Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos/Fiocruz, Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil.
GSK, Estrada dos Bandeirantes, 8464, Jacarepaguá, Rio de Janeiro - RJ, 22775-610, Brazil.
Int J Infect Dis. 2021 Jul;108:443-453. doi: 10.1016/j.ijid.2021.04.062. Epub 2021 Apr 21.
To estimate the incidence of dengue infection across geographically distinct areas of Brazil.
This prospective, household-based, cohort study enrolled participants in five areas and followed them up for up to 4 years (2014-2018). Dengue seroprevalence was assessed at each scheduled visit. Suspected dengue cases were identified through enhanced passive and active surveillance. Acute symptomatic dengue infection was confirmed through reverse-transcriptase quantitative polymerase chain reaction in combination with an antigenic assay (non-structural protein 1) and serology.
Among 3300 participants enrolled, baseline seroprevalence was 76.2%, although only 23.3% of participants reported a history of dengue. Of 1284 suspected symptomatic dengue cases detected, 50 (3.9%) were laboratory-confirmed. Based on 8166.5 person-years (PY) of follow-up, the incidence of laboratory-confirmed symptomatic infection (primary endpoint) was 6.1 per 1000 PY (95% confidence interval [CI]: 4.5, 8.1). Incidence varied substantially in different years (1.8-7.4 per 1000 PY). The incidence of inapparent primary dengue infection was substantially higher: 41.7 per 1000 PY (95% CI: 31.1, 54.6).
Our findings, highlighting that the incidence of dengue infection is underestimated in Brazil, will inform the design and implementation of future dengue vaccine trials.
NCT01751139.
估计巴西不同地理区域登革热感染的发生率。
本前瞻性、基于家庭的队列研究纳入了五个地区的参与者，并对他们进行了长达 4 年（2014-2018 年）的随访。在每次预约时评估登革热血清流行率。通过加强的被动和主动监测来发现疑似登革热病例。通过逆转录定量聚合酶链反应结合抗原检测（非结构蛋白 1）和血清学来确认急性症状性登革热感染。
在纳入的 3300 名参与者中，基线血清流行率为 76.2%，尽管只有 23.3%的参与者报告有登革热病史。在检测到的 1284 例疑似有症状的登革热病例中，有 50 例（3.9%）经实验室确诊。在 8166.5 人年（PY）的随访中，实验室确诊的有症状感染（主要终点）的发生率为每 1000 PY 6.1 例（95%置信区间[CI]：4.5，8.1）。不同年份的发病率差异很大（1.8-7.4 例/1000 PY）。无症状原发性登革热感染的发生率要高得多：每 1000 PY 41.7 例（95%CI：31.1，54.6）。
我们的研究结果强调了巴西对登革热感染的发病率估计不足，这将为未来登革热疫苗试验的设计和实施提供信息。
NCT01751139。
