Elsa Sarti1, Maïna L'Azou2, Marcela Mercado3, Pablo Kuri4, Joao Bosco Siqueira5, Erick Solis6, Fernando Noriega7, R Leon Ochiai2. 1. Sanofi Pasteur LATAM, Av. Universidad 1738, Col. Coyoacán, Mexico D.F. C.P. 04000. Electronic address: elsa.sarti@sanofipasteur.com. 2. Global Epidemiology, Sanofi Pasteur, Lyon, France. 3. Instituto Nacional de Salud, Bogotá DC, Colombia. 4. Universidad Nacional Autónoma de México Ciudad Universitaria, Distrito Federal, Mexico. 5. Universidade Federal de Goias, Goiania, Brazil. 6. Sanofi Pasteur LATAM, Av. Universidad 1738, Col. Coyoacán, Mexico D.F. C.P. 04000. 7. Sanofi Pasteur, Pennsylvania, USA.
Abstract
BACKGROUND: Dengue is a notifiable infectious disease in many countries, but under-reporting of cases to National Epidemiological Surveillance Systems (NESSs) conceals the true extent of the disease burden. The incidence of dengue identified in a cohort study was compared with those reported to NESSs. METHODS: A randomized, placebo-controlled study was undertaken in Brazil, Colombia, Honduras, Mexico, and Puerto Rico to assess the efficacy of a tetravalent dengue vaccine (CYD-TDV) in children aged 9-16 years. The incidence of dengue in the placebo group was compared with that reported to NESSs in a similar age group (10-19 years) from June 2011 to April 2014. RESULTS:Three thousand six hundred and fifteen suspected dengue cases were identified in the study over 13527 person-years of observation. The overall incidence of confirmed dengue was 2.9 per 100 person-years (range 1.5 to 4.1 per 100 person-years). In the NESSs combined, over 3.2 million suspected dengue cases were reported during the same period, corresponding to over 1 billion person-years of observation. The incidence of confirmed dengue reported by the NESSs in the same locality where the study took place was 0.286 per 100 person-years across Brazil, Colombia, and Mexico (range 0.180 to 0.734 per 100 person-years). The incidence of confirmed dengue was 10.0-fold higher in the study than that reported to NESSs in the same localities (range 3.5- to 19.4-fold higher). CONCLUSIONS: There is a substantial under-reporting of dengue in the NESSs. Understanding the level of under-reporting would allow more accurate estimates of the dengue burden in Latin America.
RCT Entities:
BACKGROUND: Dengue is a notifiable infectious disease in many countries, but under-reporting of cases to National Epidemiological Surveillance Systems (NESSs) conceals the true extent of the disease burden. The incidence of dengue identified in a cohort study was compared with those reported to NESSs. METHODS: A randomized, placebo-controlled study was undertaken in Brazil, Colombia, Honduras, Mexico, and Puerto Rico to assess the efficacy of a tetravalent dengue vaccine (CYD-TDV) in children aged 9-16 years. The incidence of dengue in the placebo group was compared with that reported to NESSs in a similar age group (10-19 years) from June 2011 to April 2014. RESULTS: Three thousand six hundred and fifteen suspected dengue cases were identified in the study over 13527 person-years of observation. The overall incidence of confirmed dengue was 2.9 per 100 person-years (range 1.5 to 4.1 per 100 person-years). In the NESSs combined, over 3.2 million suspected dengue cases were reported during the same period, corresponding to over 1 billion person-years of observation. The incidence of confirmed dengue reported by the NESSs in the same locality where the study took place was 0.286 per 100 person-years across Brazil, Colombia, and Mexico (range 0.180 to 0.734 per 100 person-years). The incidence of confirmed dengue was 10.0-fold higher in the study than that reported to NESSs in the same localities (range 3.5- to 19.4-fold higher). CONCLUSIONS: There is a substantial under-reporting of dengue in the NESSs. Understanding the level of under-reporting would allow more accurate estimates of the dengue burden in Latin America.
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