Dengue Episode Research Articles

Economic burden of dengue in urban Bangladesh: A societal perspective.

Dengue, a vector-borne disease, is a major public health problem in many tropical and subtropical countries including Bangladesh. The objective of this study is to estimate the societal cost of illness of dengue infections among the urban population in Dhaka, Bangladesh. A cost-of-illness study was conducted using a prevalence-based approach from a societal perspective. Costs attributable to dengue were estimated from a bottom-up strategy using the guideline proposed by the World Health Organization for estimating the economic burden of infectious diseases. A total of 302 hospitalized confirmed dengue patients were enrolled in this study. The average cost to society for a person with a dengue episode was US$ 479.02. This amount was ranged between US$ 341.67 and US$ 567.12 for those patients who were treated at public and private hospitals, respectively. The households out-of-pocket cost contributed to a larger portion of the total costs of illness (66%) while the cost burden was significantly higher for the poorest households than the richest quintile. Dengue disease imposes a substantial financial burden on households and society. Therefore, decision-makers should consider the treatment cost of dengue infections, particularly among the poor in the population while balancing the benefits of introducing potentially effective dengue preventive programs in Bangladesh.

Influence of previous Zika virus infection on acute dengue episode.

The co-circulation of flaviviruses in tropical regions has led to the hypothesis that immunity generated by a previous dengue infection could promote severe disease outcomes in subsequent infections by heterologous serotypes. This study investigated the influence of antibodies generated by previous Zika infection on the clinical outcomes of dengue infection. We enrolled 1,043 laboratory confirmed dengue patients and investigated their prior infection to Zika or dengue. Severe forms of dengue disease were more frequent in patients with previous Zika infection, but not in those previously exposed to dengue. Our findings suggest that previous Zika infection may represent a risk factor for subsequent severe dengue disease, but we did not find evidence of antibody-dependent enhancement (higher viral titer or pro-inflammatory cytokine overexpression) contributing to exacerbation of the subsequent dengue infection.

Effect of the Tetravalent Dengue Vaccine TAK-003 on Sequential Episodes of Symptomatic Dengue.

In the pivotal phase 3 efficacy trial (NCT02747927) of the TAK-003 dengue vaccine, 5 of 13,380 TAK-003 recipients and 13 of 6,687 placebo recipients experienced two episodes of symptomatic dengue between the first dose and the end of the study, ∼57 months later (patients received the second dose 3 months after the first dose). Two of these participants experienced repeat infection with the same serotype (i.e., homotypic reinfection). In comparison with placebo, the relative risk of a subsequent episode of symptomatic dengue was 0.19 (95% CI, 0.07-0.54) in TAK-003 recipients. Based on the small number of subsequent episodes, these data suggest a potential incremental effect of TAK-003 beyond prevention of the first episode of symptomatic dengue after vaccination.

Direct and indirect costs for hospitalized patients with dengue in Southern Sri Lanka

BackgroundThe Southern Province of Sri Lanka is endemic with dengue, with frequent outbreaks and occurrence of severe disease. However, the economic burden of dengue is poorly quantified. Therefore, we conducted a cost analysis to assess the direct and indirect costs associated with hospitalized patients with dengue to households and to the public healthcare system.MethodsFrom June 2017–December 2018, we prospectively enrolled children and adults with acute dengue hospitalized at the largest, public tertiary-care (1800 bed) hospital in the Southern Province, Sri Lanka. We administered a structured questionnaire to obtain information regarding direct costs spent by households on medical visits, medications, laboratory testing, and travel for seeking care for the illness. Indirect costs lost by households were estimated by identifying the days of work lost by patients and caregivers and school days lost by children. Direct hospital costs were estimated using gross costing approach and adjusted by multiplying by annual inflation rates in Sri Lankan rupees and converted to US dollars.ResultsA total of 1064 patients with laboratory-confirmed dengue were enrolled. The mean age (SD) was 35.9 years (15.6) with male predominance (66.2%). The mean durations of hospitalization for adults and paediatric patients were 3.86 (SD = 1.51) and 4 (SD = 1.32) days, respectively. The per-capita direct cost borne by the healthcare system was 233.76 USD, and was approximately 14 times greater than the per-capita direct cost borne by households (16.29 USD, SD = 14.02). The per-capita average number of loss of working days was 21.51 (SD = 41.71), with mean per-capita loss of income due to loss of work being 303.99 USD (SD = 569.77), accounting for over 70% of average monthly income. On average, 10.88 days (SD = 10.97) of school days were missed due to the dengue episode. School misses were expected to reduce future annual income of affected children by 0.44%.ConclusionsDengue requiring hospitalization had a substantial economic burden on the public healthcare system in Sri Lanka and the affected households. These findings emphasize the importance of strengthening dengue control activities and improved use of hospital-based resources for care to reduce the economic impact of dengue in Sri Lanka.

