Burden of dengue among febrile patients at the time of chikungunya introduction in Piedecuesta, Colombia

Carabalí, Mabel; Lim, Jacqueline Kyungah; Palencia, Diana C; Lozano‐Parra, Anyela; Gélvez, Rosa Margarita; Lee, Kang Sung; Florez, Janeth P.; Herrera, Víctor M.; Kaufman, Jay S.; Rojas, Elsa Marina; Villar, Luis

doi:10.1111/tmi.13147

Cited by 12 publications

(14 citation statements)

References 35 publications

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“…Further testing of these samples using plaque reduction neutralization assays would be desirable to characterize whether immunity is monotypic (against a single serotype) or multitypic and to get an idea of what serotypes have circulated in this region. However based on data from national surveillance and from AEDES Network projects ( www.redaedes.org ), DENV-1 to -4 serotypes have been isolated from this region in the past 19 years and therefore it is likely that a large proportion of participants has been infected by more than one serotype[ 11 – 41 – 42 ].…”

Section: Discussionmentioning

confidence: 99%

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Heterogeneity of dengue transmission in an endemic area of Colombia

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 99%

“…Here, we present the results of a household-based cross-sectional serosurvey in urban and rural areas of Piedecuesta, Colombia, an area known to be hyperendemic for DENV[ 11 ]. The purpose of the study was to estimate the age-specific seroprevalence and transmission intensity of DENV and to characterize risk factors for infection.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity of dengue transmission in an endemic area of Colombia

et al. 2020

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“…In settings of CHIKV cotransmission with DENV and ZIKV, a presumptive diagnosis of chikungunya was correct in only 10 to 40% of cases (7,8,31). Clinical prediction algorithms have been evaluated to differentiate CHIKV infections from infections with other etiologies, but these have not been independently validated in separate cohorts (59,63,66,72,76). Results from routine laboratory tests are generally not specific for chikungunya.…”

Section: Acute Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

“…3) (25,59,60,66,71). Moderate to severe thrombocytopenia favors the diagnosis of dengue rather than chikungunya, particularly if hemorrhagic signs are present (59,60,66,76). However, these laboratory findings occur in other diseases on the differential and do not provide accurate diagnostic information.…”

Section: Acute Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

2019

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Chikungunya virus (CHIKV) is an alphavirus that is primarily transmitted by Aedes species mosquitoes. Though reports of an illness consistent with chikungunya date back over 200 years, CHIKV only gained worldwide attention during a massive pandemic that began in East Africa in 2004. Chikungunya, the clinical illness caused by CHIKV, is characterized by a rapid onset of high fever and debilitating joint pain, though in practice, etiologic confirmation of CHIKV requires the availability and use of specific laboratory diagnostics. Similar to infections caused by other arboviruses, CHIKV infections are most commonly detected with a combination of molecular and serological methods, though cell culture and antigen detection are reported. This review provides an overview of available CHIKV diagnostics and highlights aspects of basic virology and epidemiology that pertain to viral detection. Although the number of chikungunya cases has decreased since 2014, CHIKV has become endemic in countries across the tropics and will continue to cause sporadic outbreaks in naive individuals. Consistent access to accurate diagnostics is needed to detect individual cases and initiate timely responses to new outbreaks.

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“…Serum and plasma samples were included if they were taken from patients experiencing fewer than 6 days of febrile illness in whom dengue was suspected. Samples from 2009 and 2010 were selected from a collection archived at -80°C; these samples were taken from patients enrolled in previous studies [11,12]. The patient samples from 2014 to 2017 were donated by clinical analysis laboratories located throughout the metropolitan area of Bucaramanga.…”

Section: Patient Samplesmentioning

confidence: 99%

Dengue in Santander State, Colombia: fluctuations in the prevalence of virus serotypes are linked to dengue incidence and genetic diversity of the circulating viruses

Carreño

Jiménez-Silva

Rey-Caro

et al. 2019

Tropical Med Int Health

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objective To investigate the link between fluctuations in the prevalence of dengue virus (DENV) serotypes and the number of dengue cases in the metropolitan area of Bucaramanga, Santander State, Colombia, in the 2007-2010-2017 method Viruses were isolated from febrile patient samples by direct application to C6/36-HT cells and typed using monoclonal antibodies. We performed autocorrelation and cross-correlation analyses to determine whether fluctuations in the prevalence of DENV serotypes and dengue cases were correlated. Full envelope (E) gene sequences were employed to examine the genetic diversity of serotypes circulating by using a phylogenetic approach.results All four dengue virus serotypes were detected. DENV-1 was the dominant serotype in both periods followed by DENV-3 or DENV-2 depending on the period; DENV-4 was the least prevalent virus in both periods. Cross-correlation analyses suggest a temporal relation between the fluctuations in the prevalence of DENV serotypes, which were almost simultaneous (lag = 0) or related to recent past fluctuations (lag > 1.0) in the number of dengue cases. Data suggest that a sustained predominance of DENV-1, an increase of the DENV-4 prevalence, and a switch from DENV-3 to DENV-2 could be linked to an outbreak. Circulating viruses were grouped into Genotype V, Asia/ American III and II for DENV-1, -2, -3 and -4, respectively; intragenotypic diversity was detected.conclusions The present work highlights the need of comprehensive studies on dynamics of DENV in Colombia to understand transmission of dengue and evaluate the effectiveness of a vaccination programme.

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Burden of dengue among febrile patients at the time of chikungunya introduction in Piedecuesta, Colombia

Abstract: These findings highlight the ongoing coexistence of both arboviruses, a distinct clinical profile of each condition in the study area that could be used by clinicians to generate a differential diagnosis, and the presence of underreporting, mostly among hospitalised cases.

Cited by 12 publications

References 35 publications

Heterogeneity of dengue transmission in an endemic area of Colombia

Heterogeneity of dengue transmission in an endemic area of Colombia

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

Dengue in Santander State, Colombia: fluctuations in the prevalence of virus serotypes are linked to dengue incidence and genetic diversity of the circulating viruses

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