Journal Article

Evaluating dengue burden in Africa in passive fever surveillance and seroprevalence studies: protocol of field studies of the Dengue Vaccine Initiative

Lim, Sl-Ki, Namkung, Suk, Bonnet, Emmanuel, Agnandji, Selidji Todagbe, Esen, Meral, Carabali, Mabel, Fernandes, Jose, Matendechero, Sultani Hadley, Lell, Bertrand, Oyembo, Noah, Njenga, Sammy M, Ridde, Valéry, Andia, Esther, Yaro, Seydou, Lee, Kang-Sung, Yoon, In-Kyu, Alexander, Neal, Lee, Jung-Seok, Barro, Ahmed, Lim, Jacqueline Kyungah

2018

Overview

IntroductionDengue is an important and well-documented public health problem in the Asia-Pacific and Latin American regions. However, in Africa, information on disease burden is limited to case reports and reports of sporadic outbreaks, thus hindering the implementation of public health actions for disease control. To gather evidence on the undocumented burden of dengue in Africa, epidemiological studies with standardised methods were launched in three locations in Africa.Methods and analysisIn 2014–2017, the Dengue Vaccine Initiative initiated field studies at three sites in Ouagadougou, Burkina Faso; Lambaréné, Gabon and Mombasa, Kenya to obtain comparable incidence data on dengue and assess its burden through standardised hospital-based surveillance and community-based serological methods. Multidisciplinary measurements of the burden of dengue were obtained through field studies that included passive facility-based fever surveillance, cost-of-illness surveys, serological surveys and healthcare utilisation surveys. All three sites conducted case detection using standardised procedures with uniform laboratory assays to diagnose dengue. Healthcare utilisation surveys were conducted to adjust population denominators in incidence calculations for differing healthcare seeking patterns. The fever surveillance data will allow calculation of age-specific incidence rates and comparison of symptomatic presentation between patients with dengue and non-dengue using multivariable logistic regression. Serological surveys assessed changes in immune status of cohorts of approximately 3000 randomly selected residents at each site at 6-month intervals. The age-stratified serosurvey data will allow calculation of seroprevalence and force of infection of dengue. Cost-of-illness evaluations were conducted among patients with acute dengue by Rapid Diagnostic Test.Ethics and disseminationBy standardising methods to evaluate dengue burden across several sites in Africa, these studies will generate evidence for dengue burden in Africa and data will be disseminated as publication in peer-review journals in 2018.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adolescent / Adult / Africa - epidemiology / Child / Child, Preschool / Cost of Illness / Dengue - epidemiology / Dengue - prevention & control / Dengue fever / Dengue Vaccines - therapeutic use / Disease / Disease prevention / Epidemics / Epidemiology / Female / Fever - etiology / Field study / Flow cytometry / Health surveillance / Humans / Illnesses / Immunoassay / Incidence / Infant / Infections / Infectious Diseases / Life Sciences / Logistic Models / Male / Microbiology and Parasitology / Middle Aged / Mosquitoes / Multivariate Analysis / Population / Public Health / Research Design / Santé publique et épidémiologie / Seroepidemiologic Studies / Site selection / Vaccines / Virology / Viruses / West Nile virus / Young Adult