A prospective, multicentre, cohort study to assess the incidence of dengue illness in households from selected communities in Brazil (2014-2018)
A prospective, multicentre, cohort study to assess the incidence of dengue illness in households from selected communities in Brazil (2014-2018)
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DOI：
10.1016/j.ijid.2021.04.062
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发表时间：
2021-06-25
影响因子：
8.4
通讯作者：
de Noronha, Tatiana Guimaraes
中科院分区：
文献类型：
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作者：
de Aguiar, Daniele Fernandes;de Barros, Eliana Nogueira C.;de Noronha, Tatiana Guimaraes
目的：估计巴西不同地理区域登革热感染的发病率。方法：这项前瞻性、以家庭为基础的队列研究在五个领域招募了参与者，并对他们进行了长达4年的随访（2014-2018）。在每次预定的访问中评估登革热血清阳性率。通过加强被动和主动监测，确定了登革热疑似病例。通过逆转录酶定量聚合酶链反应结合抗原测定（非结构蛋白1）和血清学证实急性症状登革热感染。结果：在3300名参与者中，基线血清阳性率为76.2%，尽管只有23.3%的参与者报告有登革热病史。在发现的1284例疑似症状登革热病例中，50例（3.9%）为实验室确诊病例。基于8166.5人年（PY）的随访，实验室确诊的症状性感染（主要终点）的发生率为6.1 / 1000 PY（95%可信区间[CI]: 4.5, 8.1）。不同年份的发病率差异很大（1.8-7.4 / 1000 PY）。隐性原发性登革热感染的发病率要高得多：41.7 / 1000 PY （95% CI: 31.1, 54.6）。结论：我们的研究结果强调了巴西登革热感染的发病率被低估了，这将为未来登革热疫苗试验的设计和实施提供信息。临床试验注册：NCT01751139 (c) 2021 GlaxoSmithKline biicals SA。由爱思唯尔有限公司代表国际传染病学会出版。这是一篇基于CC BY许可（http://creativecommons.org/ licenses/ BY /4.0/）的开放获取文章。
Objectives: To estimate the incidence of dengue infection across geographically distinct areas of Brazil. Methods: 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. Results: 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). Conclusions: Our findings, highlighting that the incidence of dengue infection is underestimated in Brazil, will inform the design and implementation of future dengue vaccine trials. Clinical trial registration: NCT01751139 (c) 2021 GlaxoSmithKline Biologicals SA. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/).