Rev Panam Salud Publica. 2017 Aug 21;41:e59. doi: 10.26633/RPSP.2017.59.
Estimate seroprevalence, clinical case rate, and proportion of subclinical infections from chikungunya.
A cross-sectional study was conducted in October 2015 at 39 sites distributed across Nicaragua. Demographic and clinical information was compiled through a personal survey. Blood samples were collected to detect chikungunya antibodies using the ELISA inhibition method developed by Nicaragua's National Diagnostic and Reference Center. Results were analyzed using generalized linear models and multilevel Poisson models.
A total of 11 722 participants aged >2 years were enrolled and 11 280 samples were processed. National seroprevalence was 32.8% (95% CI [95% confidence interval]: 31.9-33.6), with a clinical case rate of 26.5% (95% CI: 25.7-27.3) and a proportion of subclinical infections of 19.1% (95% CI: 17.8-20.4). Seroprevalence varied among the 39 sites and was greater at sites with higher vector infestation indices. Individually, seroprevalence was higher in participants aged >11 years.
Since its introduction, this is the first study on chikungunya seroprevalence in continental Latin America to determine national prevalence, clinical case rate, and proportion of subclinical infections. The study model, employing broad community participation and leadership by the Ministry of Health of Nicaragua, can be an example for conducting similar studies in the region.
估算基孔肯雅热的血清流行率、临床病例率以及亚临床感染比例。
2015年10月在尼加拉瓜分布的39个地点开展了一项横断面研究。通过个人调查收集人口统计学和临床信息。采集血样，使用尼加拉瓜国家诊断和参考中心开发的酶联免疫吸附试验抑制法检测基孔肯雅热抗体。使用广义线性模型和多水平泊松模型分析结果。
共纳入11722名年龄大于2岁的参与者，处理了11280份样本。全国血清流行率为32.8%（95%置信区间[95% confidence interval]：31.9 - 33.6），临床病例率为26.5%（95%置信区间：25.7 - 27.3），亚临床感染比例为19.1%（95%置信区间：17.8 - 20.4）。血清流行率在39个地点之间存在差异，在病媒侵扰指数较高的地点更高。个体方面，年龄大于11岁的参与者血清流行率更高。
自基孔肯雅热传入以来，这是拉丁美洲大陆首次关于基孔肯雅热血清流行率的研究，以确定全国流行率、临床病例率和亚临床感染比例。该研究模式采用广泛的社区参与以及尼加拉瓜卫生部的领导，可为该地区开展类似研究提供范例。
