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

Int J Infect Dis. 2017 May;58:27-36. doi: 10.1016/j.ijid.2017.02.016. Epub 2017 Mar 9.

Abstract

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.

Keywords: Colombia; Dengue; Dengue burden; Dengue prevalence; Dengue seroconversion; Serological survey.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral
  • Child
  • Child, Preschool
  • Colombia / epidemiology
  • Dengue / epidemiology*
  • Dengue / virology
  • Dengue Vaccines*
  • Dengue Virus / immunology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Neutralization Tests
  • Prevalence
  • Seroconversion*
  • Seroepidemiologic Studies
  • Serogroup
  • Young Adult

Substances

  • Antibodies, Viral
  • Dengue Vaccines