Seroprevalence of Dengue Antibodies in Three Urban Settings in Yucatan, Mexico.

Norma Pavía-Ruz,M Elizabeth Halloran,Salha Villanueva Salha Villanueva,Angel Balam-May,Hector Gómez-Dantés,Ira M Longini,Diana Patricia Rojas Diana Patricia Rojas,Pablo Manrique-Saide,Pilar Granja

doi:10.4269/ajtmh.17-0382

Abstract

.Dengue transmission in Mexico has become a major public health problem. Few epidemiological studies have examined the seroprevalence of dengue in Mexico, and recent estimates are needed to better understand dengue transmission dynamics. We conducted a dengue seroprevalence survey among 1,668 individuals including all age groups in three urban settings in Yucatan, Mexico. Children (< 19 years old) were selected randomly from schools. The adults (≥ 19 years old) were selected from healthcare facilities. Participants were asked to provide a venous blood sample and to answer a brief questionnaire with demographic information. Previous exposure to dengue was determined using indirect immunoglobulin G enzyme-linked immunosorbent assay. The overall seroprevalence was 73.6%. The age-specific seroprevalence increased with age, going from 51.4% (95% confidence interval [CI] = 45.0–57.9%) in children ≤ 8 years to 72% (95% CI = 66.3–77.2%) in the 9- to 14-years old. The highest seroprevalence was 83.4% (95% CI = 77–82.2%) in adults greater than 50 years. The seroprevalence in Merida was 68.6% (95% CI = 65–72%), in Progreso 68.7% (95% CI = 64.2–72.8%), and in Ticul 85.3% (95% CI = 81.9–88.3%). Ticul had the highest seroprevalence in all age groups. Logistic regression analysis showed that age and city of residence were associated with greater risk of prior dengue exposure. The results highlight the level of past exposure to dengue virus including young children. Similar studies should be conducted elsewhere in Mexico and other endemic countries to better understand the transmission dynamics of dengue.

Highlights

Dengue is a global public health problem affecting more than 100 countries, with approximately three billion people at risk and an estimated 390 million dengue infections annually worldwide.[1]
We present the results of a cross-sectional dengue serosurvey conducted in three cities in the state of Yucatan in 2014, as part of a series of baseline studies necessary to better understand dengue transmission dynamics in three different settings in Yucatan, Mexico
Our study found an overall dengue antibody prevalence of 73.6% in our surveyed cities in Yucatan, consistent with previous studies in this area

Summary

Introduction

Dengue is a global public health problem affecting more than 100 countries, with approximately three billion people at risk and an estimated 390 million dengue infections annually worldwide.[1]. Dengue epidemics have increased significantly worldwide,[1,5] global estimates of dengue distribution and disease burden remain imprecise in most dengue endemic areas.[6,7] The real burden of dengue is unknown as most dengue infections are asymptomatic, misdiagnosed, or not reported.[6] Some of the main issues in dengue surveillance include the lack of standardized reporting procedures, variable diagnostic laboratory capacity in traditional surveillance systems, along with the absence of reporting from the private health sector, which in our study population represents an important proportion of all healthcare providers.[8] An important, but underutilized tool in some countries is populationlevel dengue antibody surveys. Seroprevalence surveys are invaluable in identifying the burden of both symptomatic and asymptomatic infections and quantifying infection prevalence and incidence in different epidemiological settings.[9,10,11,12,13]

Objectives

Methods

Results

Conclusion