A household serosurvey to estimate the magnitude of a dengue outbreak in Mombasa, Kenya, 2013.

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 magnitu...

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Bibliographic Details
Published in:PLOS Neglected Tropical Diseases
Main Authors: Esther M Ellis, John C Neatherlin, Mark Delorey, Melvin Ochieng, Abdinoor Haji Mohamed, Daniel Ondari Mogeni, Elizabeth Hunsperger, Shem Patta, Stella Gikunju, Lilian Waiboic, Barry Fields, Victor Ofula, Samson Limbaso Konongoi, Brenda Torres-Velasquez, Nina Marano, Rosemary Sang, Harold S Margolis, Joel M Montgomery, Kay M Tomashek
Format: Article in Journal/Newspaper
Language:English
Published: Public Library of Science (PLoS) 2015
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Online Access:https://doi.org/10.1371/journal.pntd.0003733
https://doaj.org/article/e1039419f9f4482cb5bae38f42edb9fd
Description
Summary: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.