Economic burden estimation associated with dengue and chikungunya in Gujarat, India.

Dengue and chikungunya have been emerging as major vector-borne diseases. The global burden of the diseases is rising as a public health problem. The complexity of disease is governed by multiple constraints including only symptomatic treatment and inflicts heavy social and economic burden on society. The present study is designed to assess the economic burden of dengue and chikungunya infection by calculating cost per patient in Gujarat, India. A total of 210 patients were enrolled in the study from Ahmedabad and Kheda district of Gujarat from May 2018 to December 2019 of which 150 had dengue and 60 chikungunya infections, subject to the willingness of participation in the survey. Information on wage loss days, cost associated with medicines, diagnosis, special food and travel cost, etc., for the calculation of the direct and indirect costs associated with dengue and chikungunya were collected from these participants using a structured questionnaire. Informed consent was taken before including any participant in the study. In the dengue sample, 86 were males (57.3%) and the rest were females, and in the chikungunya sample, 31 were males (51.7%) and the rest females. The median age of the participants with dengue and chikungunya was 18 (p25 to p75: 8 to 26) and 30 (p25 to p75: 21 to 45) years respectively. Median family income was recorded as Rs 15,000 (p25 to p75: 9000 to 25500) and Rs 12,000 (p25 to p75: 9000 to 18500) for the dengue and chikungunya cases, respectively. The average duration of the illness was observed to be higher in chikungunya (median days (P25 to p75): 15 (7-45)) than dengue (median days (P25 to p75): 10 (5-15)). The median indirect cost in the case of dengue was Rs 1,931 (p25 to p75: 300 to 4500) while Rs 2,550 (p25 to p75: 0 to 5250) was observed for chikungunya cases. Two types of direct cost, namely, direct cost related to medical expenses and direct cost related to other expenses were calculated. Direct cost related to medical expenses was observed to be higher in dengue (Md (P25 to p75): Rs 2,450 (400-5000)) than chikungunya (Md (P25 to p75): Rs 1,500 (150-5200)) while indirect cost related to other expenses were comparable between dengue (Md (P25 to p75): Rs 1,575 (1300-2600)) and chikungunya (Md (P25 to p75): Rs 1500 (850-2850)). The average total cost for one dengue episode was estimated to be Rs 6,860 (3700-12525) whereas it was Rs 7,000 (2550-14000) for one episode of Chikungunya. Overall, patients have to bear high costs while suffering from dengue and chikungunya infections. Furthermore, the duration of illness while suffering from viral diseases also contributes to the substantial economic burden. Improved knowledge about the impact of the cost and the economic burden associated with dengue and chikungunya will help policymakers allocate and appropriate resources accordingly.

Differentiating COVID-19 and dengue from other febrile illnesses in co-epidemics: Development and internal validation of COVIDENGUE scores

ObjectivesThe purpose of this cohort study was to develop two scores able to differentiate coronavirus 2019 (COVID-19) from dengue and other febrile illnesses (OFIs). MethodsAll subjects suspected of COVID-19 who attended the SARS-CoV-2 testing center of Saint-Pierre hospital, Reunion, between March 23 and May 10, 2020, were assessed for identifying predictors of both infectious diseases from a multinomial logistic regression model. Two scores were developed after weighting the odd ratios then validated by bootstrapping. ResultsOver 49 days, 80 COVID-19, 60 non-severe dengue and 872 OFIs were diagnosed. The translation of the best fit model yielded two scores composed of 11 criteria: contact with a COVID-19 positive case (+3 points for COVID-19; 0 point for dengue), return from travel abroad within 15 days (+3/-1), previous individual episode of dengue (+1/+3), active smoking (−3/0), body ache (0/+5), cough (0/-2), upper respiratory tract infection symptoms (−1/-1), anosmia (+7/-1), headache (0/+5), retro-orbital pain (−1/+5), and delayed presentation (>3 days) to hospital (+1/0). The area under the receiver operating characteristic curve was 0.79 (95%CI 0.76–0.82) for COVID-19 score and 0.88 (95%CI 0.85–0.90) for dengue score. Calibration was satisfactory for COVID-19 score and excellent for dengue score. For predicting COVID-19, sensitivity was 97% at the 0-point cut-off and specificity 99% at the 10-point cut-off. For predicting dengue, sensitivity was 97% at the 3-point cut-off and specificity 98% at the 11-point cut-off. ConclusionsCOVIDENGUE scores proved discriminant to differentiate COVID-19 and dengue from OFIs in the context of SARS-CoV-2 testing center during a co-epidemic.

