Toro Carlos, Trevisi Patricia, López-Quintana Beatriz, Amor Aránzazu, Iglesias Nuria, Subirats Mercedes, de Guevara Concepción Ladrón, Lago Mar, Arsuaga Marta, de la Calle-Prieto Fernando, Herrero Dolores, Rubio Margarita, Puente Sabino, Baquero Margarita
Service of Microbiology and Parasitology, Carlos III Hospital, Madrid, Spain.
Investigación Hospital La Paz (IdiPAZ), La Paz University Hospital, Madrid, Spain.
Am J Trop Med Hyg. 2017 Mar;96(3):701-707. doi: 10.4269/ajtmh.16-0335. Epub 2017 Apr 6.
Epidemiological data on dengue in Africa are still scarce. We investigated imported dengue infection among travelers with a high proportion of subjects from Africa over a 9-year period. From January 2005 to December 2013, blood samples from travelers with clinical suspicion of dengue were analyzed. Dengue was diagnosed using serological, antigen detection, and molecular methods. Subjects were classified according to birthplace (Europeans versus non-Europeans) and last country visited. Overall, 10,307 serum samples corresponding to 8,295 patients were studied; 62% were European travelers, most of them from Spain, and 35.9% were non-Europeans, the majority of whom were born in Africa (mainly Equatorial Guinea) and Latin America (mainly Bolivia, Ecuador, and Colombia). A total of 492 cases of dengue were identified, the highest number of cases corresponding to subjects who had traveled from Africa ( = 189), followed by Latin America ( = 174) and Asia ( = 113). The rate of cases for Africa (4.5%) was inferior to Asia (9%) and Latin America (6.1%). Three peaks of dengue were found (2007, 2010, and 2013) which correlated with African cases. A total of 2,157 of past dengue infections were diagnosed. Non-Europeans who had traveled from Africa had the highest rate of past infection (67.8%), compared with non-Europeans traveling from Latin America (38.7%) or Asia (35%). Dengue infection in certain regions of Africa is underreported and the burden of the disease may have a magnitude similar to endemic countries in Latin America. It is necessary to consider dengue in the differential diagnosis of other febrile diseases in Africa.
非洲登革热的流行病学数据仍然匮乏。我们调查了在9年期间来自非洲的受试者比例较高的旅行者中的输入性登革热感染情况。2005年1月至2013年12月，对临床怀疑患有登革热的旅行者的血样进行了分析。登革热通过血清学、抗原检测和分子方法进行诊断。受试者根据出生地（欧洲人与非欧洲人）和最后访问的国家进行分类。总体而言，研究了对应于8295名患者的10307份血清样本；62%为欧洲旅行者，其中大多数来自西班牙，35.9%为非欧洲人，其中大多数出生于非洲（主要是赤道几内亚）和拉丁美洲（主要是玻利维亚、厄瓜多尔和哥伦比亚）。共确定了492例登革热病例，病例数最多的是来自非洲的旅行者（=189），其次是拉丁美洲（=174）和亚洲（=113）。非洲的病例率（4.5%）低于亚洲（9%）和拉丁美洲（6.1%）。发现了三个登革热高峰（2007年、2010年和2013年），这与非洲的病例相关。共诊断出2157例既往登革热感染。来自非洲的非欧洲旅行者既往感染率最高（67.8%），相比之下，来自拉丁美洲（38.7%）或亚洲（35%）的非欧洲旅行者既往感染率较低。非洲某些地区的登革热感染报告不足，该疾病的负担可能与拉丁美洲的流行国家相似。在非洲其他发热性疾病的鉴别诊断中必须考虑登革热。
