Abstract
The incidence of dengue is increasing rapidly and is a challenging health issue in the Philippines. Epidemiological data are largely based on a passive-surveillance reporting system, which leads to substantial under-reporting of cases. To estimate dengue infection and disease incidence prospectively at the community level in an endemic area of the Philippines using an active surveillance strategy. We implemented active surveillance in the highly endemic community of Alaminos, Laguna. The study consisted of a 1-year follow-up with 2 visits scheduled at the start and end of the study, as well as regular active surveillance in between and unscheduled visits for suspected cases. Blood samples were collected and analyzed to detect dengue during the first scheduled visit and all unscheduled visits, and clinical examination was performed at all visits (registered at clinicaltrials.gov NCT02766088). We enrolled 500 participants, aged from 6 months to 50 years; 76.2% were found positive for immunoglobulin G (95% confidence interval [CI], 71.9-80.0), with 92.0% among those aged 9-17 years. Active (weekly) surveillance identified 4 virologically confirmed cases of dengue (incidence proportion 0.8; 95% CI 0.3-2.1); all in participants aged ≤14 years. Routine surveillance programs such as sentinel sites are needed to characterize the entire clinical spectrum of symptomatic dengue, disease incidence, and transmission in the community.
Highlights
The incidence of dengue is increasing rapidly and is a challenging health issue in the Philippines
31.2 21.7–42.7 51.5 40.8–62.0 92.0 86.4–95.4 99.3 95.4–99.99 n, number of participants with available results; confidence intervals (CI), confidence interval; DENV, dengue virus; ELISA, enzyme-linked immunosorbent assay; GEE, generalized estimating equations; IgG, immunoglobulin G. *Proportion estimated from GEE logistic regression model taking the clustering effect into account, except for1 = (n/n) × 100 as the design effect is ≤1; †based on the robust variance estimate from the GEE model except for1 = Wald CI as the design effect is ≤1
All reported suspected dengue case (SDC) were detected by the activesurveillance process and all dengue cases confirmed virologically occurred from July to September, during the rainy summer monsoon season for the Philippines [22], a period known to be significantly associated with increased dengue incidence [23]
Summary
The incidence of dengue is increasing rapidly and is a challenging health issue in the Philippines. Objectives: To estimate dengue infection and disease incidence prospectively at the community level in an endemic area of the Philippines using an active surveillance strategy. Methods: We implemented active surveillance in the highly endemic community of Alaminos, Laguna. The study consisted of a 1-year follow-up with 2 visits scheduled at the start and end of the study, as well as regular active surveillance in between and unscheduled visits for suspected cases. Active (weekly) surveillance identified 4 virologically confirmed cases of dengue (incidence proportion 0.8; 95% CI 0.3–2.1); all in participants aged ≤14 years. Conclusions: Routine surveillance programs such as sentinel sites are needed to characterize the entire clinical spectrum of symptomatic dengue, disease incidence, and transmission in the community
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
