A Household Serosurvey to Estimate the Magnitude of a Dengue Outbreak in Mombasa, Kenya, 2013

Ellis, Esther M.; Neatherlin, John C.; Delorey, Mark; Ochieng, Melvin; Mohamed, Abdinoor Haji; Mogeni, Daniel Ondari; Hunsperger, Elizabeth; Patta, Shem; Gikunju, Stella; Waiboic, Lilian; Fields, Barry; Ofula, Victor; Konongoi, Samson Limbaso; Torres-Velasquez, Brenda; Marano, Nina; Sang, Rosemary; Margolis, Harold S.; Montgomery, Joel M.; Tomashek, Kay M.
April 2015
PLoS Neglected Tropical Diseases;Apr2015, Vol. 9 Issue 4, p1
Academic Journal
Dengue appears to be endemic in Africa with a number of reported outbreaks. In February 2013, several individuals with dengue-like illnesses and negative malaria blood smears were identified in Mombasa, Kenya. Dengue was laboratory confirmed and an investigation was conducted to estimate the magnitude of local transmission including a serologic survey to determine incident dengue virus (DENV) infections. Consenting household members provided serum and were questioned regarding exposures and medical history. RT-PCR was used to identify current DENV infections and IgM anti-DENV ELISA to identify recent infections. Of 1,500 participants from 701 households, 210 (13%) had evidence of current or recent DENV infection. Among those infected, 93 (44%) reported fever in the past month. Most (68, 73%) febrile infected participants were seen by a clinician and all but one of 32 participants who reportedly received a diagnosis were clinically diagnosed as having malaria. Having open windows at night (OR = 2.3; CI: 1.1–4.8), not using daily mosquito repellent (OR = 1.6; CI: 1.0–2.8), and recent travel outside of Kenya (OR = 2.5; CI: 1.1–5.4) were associated with increased risk of DENV infection. This survey provided a robust measure of incident DENV infections in a setting where cases were often unrecognized and misdiagnosed.


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