Hospitalization Rates and Direct Medical Costs for Fever in a Pediatric Cohort in South India.

BackgroundPrimary data on causes and costs of hospitalization are necessary for costing and cost-effectiveness analysis. Data on incidence and causes of hospitalization and consequent expenses among Indian children are limited.MethodsA cohort of 6000 children aged 0.5–15 years residing in urban Vellore was followed for 3 years, under the Vellore Typhoid Study, 2016–2017, and later under the Surveillance for Enteric Fever project, 2017–2019. Data on hospitalization events and associated antibiotic use, and direct medical costs for fever-related hospitalization of study children were obtained from caregivers through weekly follow-up by study field workers.ResultsThe incidence of hospitalization was 33 per 1000 child-years of observation. Children aged 0.5–5 years had the highest incidence of hospitalization. The top 5 infectious causes for hospitalization were acute undifferentiated fevers, respiratory tract infections, acute gastroenteritis, enteric fever, and dengue. The overall median cost of hospitalization for fever was 4243 (interquartile range, 2502–7215) Indian rupees (INR). An episode of dengue had a median cost of 5627 INR, followed by acute undifferentiated fevers and enteric fever with median costs of 3860 and 3507 INR, respectively.ConclusionsHospitalization for fever is common in young children and impacts household finances in low-income Indian households.

The Global Trends and Regional Differences in Incidence of Dengue Infection from 1990 to 2019: An Analysis from the Global Burden of Disease Study 2019.

IntroductionDengue, as a neglected tropical disease, brings a heavy socioeconomic burden. To provide tailored global prevention strategies, we analyzed the global trends and regional differences in incidence of dengue infection from 1990 to 2019.MethodsWe obtained data on annual dengue episodes and incidence rates, which reflected the epidemic status of dengue infection from the 2019 Global Burden of Disease (GBD) Study. The changes in dengue episodes and estimated annual percentage changes (EAPCs) of the age-standardized incidence rate (ASR) were calculated to quantify the temporal trends of dengue infection.ResultsGlobally, dengue ASR increased by 1.70% (95% CI 1.62%–1.78%) per year from 1990 to 2011; subsequently, it decreased by 0.41% (95% CI 0.20%–0.62%) per year from 2011 to 2019. However, the global number of dengue episodes increased steadily by 85.47% from 30.67 million in 1990 to 56.88 million in 2019. Against the global trend of decreasing ASR from 2011 to 2019, an increasing trend was reported in Oceania (EAPC 11.01, 95% CI 8.79–13.27), East Asia (EAPC 4.84, 95% CI 2.70–7.03) and Southeast Asia (EAPC 0.38, 95% CI 0.13–0.62). For socio-demographic index (SDI) regions, ASR continued to have an increasing trend in the middle (EAPC 0.26, 95% CI 0.07–0.45) and high-middle (EAPC 1.70, 95% CI 0.98–2.42) SDI regions from 2011 to 2019. In contrast to the global peak age of dengue incidence rate (10 to 25 years), the dengue incidence rate of older people (> 65 years) was higher than in other age groups in low and low-middle SDI regions. Additionally, the proportions of dengue episodes in the > 70-year-old age group increased in 2019 (using the baseline in 1990 or 2011) in most GBD regions.ConclusionsGlobal dengue episodes have increased tremendously in 3 decades. Although global dengue ASR decreased in the last decade, it is still increasing in hyperendemic regions including Oceania, East Asia and Southeast Asia, and also in the middle and high-middle SDI regions. More attention should be paid to the elderly because of the higher dengue incidence rate among them in low and low-middle SDI regions and the increased proportions of dengue episodes among the elderly in most GBD regions. Therefore, more efforts should be undertaken to develop targeted prevention strategies for crucial regions and older populations.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40121-021-00470-2.

