Correlation between reported dengue illness history and seropositivity in rural Thailand.

• Main Authors: Darunee Buddhari (Author), Kathryn B Anderson (Author), Gregory D Gromowski (Author), Richard G Jarman (Author), Sopon Iamsirithaworn (Author), Butsaya Thaisomboonsuk (Author), Taweewun Hunsawong (Author), Anon Srikiatkhachorn (Author), Alan L Rothman (Author), Anthony R Jones (Author), Stefan Fernandez (Author), Stephen J Thomas (Author), Timothy P Endy (Author)
• Format: Book
• Published: Public Library of Science (PLoS), 2021-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

In the latest World Health Organization (WHO) recommendation for Dengvaxia implementation, either serological testing or a person's history of prior dengue illness may be used as supporting evidence to identify dengue virus (DENV)-immune individuals eligible for vaccination, in areas with limited capacity for laboratory confirmation. This analysis aimed to estimate the concordance between self-reported dengue illness histories and seropositivity in a prospective cohort study for dengue virus infection in Kamphaeng Phet province, a dengue-endemic area in northern Thailand. The study enrolled 2,076 subjects from 516 multigenerational families, with a median age of 30.6 years (range 0-90 years). Individual and family member dengue illness histories were obtained by questionnaire. Seropositivity was defined based on hemagglutination inhibition (HAI) assays. Overall seropositivity for DENV was 86.5% among those aged 9-45 years, which increased with age. 18.5% of participants reported a history of dengue illness prior to enrollment; 30.1% reported a previous DENV infection in the family, and 40.1% reported DENV infection in either themselves or a family member. Relative to seropositivity by HAI in the vaccine candidate group, the sensitivity and specificity of individual prior dengue illness history were 18.5% and 81.6%, respectively; sensitivity and specificity of reported dengue illness in a family member were 29.8% and 68.0%, and of either the individual or a family member were 40.1% and 60.5%. Notably, 13.4% of individuals reporting prior dengue illness were seronegative. Given the high occurrence of asymptomatic and mild DENV infection, self-reported dengue illness history is poorly sensitive for prior exposure and may misclassify individuals as 'exposed' when they were not. This analysis highlights that a simple, highly sensitive, and highly specific test for determining serostatus prior to Dengvaxia vaccination is urgently needed.

Item Description

1935-2727
1935-2735
10.1371/journal.pntd.0009459