International Journal of Infectious Diseases (May 2017)

Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction

  • Mabel Carabali,
  • Jacqueline Kyungah Lim,
  • Diana Carolina Velez,
  • Andrea Trujillo,
  • Jorge Egurrola,
  • Kang Sung Lee,
  • Jay S. Kaufman,
  • Luiz Jacinto DaSilva,
  • Ivan Dario Velez,
  • Jorge E. Osorio

DOI
https://doi.org/10.1016/j.ijid.2017.02.016
Journal volume & issue
Vol. 58, no. C
pp. 27 – 36

Abstract

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Background: Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction. Methods: A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years. Results: A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n = 1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3–10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent. Conclusions: These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.

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