Trends in patterns of dengue transmission over 4 years in a pediatric cohort study in Nicaragua.
J Infect Dis
; 201(1): 5-14, 2010 Jan 01.
Article
em En
| MEDLINE
| ID: mdl-19929380
BACKGROUND: Dengue is the most prevalent mosquito-borne viral disease in humans and a major urban public health problem worldwide. METHODS: A prospective cohort study of approximately 3800 children initially aged 2-9 years was established in Managua, Nicaragua, in 2004 to study the natural history of dengue transmission in an urban pediatric population. Blood samples from healthy subjects were collected annually prior to the dengue season, and identification of dengue cases occurred via enhanced passive surveillance at the study health center. RESULTS: Over the first four years of the study, seroprevalence of anti-dengue virus (DENV) antibodies increased from 22%-40% in the 2-year-old cohort and 90%-95% in the 9-year-old cohort. The incidence of symptomatic dengue cases and the ratio of inapparent to symptomatic DENV infection varied substantially from year to year. The switch in dominant transmission from DENV-1 to DENV-2 was accompanied by an increase in disease severity but, paradoxically, a decrease in transmission. Phylogeographic analysis of full-length DENV-2 sequences revealed strong geographic clustering of dengue cases. CONCLUSIONS: This large-scale cohort study of dengue in the Americas demonstrates year-to-year variation of dengue within a pediatric population, revealing expected patterns in transmission while highlighting the impact of interventions, climate, and viral evolution.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vigilância da População
/
Dengue
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Child
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Child, preschool
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Female
/
Humans
/
Male
País/Região como assunto:
America central
/
Nicaragua
Idioma:
En
Revista:
J Infect Dis
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Nicarágua
País de publicação:
Estados Unidos