Estimates of dengue force of infection in children in Colombo, Sri Lanka.
Tam, Clarence C;
Tissera, Hasitha;
de Silva, Aravinda M;
De Silva, Aruna Dharshan;
Margolis, Harold S;
Amarasinge, Ananda;
(2013)
Estimates of dengue force of infection in children in Colombo, Sri Lanka.
PLoS neglected tropical diseases, 7 (6).
e2259-.
ISSN 1935-2727
DOI: https://doi.org/10.1371/journal.pntd.0002259
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Dengue is the most important vector-borne viral disease worldwide and a major cause of childhood fever burden in Sri Lanka, which has experienced a number of large epidemics in the past decade. Despite this, data on the burden and transmission of dengue virus in the Indian Subcontinent are lacking. As part of a longitudinal fever surveillance study, we conducted a dengue seroprevalence survey among children aged <12 years in Colombo, Sri Lanka. We used a catalytic model to estimate the risk of primary infection among seronegative children. Over 50% of children had IgG antibodies to dengue virus and seroprevalence increased with age. The risk of primary infection was 14.1% per year (95% CI: 12.7%-15.6%), indicating that among initially seronegative children, approximately 1 in 7 experience their first infection within 12 months. There was weak evidence to suggest that the force of primary infection could be lower for children aged 6 years and above. We estimate that there are approximately 30 primary dengue infections among children <12 years in the community for every case notified to national surveillance, although this ratio is closer to 100:1 among infants. Dengue represents a considerable infection burden among children in urban Sri Lanka, with levels of transmission comparable to those in the more established epidemics of Southeast Asia.