Households as foci for dengue transmission in highly urban Vietnam.

Autor: Anders KL; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia., Nga le H; Preventive Medicine Centre, Ho Chi Minh City, Vietnam., Thuy NT; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam., Ngoc TV; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Tam CT; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Tai LT; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Truong NT; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Duyen HT; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam., Trung VT; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam., Kien DT; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam., Wolbers M; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom., Wills B; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom., Chau NV; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Tho ND; Preventive Medicine Centre, Ho Chi Minh City, Vietnam., Simmons CP; Oxford University Clinical Research Unit-Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, University of Oxford, Oxford, United Kingdom; Department of Microbiology and Immunology, University of Melbourne, Melbourne, Australia.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2015 Feb 13; Vol. 9 (2), pp. e0003528. Date of Electronic Publication: 2015 Feb 13 (Print Publication: 2015).
DOI: 10.1371/journal.pntd.0003528
Abstrakt: Background: Dengue control programs commonly employ reactive insecticide spraying around houses of reported cases, with the assumption that most dengue virus (DENV) transmission occurs in the home. Focal household transmission has been demonstrated in rural settings, but it is unclear whether this holds true in dense and mobile urban populations. We conducted a prospective study of dengue clustering around households in highly urban Ho Chi Minh City, Vietnam.
Methods: We enrolled 71 index cases with suspected dengue (subsequently classified as 52 dengue cases and 19 non-dengue controls); each initiated the enrollment of a cluster of 25-35 household members and neighbors who were followed up over 14 days. Incident DENV infections in cluster participants were identified by RT-PCR, NS1-ELISA, and/or DENV-IgM/-IgG seroconversion, and recent infections by DENV-IgM positivity at baseline.
Principal Findings/conclusions: There was no excess risk of DENV infection within dengue case clusters during the two-week follow-up, compared to control clusters, but the prevalence of recent DENV infection at baseline was two-fold higher in case clusters than controls (OR 2.3, 95%CI 1.0-5.1, p = 0.05). Prevalence of DENV infection in Aedes aegypti was similar in case and control houses, and low overall (1%). Our findings are broadly consistent with household clustering of dengue risk, but indicate that any clustering is at a short temporal scale rather than sustained chains of localized transmission. This suggests that reactive perifocal insecticide spraying may have a limited impact in this setting.
Databáze: MEDLINE
Externí odkaz: