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A household serosurvey to estimate the magnitude of a dengue outbreak in Mombasa, Kenya, 2013.

Ellis EM, Neatherlin JC, Delorey M, Ochieng M, Mohamed AH, Mogeni DO, Hunsperger E, Patta S, Gikunju S, Waiboic L, Fields B, Ofula V, Konongoi SL, Torres-Velasquez B, Marano N, Sang R, Margolis HS, Montgomery JM, Tomashek KM - PLoS Negl Trop Dis (2015)

Bottom Line: Among those infected, 93 (44%) reported fever in the past month.Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection.This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.

View Article: PubMed Central - PubMed

Affiliation: Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.

ABSTRACT
Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.

No MeSH data available.


Related in: MedlinePlus

Map of 210 dengue virus (DENV) infected participants in Tudor, Mombasa, Kenya.Participants with evidence of current or recent DENV infection were distributed throughout the Tudor district, and there was no statistically significant clustering by area. Solid black circles represent IgM anti-DENV positive participants, white circles represent RT-PCR positive participants.
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pntd.0003733.g002: Map of 210 dengue virus (DENV) infected participants in Tudor, Mombasa, Kenya.Participants with evidence of current or recent DENV infection were distributed throughout the Tudor district, and there was no statistically significant clustering by area. Solid black circles represent IgM anti-DENV positive participants, white circles represent RT-PCR positive participants.

Mentions: Of 986 randomly-selected Tudor households, 701 (71%) households including 1,500 individuals participated in the seroincidence survey (median = 2 participants per household [range: 1–11]). Median age of study participants was 28 years (range: 0.1–94), and most were Christian (67%) and female (60%), and thus similar to Mombasa’s population [5]. In total, 210 (13%; 95% confidence interval [CI] = 10–16%) participants had evidence of DENV infection with 101 current infections, including 12 participants who were both RT-PCR and IgM positive, and 109 recent DENV infections. Of the 101 RT-PCR positive participants, DENV-1 and -2 were detected in 51 (50%) and 48 (48%) of all cases, respectively, and two (2%) DENV-1 and DENV-2 co-infections were detected. Participants with evidence of current or recent DENV infection were distributed throughout the Tudor district, and there was no statistically significant clustering by area (Fig 2). There was no significant difference in infection rate between study areas within the Tudor district.


A household serosurvey to estimate the magnitude of a dengue outbreak in Mombasa, Kenya, 2013.

Ellis EM, Neatherlin JC, Delorey M, Ochieng M, Mohamed AH, Mogeni DO, Hunsperger E, Patta S, Gikunju S, Waiboic L, Fields B, Ofula V, Konongoi SL, Torres-Velasquez B, Marano N, Sang R, Margolis HS, Montgomery JM, Tomashek KM - PLoS Negl Trop Dis (2015)

Map of 210 dengue virus (DENV) infected participants in Tudor, Mombasa, Kenya.Participants with evidence of current or recent DENV infection were distributed throughout the Tudor district, and there was no statistically significant clustering by area. Solid black circles represent IgM anti-DENV positive participants, white circles represent RT-PCR positive participants.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4414477&req=5

pntd.0003733.g002: Map of 210 dengue virus (DENV) infected participants in Tudor, Mombasa, Kenya.Participants with evidence of current or recent DENV infection were distributed throughout the Tudor district, and there was no statistically significant clustering by area. Solid black circles represent IgM anti-DENV positive participants, white circles represent RT-PCR positive participants.
Mentions: Of 986 randomly-selected Tudor households, 701 (71%) households including 1,500 individuals participated in the seroincidence survey (median = 2 participants per household [range: 1–11]). Median age of study participants was 28 years (range: 0.1–94), and most were Christian (67%) and female (60%), and thus similar to Mombasa’s population [5]. In total, 210 (13%; 95% confidence interval [CI] = 10–16%) participants had evidence of DENV infection with 101 current infections, including 12 participants who were both RT-PCR and IgM positive, and 109 recent DENV infections. Of the 101 RT-PCR positive participants, DENV-1 and -2 were detected in 51 (50%) and 48 (48%) of all cases, respectively, and two (2%) DENV-1 and DENV-2 co-infections were detected. Participants with evidence of current or recent DENV infection were distributed throughout the Tudor district, and there was no statistically significant clustering by area (Fig 2). There was no significant difference in infection rate between study areas within the Tudor district.

Bottom Line: Among those infected, 93 (44%) reported fever in the past month.Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection.This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.

View Article: PubMed Central - PubMed

Affiliation: Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico.

ABSTRACT
Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1-4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0-2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1-5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.

No MeSH data available.


Related in: MedlinePlus