Direct and indirect effects of age on dengue severity: The mediating role of secondary infection.
Severe dengue occurrence has been attributed to increasing age and different dengue virus (DENV) serotypes that cause secondary infections and immune-enhancing phenomena. Therefore, we examined if the effect of age on dengue severity was mediated by infectivity status while controlling for sex and r...
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ftdoajarticles:oai:doaj.org/article:ba921690f4ba4f16bdf47eb727c1752f 2023-11-05T03:39:58+01:00 Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. Esther Annan Jesús Treviño Bingxin Zhao Alfonso J Rodriguez-Morales Ubydul Haque 2023-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0011537 https://doaj.org/article/ba921690f4ba4f16bdf47eb727c1752f EN eng Public Library of Science (PLoS) https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011537&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011537 https://doaj.org/article/ba921690f4ba4f16bdf47eb727c1752f PLoS Neglected Tropical Diseases, Vol 17, Iss 8, p e0011537 (2023) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2023 ftdoajarticles https://doi.org/10.1371/journal.pntd.0011537 2023-10-08T00:37:57Z Severe dengue occurrence has been attributed to increasing age and different dengue virus (DENV) serotypes that cause secondary infections and immune-enhancing phenomena. Therefore, we examined if the effect of age on dengue severity was mediated by infectivity status while controlling for sex and region. Further, we assessed the spatial clustering of dengue severity for individuals with primary and secondary infection across Mexican municipalities. Health data from 2012 to 2017 was retrieved from Mexico's Ministry of Health. A mediation analysis was performed using multiple logistic regression models based on a directed acyclic graph. The models were explored for the direct effect of age on dengue severity and its indirect impact through secondary infection. In addition, severe dengue clusters were determined in some Northeastern and Southeastern municipalities through spatial analysis. We observed a nonlinear trend between age and severe dengue. There was a downward trend of severe dengue for individuals between 0 and 10 years and an upward trend above 10 years. The effect of age on dengue severity was no longer significant for individuals between 10 and 60 years after introducing infectivity status into the model. The mediating role of infectivity status in the causal model was 17%. Clustering of severe dengue among individuals with primary infection in the Northeastern region may point to the high prevalence of DENV-3 in the region. Public health efforts may prevent secondary infection among infants and the aged. In addition, there should be a further investigation into the effect of DENV-3 in individuals with primary disease. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles PLOS Neglected Tropical Diseases 17 8 e0011537 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Esther Annan Jesús Treviño Bingxin Zhao Alfonso J Rodriguez-Morales Ubydul Haque Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Severe dengue occurrence has been attributed to increasing age and different dengue virus (DENV) serotypes that cause secondary infections and immune-enhancing phenomena. Therefore, we examined if the effect of age on dengue severity was mediated by infectivity status while controlling for sex and region. Further, we assessed the spatial clustering of dengue severity for individuals with primary and secondary infection across Mexican municipalities. Health data from 2012 to 2017 was retrieved from Mexico's Ministry of Health. A mediation analysis was performed using multiple logistic regression models based on a directed acyclic graph. The models were explored for the direct effect of age on dengue severity and its indirect impact through secondary infection. In addition, severe dengue clusters were determined in some Northeastern and Southeastern municipalities through spatial analysis. We observed a nonlinear trend between age and severe dengue. There was a downward trend of severe dengue for individuals between 0 and 10 years and an upward trend above 10 years. The effect of age on dengue severity was no longer significant for individuals between 10 and 60 years after introducing infectivity status into the model. The mediating role of infectivity status in the causal model was 17%. Clustering of severe dengue among individuals with primary infection in the Northeastern region may point to the high prevalence of DENV-3 in the region. Public health efforts may prevent secondary infection among infants and the aged. In addition, there should be a further investigation into the effect of DENV-3 in individuals with primary disease. |
format |
Article in Journal/Newspaper |
author |
Esther Annan Jesús Treviño Bingxin Zhao Alfonso J Rodriguez-Morales Ubydul Haque |
author_facet |
Esther Annan Jesús Treviño Bingxin Zhao Alfonso J Rodriguez-Morales Ubydul Haque |
author_sort |
Esther Annan |
title |
Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. |
title_short |
Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. |
title_full |
Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. |
title_fullStr |
Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. |
title_full_unstemmed |
Direct and indirect effects of age on dengue severity: The mediating role of secondary infection. |
title_sort |
direct and indirect effects of age on dengue severity: the mediating role of secondary infection. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2023 |
url |
https://doi.org/10.1371/journal.pntd.0011537 https://doaj.org/article/ba921690f4ba4f16bdf47eb727c1752f |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 17, Iss 8, p e0011537 (2023) |
op_relation |
https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011537&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011537 https://doaj.org/article/ba921690f4ba4f16bdf47eb727c1752f |
op_doi |
https://doi.org/10.1371/journal.pntd.0011537 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
17 |
container_issue |
8 |
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e0011537 |
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