Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.
Elife. 2019 Apr 8;8:e42869. doi: 10.7554/eLife.42869.
Serostudies are needed to answer generalizable questions on disease risk. However, recruitment is usually biased by age or location. We present a nationally-representative study for dengue from 70 communities in Bangladesh. We collected data on risk factors, trapped mosquitoes and tested serum for IgG. Out of 5866 individuals, 24% had evidence of historic infection, ranging from 3% in the north to >80% in Dhaka. Being male (aOR:1.8, [95%CI:1.5-2.0]) and recent travel (aOR:1.3, [1.1-1.8]) were linked to seropositivity. We estimate that 40 million [34.3-47.2] people have been infected nationally, with 2.4 million ([1.3-4.5]) annual infections. Had we visited only 20 communities, seropositivity estimates would have ranged from 13% to 37%, highlighting the lack of representativeness generated by small numbers of communities. Our findings have implications for both the design of serosurveys and tackling dengue in Bangladesh.
血清学研究对于回答具有普遍性的疾病风险问题至关重要。然而，招募工作通常会受到年龄或地理位置的影响而存在偏倚。我们在孟加拉国的 70 个社区进行了一项具有全国代表性的登革热研究。我们收集了有关风险因素、诱捕的蚊子以及血清 IgG 检测的数据。在 5866 名个体中，有 24%的人有既往感染的证据，从北部的 3%到达卡的>80%不等。男性（优势比[95%置信区间]：1.8 [1.5-2.0]）和近期旅行（优势比：1.3 [1.1-1.8]）与血清阳性相关。我们估计全国有 4000 万人[3430 万至 4720 万]受到感染，每年有 240 万人[130 万至 450 万]感染。如果我们只访问了 20 个社区，那么血清阳性率的估计值将在 13%至 37%之间波动，这突出表明少数社区参与会导致代表性不足。我们的研究结果对血清学调查的设计和孟加拉国登革热的防治都具有重要意义。
