斯里兰卡登革热和日本脑炎血清阳性率的变化
Change in Dengue and Japanese Encephalitis Seroprevalence Rates in Sri Lanka.
作者信息
Jeewandara Chandima, Gomes Laksiri, Paranavitane S A, Tantirimudalige Mihiri, Panapitiya Sumedha Sandaruwan, Jayewardene Amitha, Fernando Samitha, Fernando R H, Prathapan Shamini, Ogg Graham S, Malavige Gathsaurie Neelika
机构信息
Centre for Dengue Research, Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayawardenapura, Nugegoda, Sri Lanka.
Department of Family Medicine, Faculty of Medical Sciences, University of Sri Jayawardanapura, Nugegoda, Sri Lanka.
出版信息
PLoS One. 2015 Dec 22;10(12):e0144799. doi: 10.1371/journal.pone.0144799. eCollection 2015.
BACKGROUND
Sri Lanka has been affected by epidemics of dengue infections for many decades and the incidence and severity of dengue infections have been rising each year. Therefore, we investigated the age stratified seroprevalence of dengue infections in order to facilitate future dengue vaccine strategies. In addition, since the symptomatic dengue infections have increased during the past few decades, we also investigated the possible association with Japanese Encephalitis Virus (JEV) antibody seropositivity with symptomatic dengue in a community cohort in Sri Lanka.
METHODS
1689 healthy individuals who were attending a primary health care facility were recruited. Dengue and JEV antibody status was determined in all individuals and JEV vaccination status was recorded.
RESULTS
1152/1689 (68.2%) individuals were seropositive for dengue and only 133/1152 (11.5%) of them had been hospitalized to due to dengue. A significant and positive correlation was observed for dengue antibody seropositivity and age in children (Spearmans R = 0.84, p = 0.002) and in adults (Spearmans R = 0.96, p = 0.004). We observed a significant rise in the age stratified seroprevalence rates in children over a period of 12 years. For instance, in year 2003 the annual seroconversion rate was 1.5% per annum, which had risen to 3.79% per annum by 2014. We also found that both adults (p<0.001) and in children (p = 0.03) who were hospitalized due to dengue were more likely to be seropositive for JEV antibodies. However, 244 (91.4%) of adults who were seropositive for JEV had not had the JEV vaccine.
CONCLUSIONS
Dengue seroprevalence rates have risen significantly over the last 12 years in Sri Lanka, possibly due to increased transmission. As individuals who were hospitalized due to dengue were more likely to be seropositive for JEV, the possibility of cross-reactive assays and/or of JEV infection on immunity to the DENV and clinical disease severity should be further investigated.
背景
几十年来，斯里兰卡一直受到登革热感染疫情的影响，登革热感染的发病率和严重程度逐年上升。因此，我们调查了登革热感染的年龄分层血清阳性率，以推动未来的登革热疫苗策略。此外，由于在过去几十年中有症状的登革热感染有所增加，我们还在斯里兰卡的一个社区队列中调查了日本脑炎病毒（JEV）抗体血清阳性与有症状登革热之间可能存在的关联。
方法
招募了1689名到初级卫生保健机构就诊的健康个体。测定了所有个体的登革热和JEV抗体状态，并记录了JEV疫苗接种状态。
结果
1152/1689（68.2%）的个体登革热血清呈阳性，其中只有133/1152（11.5%）因登革热住院。在儿童（斯皮尔曼相关系数R = 0.84，p = 0.002）和成人（斯皮尔曼相关系数R = 0.96，p = 0.004）中，观察到登革热抗体血清阳性与年龄之间存在显著正相关。我们观察到在12年期间儿童的年龄分层血清阳性率显著上升。例如，2003年的年血清转化率为每年1.5%，到2014年已升至每年3.79%。我们还发现，因登革热住院的成人（p<0.001）和儿童（p = 0.03）更有可能JEV抗体血清呈阳性。然而，JEV血清呈阳性的成人中有244人（91.4%）未接种JEV疫苗。
结论
在过去12年中，斯里兰卡的登革热血清阳性率显著上升，可能是由于传播增加所致。由于因登革热住院的个体更有可能JEV血清呈阳性，应进一步研究交叉反应检测和/或JEV感染对登革病毒免疫和临床疾病严重程度的可能性。
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