Evaluation of the extended efficacy of the Dengvaxia vaccine against symptomatic and subclinical dengue infection.

More than half of the world's population lives in areas at risk for dengue virus infection. A vaccine will be pivotal to controlling spread, however, the only licensed vaccine, Dengvaxia, has been shown to increase the risk of severe disease in a subset of individuals. Vaccine efforts are hampered by a poor understanding of antibody responses, including those generated by vaccines, and whether antibody titers can be used as a marker of protection from infection or disease. Here we present the results of an ancillary study to a phase III vaccine study (n = 611). All participants received three doses of either Dengvaxia or placebo and were followed for 6 years. We performed neutralization tests on annual samples and during confirmed dengue episodes (n = 16,508 total measurements). We use mathematical models to reconstruct long-term antibody responses to vaccination and natural infection, and to identify subclinical infections. There were 87 symptomatic infections reported, and we estimated that there were a further 351 subclinical infections. Cumulative vaccine efficacy was positive for both subclinical and symptomatic infection, although the protective effect of the vaccine was concentrated in the first 3 years following vaccination. Among individuals with the same antibody titer, we found no difference between the risk of subsequent infection or disease between placebo and vaccine recipients, suggesting that antibody titers are a good predictor of both protection and disease risk.

Household and Hospitalization Costs of Pediatric Dengue Illness in Colombo, Sri Lanka.

Dengue, a mosquito-borne viral infection that affects millions around the world, poses a substantial economic burden in endemic countries. We conducted a prospective costing study in hospitalized pediatric dengue patients at the Lady Ridgeway Hospital for Children (LRHC), a public pediatric hospital in Colombo district, Sri Lanka, to assess household out-of-pocket and hospitalization costs of dengue in pediatric patients during peak dengue transmission season. Between August and October 2013, we recruited 216 hospitalized patients (aged 0-3 years, 27%; 4-7 years, 29%; 8-12 years, 42%) who were clinically or laboratory diagnosed with dengue. Using 2013 US dollars, household out-of-pocket spending, on average, was US$59 (SD 49) per episode and increased with disease severity (DF, US$52; DHF/DSS, US$78). Pediatric dengue patients received free-of-charge medical care during hospitalization at LRHC, and this places a high financial burden on hospitals. The direct medical cost of hospitalization was US$68 (SD 31.4) for DF episode, and US$122.7 (SD 65.2) for DHF/DSS episode. Yet a hospitalized dengue illness episode still accounted for 20% to 35% of household monthly income due to direct and indirect costs. Additionally, a majority of caregivers (70%) sought outpatient care before hospitalization, most of whom (81%) visited private health facilities. Our findings indicate that hospitalized pediatric dengue illness poses a nontrivial cost burden to households and healthcare systems, emphasizing the importance of preventing and controlling the transmission of dengue in endemic countries.

The The Effect of Carica Papaya Leaf Extract on Increasing Platelet Count Among Dengue Fever Patients: A Meta-Analysis

