Prospective Cohort Study with Active Surveillance for Fever in Four Dengue Endemic Countries in Latin America

Abstract

To prepare for a Phase III dengue vaccine efficacy trial, 20 investigational sites were selected for this observational study to identify dengue infections in a closed cohort (N = 3,000 children 9–16 years of age). Of 255 acute febrile episodes experienced by 235 children, 50 (21.3%) were considered serologically probable dengue, and 18 (7.7%) were considered virologically confirmed (i.e., dengue NS1 antigen positive) dengue cases. Considering the disease-free and at-risk period from study start to onset of symptoms, the overall incidence density of acute febrile episodes was 17.7 per 100 person-years of follow-up, ranging from 15.3 in Colombia to 22.0 in Puerto Rico. This study showed that all sites were capable of capturing and following up acute febrile episodes within a specific timeframe among the established cohort and to detect dengue cases.

Long-term epidemiological dynamics of dengue in Barbados – one of the English-speaking Caribbean countries

“…Studies from south-east Asia have shown a similar shift in the affected age group pattern [19,37]. A previous sero-epidemiologic study in this population and another study from the region showing a high dengue seroprevalence by early adulthood explains the age distribution of symptomatic dengue in this population [22,38,39].…”

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

“…In addition, the CYD15 study was a major, well-publicized study, and it is possible that physicians and other healthcare providers in the area where it was conducted may have been more aware or reminded of the need to report suspected cases for laboratory confirmation. Alternatively, as the sites in the CYD15 study were selected with the knowledge that they had a high dengue burden, 29 the difference in incidence rates reported at the national level compared with the study cohort may simply reflect the geographical variability in the burden of dengue across these countries.…”

Risk Factors Associated with Dengue Transmission and Spatial Distribution of High Seroprevalence in Schoolchildren from the Urban Area of Medellin, Colombia

“…These discrepancies suggest the inadequacy of the current indices in dengue transmission, probably because they were initially developed for the evaluation of yellow fever transmission risk [36]. Additionally, human movements depend on social and economic factors and also govern DENV transmission through time and space [37, 38]. These movements determine the introduction of DENV into Ae.…”