A comparative study on active and passive epidemiological surveillance for dengue in five countries of Latin America. (March 2016)

• Record Type: Journal Article
• Authors: Sarti, Elsa; L'Azou, Maïna; Mercado, Marcela; Kuri, Pablo; Siqueira, Joao Bosco; Solis, Erick; Noriega, Fernando; Ochiai, R. Leon
• Is Part Of: International journal of infectious diseases. Volume 44(2016:Mar.)
• Page Start: 44
• Page End: 49
• Publication Date: 2016-03
• Subjects: Dengue -- Flavivirus -- Surveillance -- Epidemiology -- South America; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2016.01.015
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: There is substantial under-reporting of dengue to national surveillance systems. The level of underreporting varies considerably by country. The number of dengue cases is estimated to be 3.5–19-fold higher than reported. Understanding the level of under-reporting allows for more accurate dengue estimates. Summary: Background: Dengue is a notifiable infectious disease in many countries, but under-reporting of cases to National Epidemiological Surveillance Systems (NESSs) conceals the true extent of the disease burden. The incidence of dengue identified in a cohort study was compared with those reported to NESSs. Methods: A randomized, placebo-controlled study was undertaken in Brazil, Colombia, Honduras, Mexico, and Puerto Rico to assess the efficacy of a tetravalent dengue vaccine (CYD-TDV) in children aged 9–16 years. The incidence of dengue in the placebo group was compared with that reported to NESSs in a similar age group (10–19 years) from June 2011 to April 2014. Results: Three thousand six hundred and fifteen suspected dengue cases were identified in the study over 13 527 person-years of observation. The overall incidence of confirmed dengue was 2.9 per 100 person-years (range 1.5 to 4.1 per 100 person-years). In the NESSs combined, over 3.2 million suspected dengue cases were reported during the same period, corresponding to over 1 billion person-years of observation. The incidence of confirmed dengue reported by the NESSs in the same locality where the study took place was 0.286 per 100 person-years across Brazil, Colombia, and Mexico (range 0.180 to 0.734 per 100 person-years). The incidence of confirmed dengue was 10.0-fold higher in the study than that reported to NESSs in the same localities (range 3.5- to 19.4-fold higher). Conclusions: There is a substantial under-reporting of dengue in the NESSs. Understanding the level of under-reporting would allow more accurate estimates of the dengue burden in Latin America.