Objective: Hemorrhagic fever is a very serious complication of dengue, which remains a major public health concern in the Philippines. On average, there are 170, 503 symptomatic dengue infections and 750 deaths reported in 4 years, with an incidence of around 180 dengue episodes per 100, 000, and a case fatality rate of approximately 0.44%, owing mostly to bleeding secondary to thrombocytopenia, with reported mortalities occurring among individuals less than 20 years of age. In most rural areas in the country, a health care institution is often inaccessible and most patients cannot afford the high cost of hospitalization and transfusion. In a local study of the knowledge, attitude, and practices on dengue, herbal medicines including “tawa-tawa” and papaya are often used as an alternative supportive treatment due to easy availability and low cost. Animal studies also support a potential therapeutic effect. The objective of this review is to assess the effects of C. papaya leaf extract as an adjunct treatment among patients with dengue hemorrhagic fever using a systematically searched and synthesized meta-analysis.
 Materials and Methods: Six randomized clinical trials with a total of 988 subjects involving the efficacy of C. papaya leaf extract in increasing platelet count in dengue patients were searched through PubMed, Google Scholar, Scopus, and Science Direct and selected after assessing the eligibility and validity of the articles through a standard criterion. Mean difference of platelet counts from days 1 to 5 were pooled together and analyzed by Review Manager (RevMan) software 5.3.
 Results: Pooled estimates revealed significant increase in platelet count at Day 3 (MD=12.18; CI 10.28-14.08), Day 4 (MD=31.30; CI 27.77-34.83), and Day 5 (MD=13.23; CI 9.90-16.55). Random effects model at Day 5 also showed significant increase in platelet count. Likewise, a subgroup analyses of studies based on route of administration, frequency, and dosage were performed and showed significant increase in platelet count.
 Conclusion: Based on this meta-analysis, supplementation with C. papaya leaf extract in patients with dengue shows a beneficial effect in increasing platelet count.

Lessons to Be Learnt For Policy Planners on Promoting Health Education on Childhood Fever Management: Evidence from a Cohort of Children with Dengue Fever

Introduction Dengue fever has been a public health challenge in Sri Lanka. Many of the home-based secondary preventive measures are influenced by the parental knowledge on fever. This study was done to describe the level of knowledge on fever among parents and its associations with the events of child’s dengue episode with the view of exploring the components that should be covered in related health educational messages. Methods A descriptive cross-sectional study was done in six general medical wards of the premier children’s hospital in Sri Lanka. Parents who were the bystanders of children admitted as suspected cases of dengue according to the surveillance guidelines, consisted the study population. The sample size was determined with a statistical formula. An interviewer administered questionnaire was used. Data collection was done by two trained data collectors. Descriptive statistics and the chi square test were used with a significance level of 5%. Prior ethics approval was obtained. Results Study sample included 423 parents with a response rate of 99.5%. Most were parents of children of school going age (64.8%) and majority were mothers (97.6%). In more than half (50.4%), the level of knowledge was unsatisfactory. The level of knowledge was significantly associated with the education level (p<0.05), but not with the gender or the employment status (p>0.05) of the parents. A higher knowledge was further associated with a higher utilization of thermometer, and the administration of the correct anti-pyretic dosage and early laboratory diagnosis (p<0.05). Conclusions and Recommendations A higher level of knowledge on fever is associated with favourable clinical events in the dengue episode. The level of knowledge on fever must be improved irrespective of the gender and the employment status of the parents prioritizing those with a lower level of education. Public health interventions must be implemented by regular updating of public health staff’s knowledge on prevention of dengue, fever management their implications on laboratory diagnosis and treatment costs through in service training and in empowering the field health staff in disseminating relevant health education messages to the community.

Paralisia do nervo ocolumotor após infecção por dengue: um relato de caso

Objetivo: Relatar um caso de paralisia extraocular completa do III par craniano, sem acometimento pupilar, após infecção por vírus da dengue. Detalhamento do caso: Trata-se de um relato de caso, de uma paciente do sexo feminino, de 36 anos, que procurou o pronto atendimento após apresentar visão turva, diplopia binocular, cefaleia de leve intensidade e ptose palpebral esquerda subitamente em maio de 2019. Em relação à história pregressa, apresentou episódio de dengue em março, confirmado por sorologia (IgM), negou outras comorbidades. Optou-se pela internação para realização de propedêutica complementar que não evidenciou alterações nos exames laboratoriais e de imagem. Foi realizado tratamento com metilprednisolona, com melhora parcial e incompleta dos déficits oculares. Foi então estabelecido o diagnóstico por exclusão de paralisia do III par craniano secundário à dengue, recebendo alta hospitalar com encaminhamento para acompanhamento ambulatorial. Considerações finais: A associação entre infecção por dengue e acometimento neurológico é descrita na literatura, sendo as neurites com paralisia de nervos cranianos pouco relatadas. Os mecanismos envolvidos nessa afecção são pouco compreendidos, sendo necessários mais estudos especialmente para uniformizar protocolos de atendimento à dengue que apresentem tais complicações.

