Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction. (May 2017)

• Record Type: Journal Article
• Authors: Carabali, Mabel; Lim, Jacqueline Kyungah; Velez, Diana Carolina; Trujillo, Andrea; Egurrola, Jorge; Lee, Kang Sung; Kaufman, Jay S.; DaSilva, Luiz Jacinto; Velez, Ivan Dario; Osorio, Jorge E.
• Is Part Of: International journal of infectious diseases. Volume 58(2017:May)
• Page Start: 27
• Page End: 36
• Publication Date: 2017-05
• Subjects: Dengue -- Serological survey -- Dengue prevalence -- Dengue seroconversion -- Dengue burden -- Colombia; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2017.02.016
• Languages: English
• ISSNs: 1201-9712

Abstract

Graphical abstract: Highlights: A total of 3684 individuals between 1 and 65 years old participated in the survey. The overall seroprevalence by IgG Indirect ELISA was 61%. The overall seroconversion rate was 8.7% per 1000 person-months over 2.5 years. The highest rate of infection was observed during the fifth visit (February 2014). Summary: Background: Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction. Methods: A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years. Results: A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits ( n = 1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3–10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent. Conclusions: These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.