Estimating dengue transmission intensity from sero-prevalence surveys in multiple countries.
Estimating dengue transmission intensity from sero-prevalence surveys in multiple countries.
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DOI：
10.1371/journal.pntd.0003719
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发表时间：
2015-04
影响因子：
3.8
通讯作者：
Ferguson NM
中科院分区：
文献类型：
--
作者：
Imai N;Dorigatti I;Cauchemez S;Ferguson NM
对登革热传播强度的估计仍然不明确。由于大多数感染是无症状的，监测系统大大低估了真实的感染率。随着新控制措施的开发取得进展，获得对平均登革热传播强度的可靠估计是评估登革热疾病负担和干预措施可能影响的关键。登革热的感染力(λ)和相应的基本繁殖数(R0)是通过文献中确定的非血清型(Ig G)和血清型特异性(PrnT)年龄分层血清阳性率调查来估计的。R0的估计值大多在1-4之间。假设两个异源感染导致完全免疫，则R0的估计值比包括第三和第四代感染时高两倍。从免疫球蛋白数据估计的λ与从PRNT数据得出的特定血清型感染力量的总和相当，特别是在允许血清型间相互作用的情况下。我们的分析突出了登革热传播的高度异质性。关于血清型相互作用和免疫的基本假设如何影响感染力和R0之间的关系，将对控制规划产生影响。虽然PRNT数据提供了最多的信息，但我们的研究表明，即使是成本低得多的基于ELISA法的检测也可以提供总体传播强度的可比基线估计，这将是资源受限环境下的一个重要考虑因素。据估计，每年有3.9亿人感染登革热，给全球公共卫生造成了巨大的负担。然而，对不同环境下登革热传播强度的估计仍然很少，这使得制定有效的控制计划变得困难。由于许多登革热感染没有症状，通过医院报告的病例只占真实病例的一小部分。作者使用可以检测过去所有感染的血清阳性率调查来估计22个国家的登革热传播强度。使用较便宜的诊断测试收集的数据得出的估计值与使用较昂贵测试的数据相当，这是对资源受限国家的监测的一个重要结论。我们发现，在流行环境中，登革热传播强度差异高达4倍，估计对多少登革热感染被假定为完全免疫具有一定的敏感性。
Estimates of dengue transmission intensity remain ambiguous. Since the majority of infections are asymptomatic, surveillance systems substantially underestimate true rates of infection. With advances in the development of novel control measures, obtaining robust estimates of average dengue transmission intensity is key for assessing both the burden of disease from dengue and the likely impact of interventions. The force of infection (λ) and corresponding basic reproduction numbers (R0) for dengue were estimated from non-serotype (IgG) and serotype-specific (PRNT) age-stratified seroprevalence surveys identified from the literature. The majority of R0 estimates ranged from 1–4. Assuming that two heterologous infections result in complete immunity produced up to two-fold higher estimates of R0 than when tertiary and quaternary infections were included. λ estimated from IgG data were comparable to the sum of serotype-specific forces of infection derived from PRNT data, particularly when inter-serotype interactions were allowed for. Our analysis highlights the highly heterogeneous nature of dengue transmission. How underlying assumptions about serotype interactions and immunity affect the relationship between the force of infection and R0 will have implications for control planning. While PRNT data provides the maximum information, our study shows that even the much cheaper ELISA-based assays would provide comparable baseline estimates of overall transmission intensity which will be an important consideration in resource-constrained settings. With an estimated 390 million infections each year, dengue imposes a significant global public health burden. Yet estimates of the intensity of dengue transmission in different settings are still sparse, making it difficult to plan efficient control programs. Since many dengue infections have no symptoms, cases reported through hospitals are only a small proportion of true cases. The authors used seroprevalence surveys which can detect all past infections to estimate dengue transmission intensity in 22 countries. Estimates derived from data collected using cheaper diagnostic tests were comparable to those making use of more expensive tests, an important conclusion for surveillance in resource constrained countries. We found dengue transmission intensity varied up to 4-fold in endemic settings, with estimates showing some sensitivity to how many dengue infections were assumed to confer complete immunity.
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DOI：
10.3934/mbe.2013.10.1455
发表时间：
2013-10
期刊：
Mathematical biosciences and engineering : MBE
影响因子：
--
作者：
Chowell G;Fuentes R;Olea A;Aguilera X;Nesse H;Hyman JM
通讯作者：
Hyman JM
影响因子：
15.8
作者：
Cummings DA;Iamsirithaworn S;Lessler JT;McDermott A;Prasanthong R;Nisalak A;Jarman RG;Burke DS;Gibbons RV
通讯作者：
Gibbons RV
影响因子：
11.8
作者：
Brunkard JM;Robles López JL;Ramirez J;Cifuentes E;Rothenberg SJ;Hunsperger EA;Moore CG;Brussolo RM;Villarreal NA;Haddad BM
通讯作者：
Haddad BM
影响因子：
4.2
作者：
Bartley, LM;Carabin, H;Farrar, J
通讯作者：
Farrar, J
影响因子：
4.2
作者：
Chowell, G.;Torre, C. A.;Castillo-Chavez, C.
通讯作者：
Castillo-Chavez, C.