Cost of Dengue Illness in Indonesia across Hospital, Ambulatory, and not Medically Attended Settings

.Informed decisions concerning emerging technologies against dengue require knowledge about the disease’s economic cost and each stakeholder’s potential benefits from better control. To generate such data for Indonesia, we reviewed recent literature, analyzed expenditure and utilization data from two hospitals and two primary care facilities in Yogyakarta city, and interviewed 67 dengue patients from hospital, ambulatory, and not medically attended settings. We derived the cost of a dengue episode by outcome, setting, and the breakdown by payer. We then calculated aggregate Yogyakarta and national costs and 95% uncertainty intervals (95% UIs). Dengue costs per nonfatal case in hospital, ambulatory, not medically attended, and overall average settings were US$316.24 (95% UI: $242.30–$390.18), US$22.45 (95% UI: $14.12–$30.77), US$7.48 (95% UI: $2.36–$12.60), and US$50.41 (95% UI: $35.75–$65.07), respectively. Costs of nonfatal episodes were borne by the patient’s household (37%), social contributors (relatives and friends, 20%), national health insurance (25%), and other sources (government, charity, and private insurance, 18%). After including fatal cases, the average cost per episode became $90.41 (95% UI: $72.79–$112.35). Indonesia had an estimated 7.535 (95% UI: 1.319–16.513) million dengue episodes in 2017, giving national aggregate costs of $681.26 (95% UI: $232.28–$2,371.56) million. Unlike most previous research that examined only the formal medical sector, this study included the estimated 63% of national dengue episodes that were not medically attended. Also, this study used actual costs, rather than charges, which generally understate dengue’s economic burden in public facilities. Overall, this study found that Indonesia’s aggregate cost of dengue was 73% higher than previously estimated, strengthening the need for effective control.

Productivity costs from a dengue episode in Asia: a systematic literature review

BackgroundDengue is a mosquito-borne viral infection which has been estimated to cause a global economic burden of US$8.9 billion per year. 40% of this estimate was due to what are known as productivity costs (the costs associated with productivity loss from both paid and unpaid work that results from illness, treatment or premature death). Although productivity costs account for a significant proportion of the estimated economic burden of dengue, the methods used to calculate them are often very variable within health economic studies. The aim of this review was to systematically examine the current estimates of the productivity costs associated with dengue episodes in Asia and to increase awareness surrounding how productivity costs are estimated.MethodWe searched PubMed and Web of Knowledge without date and language restrictions using terms related to dengue and cost and economics burden. The titles and abstracts of publications related to Asia were screened to identify relevant studies. The reported productivity losses and costs of non-fatal and fatal dengue episodes were then described and compared. Costs were adjusted for inflation to 2017 prices.ResultsWe reviewed 33 relevant articles, of which 20 studies reported the productivity losses, and 31 studies reported productivity costs. The productivity costs varied between US$6.7–1445.9 and US$3.8–1332 for hospitalized and outpatient non-fatal episodes, respectively. The productivity cost associated with fatal dengue episodes varied between US$12,035-1,453,237. A large degree of this variation was due to the range of different countries being investigated and their corresponding economic status. However, estimates for a given country still showed notable variation.ConclusionWe found that the estimated productivity costs associated with dengue episodes in Asia are notable. However, owing to the significant variation in methodology and approaches applied, the reported productivity costs of dengue episodes were often not directly comparable across studies. More consistent and transparent methodology regarding the estimation of productivity costs would help the estimates of the economic burden of dengue be more accurate and comparable across studies.

DENGUE PREDOMINANCE IN INDIA: A REPORT

Dengue keeps on being a significant reason for infection trouble in India, influencing the population in their typical pace of the life. Dengue in India has drastically extended in the course of the most recent couple of decades, with quickly evolving the study of disease transmission. The pervasiveness of dengue is diverse in different examinations in India, as a result of thought of a population of specific district or state at various purposes of times. The principal major dengue hemorrhagic fever episode in the whole country happened in 1996 by dengue infection serotype 2, and after a hole of very nearly 10 years, the nation confronted one more dengue fever flare-up in the year 2003 by dengue infection serotype 3. An emotional increment in the number and repeat of scenes followed, and, at present, in a huge part of the states of India, dengue is basically endemic. At present, all the four serotypes are discovered accessible for use; however, the prevalent serotype continues evolving. In spite of this pattern, observation, revealing, and conclusion of dengue remain to a great extent uninvolved in India. Progressively dynamic network-based epidemiological investigations with escalated vector control and activities for dengue immunization improvement ought to be outfitted to control the spread of dengue in India. All the distributed information related to dengue from audit of all zones of India from 2015 to 2018 is available on government official websites. Despite the fact that, the quantity of dengue cases has demonstrated a consistent ascent as time passes, the mortality has decreased. The general death pace of 1.2% in 2015 dropped to 0.25% in 2018.

