Factors Associated with Dengue Virus Infection and Reinfection in Asymptomatic Children in Two Colombian Municipalities

Abstract

Dengue is the most important arbovirosis in the world. In this study, we assessed the knowledge, attitudes, and practices (KAP) regarding dengue in parents from two small Colombian municipalities in the Cundinamarca Province. Parents and their healthy children from 4 to 14 years of age were included in some public elementary schools. After a medical examination, blood samples were taken for diagnosis of dengue using enzyme-linked immunosorbent assays (capture immunoglobulin M and capture immunoglobulin G [IgG], indirect IgG and detection non-structural viral protein 1) and detection of viral RNA by reverse transcription polymerase chain reaction. In addition, a KAP survey was applied to the children's parents or tutors. The indirect IgG test determined that of the 347 examined children, 87.9% had a previous infection with the dengue virus (DENV), 12.7% of them were positive for viral RNA (asymptomatic infection), and 32.0% presented reinfections. Risk factors evaluation showed that children aged 8 years and older living in the municipalities for more than 7 years were more likely to be infected or reinfected by DENV. In the same way, poor nutrition, lack of water supply, sewer service, or waste disposal services could raise the likelihood of dengue infections. The surveys indicated that parents have unhealthy practices and a low knowledge about the transmission of the disease, which could result in an increase of mosquito breeding sites, allowing sustained dengue transmission.

Dengue Infections in Colombia: Epidemiological Trends of a Hyperendemic Country

“…During those years, Colombians migrated from the countryside to the city at a higher rate leading overcrowding in cities with insufficient basic infrastructure and poor housing conditions. As a result, the likelihood of dengue infections increases due to subsequent improper practices for disposal of solid waste, and lack of waste and sewage collection services [ 9 , 43 , 44 ]. Finally, it is possible that intraserotype strain-specific antigenic variations occur over time in the dengue genetic evolution process, leading to a difference in the binding avidity of the existent antibodies, increasing the infection susceptibility of a person and the odds to progress to severe forms of dengue [ 45 ].…”

Prevalence of dengue antibodies in healthy children and adults in different Colombian endemic areas

“…The Indirect IgG ELISA (Panbio Alere test 01PE30), which reports in dengue secondary infections a sensitivity of 100% (95% CI, 96.1%-100%), whilst the sensitivity in primary infections from endemic areas is 87.0% (95% CI, 66.4%-97.2%). In seronegative samples, the specificity of this test is 100% (95% CI, 96.6%-100.0%), and serologic concordance of this diagnostic test is 75.1% (95% CI, 70.8%-79.4%) to define previous contact with the virus (Castellanos et al, 2016;Castro et al, 2018). For the detection of IgM antibodies, a MAC-ELISA system was used (UMELISA Dengue IgM Plus UM 2016, Tecnosuma, Cuba), following the manufacturer's instructions.…”

Sociocultural determinants of adoption of preventive practices for hantavirus: A knowledge, attitudes, and practices survey in Tonosí, Panama

“…The results of KAP surveys help create culturally-competent interventions that are specific to the affected community [8]. Recently, in Latin America, KAP surveys have been used to assess knowledge, attitudes, and practices and inform interventions for Dengue, Zika, Chikungunya, and Malaria [9][10][11][12][13].…”