Peridomestic Infection as a Determining Factor of Dengue Transmission
The study of endemic dengue transmission is essential for proposing alternatives to impact its burden. The traditional paradigm establishes that transmission starts around cases, but there are few studies that determine the risk. To assess the association between the peridomestic dengue infection an...
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Published in | PLoS neglected tropical diseases Vol. 9; no. 12; p. e0004296 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Public Library of Science
01.12.2015
Public Library of Science (PLoS) |
Subjects | |
Online Access | Get full text |
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Summary: | The study of endemic dengue transmission is essential for proposing alternatives to impact its burden. The traditional paradigm establishes that transmission starts around cases, but there are few studies that determine the risk.
To assess the association between the peridomestic dengue infection and the exposure to a dengue index case (IC), a cohort was carried out in two Mexican endemic communities. People cohabitating with IC or living within a 50-meter radius (exposed cohort) and subjects of areas with no ICs in a 200-meter radius (unexposed cohort) were included.
Exposure was associated with DENV infection in cohabitants (PRa 3.55; 95%CI 2.37-5.31) or neighbors (PRa 1.82; 95%CI 1.29-2.58). Age, location, toilets with no direct water discharge, families with children younger than 5 and the House Index, were associated with infection. Families with older than 13 were associated with a decreased frequency. After a month since the IC fever onset, the infection incidence was not influenced by exposure to an IC or vector density; it was influenced by the local seasonal behavior of dengue and the age. Additionally, we found asymptomatic infections accounted for 60% and a greater age was a protective factor for the presence of symptoms (RR 0.98; 95%CI 0.97-0.99).
The evidence suggests that dengue endemic transmission in these locations is initially peridomestic, around an infected subject who may be asymptomatic due to demographic structure and endemicity, and it is influenced by other characteristics of the individual, the neighborhood and the location. Once the transmission chain has been established, dengue spreads in the community probably by the adults who, despite being the group with lower infection frequency, mostly suffer asymptomatic infections and have higher mobility. This scenario complicates the opportunity and the effectiveness of control programs and highlights the need to apply multiple measures for dengue control. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceived and designed the experiments: RAMV FADQ JRC. Performed the experiments: RAMV JRC SRP RSL. Analyzed the data: RAMV RDL FADQ JVH RSL SRP PKM JRC. Contributed reagents/materials/analysis tools: RSL SRP. Wrote the paper: RAMV RDL FADQ JVH RSL SRP PKM JRC. The authors have declared that no competing interests exist. |
ISSN: | 1935-2735 1935-2727 1935-2735 |
DOI: | 10.1371/journal.pntd.0004296 |