Autochthonous chikungunya and dengue fever outbreak in Mainland France, 2010-2018

Abstract Background Aedes albopictus, vector of dengue and chikungunya viruses, is implanted in mainland France, exposing to the risk of autochthonous transmission. Since 2006, epidemiological and entomological surveillance activities aim to prevent or limit the occurrence of autochthonous cases. We aimed to describe episodes of transmission and control measures implemented in order to reflect on surveillance activities. Methods We reviewed all publications and documents produced on autochthonous transmission episodes in France and surveillance protocols. We reviewed surveillance activities, investigation methods and control measures implemented. Results Between 2010 and 2018, eight episodes of autochthonous dengue fever transmission and three of chikungunya were recorded in mainland France. All of them occurred in the South east of France, between July and October, when vector density was the highest. Transmission areas were limited to single domestic houses located in discontinuous urban areas. Only two episodes happened in two distinct areas. Chikungunya episodes led to 31 cases and dengue fever episodes to 23 cases. Most cases were identified by door-to-door investigations set-up in transmission areas. We isolated serotypes 1 and 2 for dengue and East Central South Africa lineage for chikungunya in autochthonous cases. Adulticide vector control measures were effective in controlling transmission. Seven episodes of transmission were due to failure in identifying primary imported cases. Four episodes occurred because of the absence or the lack of vector controls measures around primary imported cases. Conclusions Surveillance activities, and autochthonous cases investigations, were effective in limiting the extent of transmission, but were highly demanding for surveillance actors. Identified causes of transmission highlight the need of regular awareness campaigns targeting physicians and biologists. Key messages Effectiveness of the surveillance system of dengue, chikungunya and zika viruses, and autochthonous cases investigations. Needs of awareness and training courses targeting health professionals to the risk represented by these viruses.

Combining of Transfer Learning with Faster-RCNN For Aedes Aegyti Larvae Detection

The dengue epidemiology episode has become one of the global phenomena especially the rain forest countries including Malaysia. Environmental management, the used of chemical and biological environment are control strategies that has been proposed and practiced by World Health Organization. However, based on statistic al of dengue cases, there is still no concrete solution in curbing this problem especially at non-accessible places. This paper proposed a study on detection Aedes Aegypti larvae in water storage tank by combining transfer learning with Faster-RCNN. The purpose of the study is to acquire train and validation losses along with detection performance metrics. The experimental results disclose that the probability detection has scored 97.01% while false alarm has scored 5.97%. Those significant value has depicted that the trained model has high detection accuracies.

Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil

ObjectivesDengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects...

Yellow fever (YF) vaccination does not increase dengue severity: A retrospective study based on 11,448 dengue notifications in a YF and dengue endemic region.

We study the association between prior yellow fever immunization and clinical outcomes of dengue infections in individuals of varying sexes and ages. Serological interactions between dengue virus and other flaviviruses could drive antibody dependent enhancement, which is associated with disease severity in dengue infections. This effect may influence disease severity in individuals subsequently affected by related flaviviruses, such as dengue. We compare the severity of dengue episodes between patients vaccinated and non-vaccinated against yellow fever. We evaluated the severity of 11,448 lab-confirmed dengue cases reported in São José do Rio Preto, Brazil, in 7370 YF vaccinated patients compared to 4043 unvaccinated patients. We regressed dengue severity against YF vaccine status and a number of demographic, clinical, and laboratory variables as controls. We also evaluated the association between YF vaccination status and the clinical and laboratory symptoms of dengue patients. We did not find any evidence of increased risk for severe dengue in patients vaccinated against YF (odds ratio = 1.00; 95% confidence interval = 0.87-1.14). Most of the variables analyzed did not have a statistically significant association with YF vaccination status. We found no evidence that YF vaccination in dengue-endemic areas increases the risk of severe dengue fever.