Heterogeneity of dengue transmission in an endemic area of Colombia
| Autor: | Anyela Lozano Parra, Victor M. Herrera, María Isabel Estupiñán Cárdenas, Luís Ángel Villar Centeno, Zuly Milena Zaraza Moncayo, Janeth Patricia Flórez García, Maria Consuelo Miranda Montoya, Isabel Rodriguez Barraquer |
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| Rok vydání: | 2020 |
| Předmět: |
RNA viruses
Male Rural Population 0301 basic medicine Viral Diseases Urban Population Health Care Providers RC955-962 Social Sciences Force of infection Pathology and Laboratory Medicine Geographical locations Dengue Fever Serology law.invention Dengue fever Dengue Medical Conditions 0302 clinical medicine Seroepidemiologic Studies law Arctic medicine. Tropical medicine Surveys and Questionnaires Medicine and Health Sciences Public and Occupational Health Medical Personnel Child Geographic Areas Travel Geography Age Factors Vaccination and Immunization Vaccination Professions Infectious Diseases Transmission (mechanics) Medical Microbiology Viral Pathogens Child Preschool Viruses Female Public aspects of medicine RA1-1270 Pathogens Research Article Neglected Tropical Diseases Urban Areas Adult Adolescent Immunology 030231 tropical medicine Enzyme-Linked Immunosorbent Assay Colombia Human Geography Microbiology Urban Geography 03 medical and health sciences Physicians medicine Humans Seroprevalence Microbial Pathogens Socioeconomic status Biology and life sciences Flaviviruses business.industry Organisms Public Health Environmental and Occupational Health Dengue Virus South America Tropical Diseases medicine.disease Rural Areas Health Care Cross-Sectional Studies 030104 developmental biology Immunoglobulin G Earth Sciences Population Groupings Preventive Medicine People and places Rural area business Demography |
| Zdroj: | PLoS Neglected Tropical Diseases PLoS Neglected Tropical Diseases, Vol 14, Iss 9, p e0008122 (2020) |
| ISSN: | 1935-2735 |
| DOI: | 10.1371/journal.pntd.0008122 |
| Popis: | Population based serological surveys are the gold-standard to quantify dengue (DENV) transmission. The purpose of this study was to estimate the age-specific seroprevalence and the force of infection of DENV in an endemic area of Colombia. Between July and October 2014, we conducted a household based cross-sectional survey among 1.037 individuals aged 2 to 40 years living in 40 randomly selected locations in urban Piedecuesta, Santander, Colombia. In addition, we also enrolled 246 indviduals living in rural “veredas”. Participants were asked to answer a questionnaire that included demographic, socioeconomic and environmental questions and to provide a 5 ml blood sample. Sera were tested using the IgG indirect ELISA (Panbio) kit to determine past DENV infection. The overall DENV seroprevalence was 70% (95% CI = 67%-71%), but was significantly higher in urban (81%, 95% CI = 78%-83%) as compared to rural (21%, 95% CI = 17%-27%) locations. Age was a major predictor of seropositivity, consistent with endemic circulation of the virus. Using catalytic models we estimated that on average, 12% (95%CI = 11%-13%) of susceptible individuals living in the city are infected by DENV each year. Beyond age, the only predictor of seropositivity in urban locations was prior history of dengue diagnosed by a physician (aPR 1.15, 95% CI = 0.98–1.35). Among participants living in rural settings, those that reported traveling outside of their vereda were more likely to be seropositive (aPR 3.60, 95%CI = 1.54–8.42) as well as those who were born outside of Santander department (aPR = 2.77, 95%CI = 1.20–6.37). These results are consistent with long term endemic circulation of DENV in Piedecuesta, with large heterogeneities between urban and rural areas located just a few kilometers apart. Design of DENV control interventions, including vaccination, will need to consider this fine scale spatial heterogeneity. Author summary Dengue is the most rapidly expanding arbovirus in the world. Counts of reported dengue cases, as usually reported by surveillance systems, are a poor metric of the underlying transmission because most of the infections are asymptomatic. Population based serological surveys, where the prevalence of antibodies to dengue virus are measured in a random sample of the population, are considered the gold-standard to quantify dengue transmission. In this study, the authors conducted a population based serological survey in urban and rural areas of Piedecuesta, Santander, Colombia. Seropositivity was significantly higher in urban as compared to rural locations. Age was a major predictor of seropositivity, consistent with long-term circulation of the virus in this setting. They estimated that, on average, 12% of susceptible individuals living in urban locations get infected by dengue each year. The only predictor of prior dengue infection in urban inhabitants was self-reported history dengue. In rural locations, traveling regularly outside of their “vereda” (neighborhood) and having been born outside of Santander department were associated with seropositivity. These results show that the Piedecuesta municipality is an endemic area of dengue transmission, with large heterogeneities between urban and rural settings. Control interventions, including vaccination should be targeted at fine spatial scales. |
| Databáze: | OpenAIRE |
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