Date Published: April 19, 2018
Publisher: The American Society of Tropical Medicine and Hygiene
Author(s): Norma Pavía-Ruz, Diana Patricia Rojas, Salha Villanueva, Pilar Granja, Angel Balam-May, Ira M. Longini, M. Elizabeth Halloran, Pablo Manrique-Saide, Hector Gómez-Dantés.
Dengue transmission in Mexico has become a major public health problem. Few epidemiological studies have examined the seroprevalence of dengue in Mexico, and recent estimates are needed to better understand dengue transmission dynamics. We conducted a dengue seroprevalence survey among 1,668 individuals including all age groups in three urban settings in Yucatan, Mexico. Children (< 19 years old) were selected randomly from schools. The adults (≥ 19 years old) were selected from healthcare facilities. Participants were asked to provide a venous blood sample and to answer a brief questionnaire with demographic information. Previous exposure to dengue was determined using indirect immunoglobulin G enzyme-linked immunosorbent assay. The overall seroprevalence was 73.6%. The age-specific seroprevalence increased with age, going from 51.4% (95% confidence interval [CI] = 45.0–57.9%) in children ≤ 8 years to 72% (95% CI = 66.3–77.2%) in the 9- to 14-years old. The highest seroprevalence was 83.4% (95% CI = 77–82.2%) in adults greater than 50 years. The seroprevalence in Merida was 68.6% (95% CI = 65–72%), in Progreso 68.7% (95% CI = 64.2–72.8%), and in Ticul 85.3% (95% CI = 81.9–88.3%). Ticul had the highest seroprevalence in all age groups. Logistic regression analysis showed that age and city of residence were associated with greater risk of prior dengue exposure. The results highlight the level of past exposure to dengue virus including young children. Similar studies should be conducted elsewhere in Mexico and other endemic countries to better understand the transmission dynamics of dengue.
Dengue is a global public health problem affecting more than 100 countries, with approximately three billion people at risk and an estimated 390 million dengue infections annually worldwide.1 Dengue is one of the vector-borne viral diseases with high impact throughout the Americas with an average of 1.8 million of dengue cases reported during the current decade.2 Brazil, Colombia, and Mexico account for the largest burden of disease in the region.3,4
Our study found an overall dengue antibody prevalence of 73.6% in our surveyed cities in Yucatan, consistent with previous studies in this area. In contrast to previous studies, we found that women had a higher dengue antibody prevalence than males. In addition, we found that Ticul, a city previously classified as an area with a medium level of dengue transmission, had the highest prevalence of previously exposed individuals (85.3% versus ∼68% in the other surveyed cities), and this observation held when comparing all the surveyed age groups. More than 70% of children in the age group between 9 and 14 years had been exposed to dengue, which has important implications to help targeting dengue vaccines and maximizing future vaccine impact.