Tissera Hasitha, Amarasinghe Ananda, De Silva Aruna Dharshan, Kariyawasam Pradeep, Corbett Kizzmekia S, Katzelnick Leah, Tam Clarence, Letson G William, Margolis Harold S, de Silva Aravinda M
Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Public Health Department, Colombo Municipal Council, Colombo, Sri Lanka; Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina; London School of Hygiene and Tropical Medicine, London, United Kingdom; Pediatric Dengue Vaccine Initiative, International Vaccine Institute, Seoul, South Korea; Department of Zoology, University of Cambridge, Cambridge, United Kingdom; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; El Paso County Public Health, Colorado Springs, Colorado; Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Public Health Department, Colombo Municipal Council, Colombo, Sri Lanka; Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina; London School of Hygiene and Tropical Medicine, London, United Kingdom; Pediatric Dengue Vaccine Initiative, International Vaccine Institute, Seoul, South Korea; Department of Zoology, University of Cambridge, Cambridge, United Kingdom; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; El Paso County Public Health, Colorado Springs, Colorado; Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Am J Trop Med Hyg. 2014 Jul;91(1):132-7. doi: 10.4269/ajtmh.13-0540. Epub 2014 May 27.
Dengue is the most significant arthropod-borne viral infection of humans. Persons infected with dengue viruses (DENV) have subclinical or clinically apparent infections ranging from undifferentiated fever to dengue hemorrhagic fever/shock syndrome. Although recent studies estimated that the Indian subcontinent has the greatest burden of DENV infection and disease worldwide, we do not have reliable, population-based estimates of the incidence of infection and disease in this region. The goal of this study was to follow-up a cohort of 800 children living in a heavily urbanized area of Colombo, Sri Lanka to obtain accurate estimates of the incidence of DENV infection and disease. Annual blood samples were obtained from all children to estimate dengue seroprevalence at enrollment and to identify children exposed to new DENV infections during the study year. Blood was also obtained from any child in whom fever developed over the course of the study year to identify clinically apparent DENV infections. At enrollment, dengue seroprevalence was 53.07%, which indicated high transmission in this population. Over the study year, the incidence of DENV infection and disease were 8.39 (95% confidence interval = 6.56-10.53) and 3.38 (95% confidence interval = 2.24-4.88), respectively, per 100 children per year. The ratio of clinically inapparent to apparent infections was 1.48. These results will be useful for obtaining more accurate estimates of the burden of dengue in the region and for making decisions about testing and introduction of vaccines.
登革热是人类最重要的节肢动物传播的病毒感染。感染登革病毒（DENV）的人会出现亚临床或临床明显感染，范围从未分化发热到登革出血热/休克综合征。尽管最近的研究估计，印度次大陆是全球登革病毒感染和疾病负担最重的地区，但我们没有该地区基于人群的可靠感染和疾病发病率估计。本研究的目的是对居住在斯里兰卡科伦坡一个高度城市化地区的800名儿童进行队列随访，以准确估计登革病毒感染和疾病的发病率。每年采集所有儿童的血液样本，以估计入组时的登革热血清阳性率，并识别在研究年度内接触新登革病毒感染的儿童。还从研究年度内出现发热的任何儿童身上采集血液，以识别临床明显的登革病毒感染。入组时，登革热血清阳性率为53.07%，这表明该人群中传播率很高。在研究年度内，登革病毒感染和疾病的发病率分别为每100名儿童每年8.39例（95%置信区间=6.56-10.53）和3.38例（95%置信区间=2.24-4.88）。临床不明显感染与明显感染的比例为1.48。这些结果将有助于更准确地估计该地区登革热的负担，并为检测和引入疫苗的决策提供依据。
