Dataset Information

Opportunities for improved surveillance and control of dengue from age-specific case data.

ABSTRACT: One of the challenges faced by global disease surveillance efforts is the lack of comparability across systems. Reporting commonly focuses on overall incidence, despite differences in surveillance quality between and within countries. For most immunizing infections, the age distribution of incident cases provides a more robust picture of trends in transmission. We present a framework to estimate transmission intensity for dengue virus from age-specific incidence data, and apply it to 359 administrative units in Thailand, Colombia, Brazil and Mexico. Our estimates correlate well with those derived from seroprevalence data (the gold standard), capture the expected spatial heterogeneity in risk, and correlate with known environmental drivers of transmission. We show how this approach could be used to guide the implementation of control strategies such as vaccination. Since age-specific counts are routinely collected by masany surveillance systems, they represent a unique opportunity to further our understanding of disease burden and risk for many diseases.

SUBMITTER: Rodriguez-Barraquer I

PROVIDER: S-EPMC6579519 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Opportunities for improved surveillance and control of dengue from age-specific case data.

Rodriguez-Barraquer Isabel I Salje Henrik H Cummings Derek A DA

eLife 20190523

One of the challenges faced by global disease surveillance efforts is the lack of comparability across systems. Reporting commonly focuses on overall incidence, despite differences in surveillance quality between and within countries. For most immunizing infections, the age distribution of incident cases provides a more robust picture of trends in transmission. We present a framework to estimate transmission intensity for dengue virus from age-specific incidence data, and apply it to 359 adminis ...[more]

PMID: 31120419

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Project description:The global challenges and threats from infectious diseases including antimicrobial drug resistance and emerging infections due to the rapidly changing climate require that we continuously revisit the fitness of our infrastructure. The databases used for surveillance represent an important infrastructure. Historically, many databases have evolved from different needs and from different organizations. Despite growing data storage and computing capacities, data are, however, rarely used to their full potential. The objective of this review was to outline different data sources available in Denmark. We applied a one-health perspective and included data sources on animal demographics and movements, medicine prescription, diagnostic test results as well as relevant data on human health. Another objective was to suggest approaches for fit-for-purpose integration of data as a resource for risk assessment and generation of evidence for policies to protect animal and human health. Danish databases were reviewed according to a systematic procedure including ownership, intended purposes of the database, target and study populations, metrics and information used, measuring methods (observers, diagnostic tests), recording procedures, data flow, database structure, and control procedures to ensure data quality. Thereby, structural metadata were gathered across available Danish databases including animal health, zoonotic infections, antimicrobial use, and relevant administrative data that can support the overall aim of supporting risk assessment and development of evidence. Then illustrative cases were used to assess how combinations and integration of databases could improve existing evidence to support decisions in animal health policies (e.g., combination of information on diseases in different herds or regions with information on isolation of pathogens from humans). Due to the complexity of databases, full integration at the individual level is often not possible. Still, integration of data at a higher level (e.g., municipality or region) can provide important information on risks and hence risk management. We conclude by discussing how databases by linkage can be improved in the future, and emphasize that legal issues are important to address in order to optimize the use of the available data.

Project description:Laboratory confirmation of Zika virus (ZIKV) infection during pregnancy is challenging due to cross-reactivity with dengue virus (DENV) and limited knowledge about the kinetics of anti-Zika antibody responses during pregnancy. We described ZIKV and DENV serological markers and the maternal-fetal transfer of antibodies among mothers and neonates after the ZIKV microcephaly outbreak in Northeast Brazil (2016). We included 89 microcephaly cases and 173 neonate controls at time of birth and their mothers. Microcephaly cases were defined as newborns with a particular head circumference (2 SD below the mean). Two controls without microcephaly were matched by the expected date of delivery and area of residence. We tested maternal serum for recent (ZIKV genome, IgM and IgG3 anti-NS1) and previous (ZIKV and DENV neutralizing antibodies [NAbs]) markers of infection. Multiple markers of recent or previous ZIKV and DENV infection in mothers were analyzed using principal component analysis (PCA). At delivery, 5.6% of microcephaly case mothers and 1.7% of control mothers were positive for ZIKV IgM. Positivity for ZIKV IgG3 anti-NS1 was 8.0% for case mothers and 3.5% for control mothers. ZIKV NAbs was slightly higher among mothers of cases (69.6%) than that of mothers of controls (57.2%; p = 0.054). DENV exposure was detected in 85.8% of all mothers. PCA discriminated two distinct components related to recent or previous ZIKV infection and DENV exposure. ZIKV NAbs were higher in newborns than in their corresponding mothers (p<0.001). We detected a high frequency of ZIKV exposure among mothers after the first wave of the ZIKV outbreak in Northeast Brazil. However, we found low sensitivity of the serological markers to recent infection (IgM and IgG3 anti-NS1) in perinatal samples of mothers of microcephaly cases. Since the neutralization test cannot precisely determine the time of infection, testing for ZIKV immune status should be performed as early as possible and throughout pregnancy to monitor acute Zika infection in endemic areas.

Dataset Information

Opportunities for improved surveillance and control of dengue from age-specific case data.

Publications

Opportunities for improved surveillance and control of dengue from age-specific case data.

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