Suneela Garg1, Anita Chakravarti2, Ritesh Singh3, N R Ramesh Masthi4, Ram Chandra Goyal5, Guru Rajesh Jammy6, Enakshi Ganguly6, Nandini Sharma2, M M Singh2, Germano Ferreira7, Annick Moureau8, Sujeet Ojha9, Joshua Nealon10. 1. Maulana Azad Medical College, 2 Bahadur Shah Zafar Marg, New Delhi 110002, India. Electronic address: gargsuneela@gmail.com. 2. Maulana Azad Medical College, 2 Bahadur Shah Zafar Marg, New Delhi 110002, India. 3. College of Medicine and JNM Hospital, Kalyani, India. 4. Kempegowda Institute of Medical Sciences, Bangalore, India. 5. JN Medical College, Wardha, India. 6. SHARE INDIA - MediCiti Institute of Medical Sciences, Hyderabad, India. 7. Sanofi Pasteur Global Epidemiology, Lyon, France. 8. Sanofi Pasteur, Marcy l'Etoile, France. 9. Sanofi-Synthelabo (India) Pvt Ltd, Mumbai, India. 10. Sanofi Pasteur Asia & JPAC Region, Singapore.
Abstract
BACKGROUND: Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243). METHODS: A convenience sample of 2609 healthy children aged 5-10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire. RESULTS: Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7-61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype. CONCLUSIONS: The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India.
BACKGROUND: Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243). METHODS: A convenience sample of 2609 healthy children aged 5-10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire. RESULTS: Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7-61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype. CONCLUSIONS: The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India.
Authors: Camille Fritzell; Dominique Rousset; Antoine Adde; Mirdad Kazanji; Maria D Van Kerkhove; Claude Flamand Journal: PLoS Negl Trop Dis Date: 2018-07-16