Heterogeneity of dengue transmission in an endemic area of Colombia

María Isabel Estupiñán Cárdenas, Víctor Mauricio Herrera, María Consuelo Miranda Montoya, Anyela Lozano Parra, Zuly Milena Zaraza Moncayo, Janeth Patricia Flórez García, Isabel Rodríguez Barraquer, Luis Ángel Villar Centeno

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Population based serological surveys are the gold-standard to quantify dengue (DENV) transmission. The purpose of this study was to estimate the age-specific seroprevalence and the force of infection of DENV in an endemic area of Colombia. Between July and Octo-ber 2014, we conducted a household based cross-sectional survey among 1.037 individuals aged 2 to 40 years living in 40 randomly selected locations in urban Piedecuesta, Santan-der, Colombia. In addition, we also enrolled 246 indviduals living in rural “veredas”. Participants were asked to answer a questionnaire that included demographic, socioeconomic and environmental questions and to provide a 5 ml blood sample. Sera were tested using the IgG indirect ELISA (Panbio) kit to determine past DENV infection. The overall DENV seroprevalence was 70% (95% CI = 67%-71%), but was significantly higher in urban (81%, 95% CI = 78%-83%) as compared to rural (21%, 95% CI = 17%-27%) locations. Age was a major predictor of seropositivity, consistent with endemic circulation of the virus. Using cata-lytic models we estimated that on average, 12% (95%CI = 11%-13%) of susceptible individuals living in the city are infected by DENV each year. Beyond age, the only predictor of seropositivity in urban locations was prior history of dengue diagnosed by a physician (aPR 1.15, 95% CI = 0.98–1.35). Among participants living in rural settings, those that reported traveling outside of their vereda were more likely to be seropositive (aPR 3.60, 95%CI = 1.54–8.42) as well as those who were born outside of Santander department (aPR = 2.77, 95%CI = 1.20–6.37). These results are consistent with long term endemic circulation of DENV in Piedecuesta, with large heterogeneities between urban and rural areas located just a few kilometers apart. Design of DENV control interventions, including vaccination, will need to consider this fine scale spatial heterogeneity.

Original languageEnglish
Article numbere0008122
Pages (from-to)1-15
Number of pages15
JournalPLoS Neglected Tropical Diseases
Volume14
Issue number9
DOIs
StatePublished - Sep 2020
Externally publishedYes

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