Key findings and comparisons from analogous case-cluster studies for dengue virus infection conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand
Abstract
Dengue viruses (DENV) pose a significant and increasing threat to human health across broad regions of the globe. Currently, prevention, control, and treatment strategies are limited. Promising interventions are on the horizon, including multiple vaccine candidates under development and a renewed and innovative focus on controlling the vector, Aedes aegypti. However, significant gaps persist in our understanding of the similarities and differences in DENV epidemiology across regions of potential implementation and evaluation. In this manuscript, we highlight and compare findings from two analogous cluster-based studies for DENV transmission and pathogenesis conducted in Thailand and Ecuador to identify key features and questions for further pursuit. Despite a remarkably similar incidence of DENV infection among enrolled neighborhood contacts at the two sites, we note a higher occurrence of secondary infection and severe illness in Thailand compared to Ecuador. A higher force of infection in Thailand, defined as the incidence of infection among susceptible individuals, is suggested by the higher number of captured Aedes mosquitoes per household, the increasing proportion of asymptomatic infections with advancing age, and the high proportion of infections identified as secondary-type infections by serology. These observations should be confirmed in long-term, parallel prospective cohort studies conducted across regions, which would advantageously permit characterization of baseline immune status (susceptibility) and contemporaneous assessment of risks and risk factors for dengue illness.
Citation
Anderson , K B , Stewart-Ibarra , A M , Buddhari , D , Beltran Ayala , E F , Sippy , R J , Iamsirithaworn , S , Ryan , S J , Fernandez , S , Jarman , R G , Thomas , S J & Endy , T P 2020 , ' Key findings and comparisons from analogous case-cluster studies for dengue virus infection conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand ' , Frontiers in Public Health , vol. 8 , 2 . https://doi.org/10.3389/fpubh.2020.00002
Publication
Frontiers in Public Health
Status
Peer reviewed
ISSN
2296-2565Type
Journal article
Description
The Thai research study presented here was funded by an R01 award from the National Institutes of Health (PI: TE, GM83224-01A1). This Ecuadorian research study was supported, in part, by the Department of Defense Global Emerging Infection Surveillance (GEIS) grant (P0220_13_OT) and the Department of Medicine of SUNY Upstate Medical University. AS-I and SR were additionally supported by NSF DEB EEID 1518681 and NSF DEB RAPID 1641145.Collections
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