title: Under-recognition and reporting of dengue in Cambodia: a capture-recapture analysis of the National Dengue Surveillance System.
abstract: Robust disease burden estimates are important for decision-making concerning introduction of new vaccines. Dengue is a major public health problem in the tropics but robust disease burden estimates are lacking. We conducted a two-sample, capture-recapture study in the largest province in Cambodia to determine disease under-recognition to the National Dengue Surveillance System (NDSS). During 2006-2008, community-based active surveillance for acute febrile illness was conducted in 0- to 19-year-olds in rural and urban areas combined with testing for dengue virus infection. Of 14 354 individuals under active surveillance (22 498 person-seasons), the annual incidence ranged from 13·4 to 57·8/1000 person-seasons. During the same period, NDSS incidence rates ranged from 1·1/1000 to 5·7/1000, which was 3·9- to 29·0-fold lower than found in the capture-recapture study. In hospitalized cases, the rate of under-recognition was 1·1- to 2·4-fold. This study shows the substantial degree of under-recognition/reporting of dengue and that reported hospitalized cases are not a good surrogate for estimating dengue disease burden.
authors: Institut Pasteur in Cambodia, Réseau International des Instituts Pasteur, Phnom Penh, Cambodia. svong@pasteur-kh.org
authors: S
authors: S
authors: Vong
authors: S
authors: S
authors: Goyet
authors: S
authors: S
authors: Ly
authors: C
authors: C
authors: Ngan
authors: R
authors: R
authors: Huy
authors: V
authors: V
authors: Duong
authors: O
authors: O
authors: Wichmann
authors: G W
authors: GW
authors: Letson
authors: H S
authors: HS
authors: Margolis
authors: P
authors: P
authors: Buchy
mesh_terms: D000293:Adolescent; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D055815:Young Adult