A comparative study on active and passive epidemiological surveillance for dengue in five countries of Latin America

Abstract

There is a substantial under-reporting of dengue in the NESSs. Understanding the level of under-reporting would allow more accurate estimates of the dengue burden in Latin America.

Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction

“…In this case, the incidence rate of dengue infections that were either mild (because the subject acknowledged the presence of symptoms) or inapparent is indicated, because only 9.8% of seroconverted subjects reported fever during the previous 6 months. Although similar rates have been observed in Nicaragua and in other endemic countries,16, 27, 31, 33 the rate of ‘subclinical’ dengue infection remains unclear, and in the presence of a low confirmation rate of dengue cases, the accurate identification of dengue burden remains challenging 16, 33, 35…”

“…Although it was outside the scope of this study, the assessment of neighborhood-specific strategies for vector control and other environmental characteristics might have been helpful for understanding the relatively homogeneous distribution of DENV prevalence and the more variable behavior for seroconversion. In Latin America, risk assessment by environmental (including entomological evaluation), socioeconomic, and health care access characteristics has been considered a useful tool to identify the dengue burden 15, 25, 34, 35. Moreover, comparing neighborhoods or other small geographic units to identify areas with dengue is key to address vector control and other targeted strategies for disease control 11, 15, 19, 25, 31…”

“…The study period lasted around 2.5 years, allowing incidence rates for new dengue infections to be calculated – information that is needed and has been broadly discussed 15, 35. Knowing the seasonality of dengue, sensitive information about the patterns of dengue distribution were captured for the study area.…”

Epidemiological Characteristics of Dengue Disease in Latin America and in the Caribbean: A Systematic Review of the Literature

“…It is well recognized that there is a tendency for passive national surveillance systems to underreport dengue cases. Estimates of the number of dengue cases reported by national surveillance systems in Latin America may be up to 28-fold lower than the number of actual cases [31, 84–86], with a greater tendency for underreporting in adults than children [85]. …”

Disease Burden of Dengue in the Philippines: Adjusting for Underreporting by Comparing Active and Passive Dengue Surveillance in Punta Princesa, Cebu City

“…Misdiagnosis, particularly in countries with high incidence of other febrile illnesses,33–36 and underdiagnosis due to limited sensitivity and cost constraints of diagnostics tests may also contribute to underreporting 37,38. Additional sources of uncertainty in estimates of dengue incidence have been discussed elsewhere,39 and several studies have estimated average reporting rates of dengue episodes 3,40,41. Most studies have been limited to cohorts of children and/or adolescents 40.…”