Ellis Esther M, Neatherlin John C, Delorey Mark, Ochieng Melvin, Mohamed Abdinoor Haji, Mogeni Daniel Ondari, Hunsperger Elizabeth, Patta Shem, Gikunju Stella, Waiboic Lilian, Fields Barry, Ofula Victor, Konongoi Samson Limbaso, Torres-Velasquez Brenda, Marano Nina, Sang Rosemary, Margolis Harold S, Montgomery Joel M, Tomashek Kay M
Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya.
PLoS Negl Trop Dis. 2015 Apr 29;9(4):e0003733. doi: 10.1371/journal.pntd.0003733. eCollection 2015 Apr.
Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.
登革热在非洲似乎呈地方流行，有多次疫情报告。2013年2月，在肯尼亚蒙巴萨发现了几名患有登革热样疾病且疟疾血涂片呈阴性的患者。登革热经实验室确诊，并开展了一项调查以评估当地传播的规模，包括进行血清学调查以确定登革热病毒（DENV）感染情况。同意参与的家庭成员提供了血清，并就暴露情况和病史接受了询问。采用逆转录聚合酶链反应（RT-PCR）来识别当前的DENV感染，采用IgM抗DENV酶联免疫吸附测定（ELISA）来识别近期感染。在来自701户家庭的1500名参与者中，210人（13%）有当前或近期DENV感染的证据。在这些感染者中，93人（44%）报告在过去一个月内有发热症状。大多数发热的感染者（68人，73%）看过临床医生，据报告接受诊断的32名参与者中，除一人外，其余均被临床诊断为患有疟疾。夜间开窗（比值比[OR]=2.3；可信区间[CI]：1.1 - 4.8）、不每天使用驱蚊剂（OR = 1.6；CI：1.0 - 2.8）以及近期前往肯尼亚境外旅行（OR = 2.5；CI：1.1 - 5.4）与DENV感染风险增加有关。这项调查有力地衡量了在病例常未被识别和误诊的情况下DENV感染的情况。
