Timothy P Endy
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States.,Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY, United States.,Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, United States
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