Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico.
Laboratorio Estatal de Salud Pública y Referencia Epidemiológica, Servicios de Salud de Yucatán, Merida, Yucatan, Mexico.
PLoS Negl Trop Dis. 2018 Nov 21;12(11):e0006748. doi: 10.1371/journal.pntd.0006748. eCollection 2018 Nov.
The implementation of vector control interventions and potential introduction new tools requires baseline data to evaluate their direct and indirect effects. The objective of the study is to present the seroprevalence of dengue infection in a cohort of children 0 to 15 years old followed during 2015 to 2016, the risk factors and the role of enhanced surveillance strategies in three urban sites (Merida, Ticul and Progreso) in Yucatan, Mexico.
A cohort of school children and their family members was randomly selected in three urban areas with different demographic, social conditions and levels of transmission. We included results from 1,844 children aged 0 to 15 years. Serum samples were tested for IgG, NS1 and IgM. Enhanced surveillance strategies were established in schools (absenteeism) and cohort families (toll-free number).
Seroprevalence in children 0 to 15 years old was 46.8 (CI 95% 44.1-49.6) with no difference by sex except in Ticul. Prevalence increased with age and was significantly lower in 0 to 5 years old (26.9%, 95% CI:18.4-35.4) compared with 6 to 8 years old (43.9%, 95% CI:40.1-47.7) and 9 to 15 years old (61.4%, 95% CI:58.0-64.8). Sharing the domestic space with other families increased the risk 1.7 times over the individual families that own or rented their house, while risk was significantly higher when kitchen and bathroom were outside. Complete protection with screens in doors and windows decreased risk of infection. Seroprevalence was significantly higher in the medium and high risk areas.
The prevalence of antibodies in children 0 to 15 years in three urban settings in the state of Yucatan describe the high exposure and the heterogenous transmission of dengue virus by risk areas and between schools in the study sites. The enhanced surveillance strategy was useful to improve detection of dengue cases with the coincident transmission of chikungunya and Zika viruses.
实施病媒控制干预措施和潜在引入新工具需要基线数据,以评估其直接和间接效果。本研究的目的是介绍 2015 年至 2016 年期间在尤卡坦州三个城市(梅里达、蒂库和普罗格雷索)对 0 至 15 岁儿童进行的队列研究中登革热感染的血清阳性率、危险因素以及强化监测策略的作用。
在三个具有不同人口统计学、社会条件和传播水平的城市地区,随机选择了一组学童及其家庭成员作为队列。我们纳入了 1844 名 0 至 15 岁的儿童。检测血清 IgG、NS1 和 IgM。在学校(缺勤)和队列家庭(免费电话)建立了强化监测策略。
0 至 15 岁儿童的血清阳性率为 46.8%(95%CI:44.1%-49.6%),除蒂库外,性别之间无差异。阳性率随年龄增长而增加,0 至 5 岁组明显低于 6 至 8 岁组(43.9%,95%CI:40.1%-47.7%)和 9 至 15 岁组(61.4%,95%CI:58.0%-64.8%)。与拥有或租用自己房屋的单个家庭相比,与其他家庭共享家庭空间会使风险增加 1.7 倍,而当厨房和浴室在室外时,风险会显著增加。门窗有完整的防蚊纱窗可降低感染风险。中、高危地区的血清阳性率明显较高。
尤卡坦州三个城市地区 0 至 15 岁儿童的抗体流行率描述了高暴露水平和登革热病毒通过高危地区和研究地点学校之间的异质传播。强化监测策略有助于提高对登革热病例的检测,同时还能发现基孔肯雅热和寨卡病毒的并发传播。