Seroprevalence of dengue in Trinidad using rapid test kits: a cord blood survey.
ABSTRACT A cross-sectional sero-epidemiological study was conducted to determine the prevalence of dengue in Trinidad. Two commercial rapid test kits, PanBio Dengue Duo IgM and IgG Rapid Strip Test and the Bio-Check Plus Dengue G/M Cassette Test (Brittney) were used. The immunosorbent assay (ELISA) (FOCUS Technologies, California) was used as the control. One hundred and twenty five cord blood samples were collected (46 from Mt. Hope Women's Hospital (MH) and 79 from the San Fernando General Hospital (SF)). All blood samples were tested in accordance with the two rapid kits and ELISA assay manufacturer's instructions. From 125 cord blood samples, the IgG FOCUS ELISA results showed 93.5 and 95% infections at MH and SF, respectively. Whereas the Brittney and PanBio kits showed 10.9 and 5.1%, and 26.1 and 50.6% for MH and SF, respectively. Based on the FOCUS ELISA (control) assays, the combined seroprevalence rate from north and south Trinidad was 94.4%. IgG and IgM sensitivity and specificity levels were higher in the PanBio than Brittney test kits. The high seroprevalence rates observed in Trinidad are discussed to stimulate more research to explain this phenomenon and to prevent the Southeast Asian scenario from developing in the Americas.
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ABSTRACT: The seasonality, patterns and the climate associations of the reported cases of dengue in the Caribbean were studied by analyzing the annual and monthly variability of reported cases as well as those of climate parameters (temperature and precipitation). More attention was given to Trinidad and Tobago, Barbados, and Jamaica, as those countries contributed mostly to the reported cases. The data were for the period 1980–2003. Results showed that the incidence of dengue in the Caribbean were higher in the last decade (1990s) compared to that in the previous decade (1980s). The yearly patterns of dengue exhibited a well-defined seasonality. The epidemics appeared to occur in the later half of the year following onset of rainfall and increasing temperature. Analysis revealed that the association of the epidemics with temperature was stronger, especially in relation to the onset of dengue, and the probability of epidemics was high during El Niño periods. In years with early warmer periods epidemics appeared to occur early, which was a scenario more probable in the year after an El Niño (an El Niño+1year). Indices linked to temperatures that are useful for gauging the potential for onset of dengue were examined. An index based on a moving average temperature (MAT) appeared to be effective in gauging such potential and its average (AMAT) signals a threshold effect. MAT index has potential use in adaptation and mitigation strategies.Mitigation and Adaptation Strategies for Global Change 01/2008; 13(4):341-357. · 1.86 Impact Factor
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ABSTRACT: An analysis of the dialogue surrounding historical and current dengue incidence, prevalence, morbidity and mortality reveals that race is defined as a risk factor influencing host immune response. African descendent populations in the Americas are often highlighted as having an innate resistance to severe dengue infection. This paper explores this hypothesis and, using a historical, epidemiological and immunological perspective, attempts to evaluate its viability. This multidisciplinary approach elucidates the need to proceed cautiously in any research searching for correlations between biological racial characteristics and disease. It emphasizes that the investigation of the hypothesized African descendent population dengue resistance be approached from the perspective of dengue while at the same time acknowledging variation within a population that has historically been oversimplified.Latin American and Caribbean Ethnic Studies 11/2011; 2011(pp. 283–309):283-309.
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ABSTRACT: BACKGROUND: The epidemiology and clinical presentation of dengue fever among children in the Caribbean is poorly characterized. We therefore studied the epidemiology, clinical presentation, immunological characteristics, morbidity and mortality from dengue virus infection among children in Barbados, one of the English-speaking Caribbean countries. METHOD: In this population-based, retrospective descriptive study, we screened all children on the island up to the age of 16 years who presented over a 10-year period (January 2000 through December 2009) with febrile illness and suspected dengue virus infection (n = 1809). We report on all the laboratory-confirmed cases of dengue (702/1809), for 545 of which we had complete clinical data. RESULTS: The annual incidence of dengue virus infection among children ranged between 0.29 and 2.92 cases/1000 children, with most cases seen during October through January.Children presented with undifferentiated fever (287/545, 53%), classical dengue fever (225/545, 41%), dengue hemorrhagic fever (15/545, 3%) and expanded dengue syndrome (i.e. severe involvement of liver, kidneys, brain, heart, or other unusual manifestations) (18/545, 3%). In most cases (73%), the infection was secondary. Thirty per cent of cases were diagnosed among hospitalized children and the overall crude mortality rate was 0.3%. CONCLUSION: Our study for the first time describes the epidemiology and disease characterization of dengue in Barbados, and quantifies the morbidity and mortality among children for this rapidly emerging public health problem in the Caribbean sub-region of the Americas.Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2013; · 1.82 Impact Factor