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A Household Serosurvey to Estimate the Magnitude of a Dengue Outbreak in Mombasa, Kenya, 2013

2015; Public Library of Science; Volume: 9; Issue: 4 Linguagem: Inglês

10.1371/journal.pntd.0003733

1935-2735

Esther M. Ellis, John Neatherlin, Mark J. Delorey, Melvin Ochieng, Abdinoor Haji Mohamed, Ondari D. Mogeni, Elizabeth Hunsperger, Shem Patta, Stella Gikunju, Lilian Waiboic, Barry S. Fields, Victor Ofula, Samson Konongoi, Brenda Torres-Velásquez, Nina Marano, Rosemary Sang, Harold S. Margolis, Joel M. Montgomery, Kay M. Tomashek,

Malaria Research and Control

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.