title: A prospective cohort study to evaluate peridomestic infection as a determinant of dengue transmission: protocol.
abstract: BACKGROUND
  Vector control programs, which have focused mainly on the patient house and peridomestic areas around dengue cases, have not produced the expected impact on transmission. This project will evaluate the assumption that the endemic/epidemic transmission of dengue begins around peridomestic vicinities of the primary cases. Its objective is to assess the relationship between symptomatic dengue case exposure and peridomestic infection incidence.
  
  
  METHODS
  A prospective cohort study will be conducted (in Tepalcingo and Axochiapan, in the state of Morelos, Mexico), using the state surveillance system for the detection of incident cases. Paired blood specimens will be collected from both the individuals who live with the incident cases and a sample of subjects residing within a 25-meter radius of such cases (exposed cohort), in order to measure dengue-specific antibodies. Other subjects will be selected from areas which have not presented any incident cases within 200 meters, during the two months preceding the sampling (non-exposed cohort). Symptomatic/asymptomatic incident infection will be considered as the dependent variable, exposure to confirmed dengue cases, as the principal variable, and the socio-demographic, environmental and socio-cultural conditions of the subjects, as additional explanatory variables.
  
  
  CONCLUSIONS
  Results indicating a high infection rate among the exposed subjects would justify the application of peridomestic control measures and call for an evaluation of alternate causes for insufficient program impact. On the other hand, a low incidence of peridomestic-infected subjects would support the hypothesis that infection occurs outside the domicile, and would thus explain why the vector control measures applied in the past have exerted such a limited impact on cases incidence rates. The results of the present study may therefore serve to reassess site selection for interventions of this type.
authors.affiliation: Centro de Investigaciones sobre Enfermedades Infecciosas-CISEI, Instituto Nacional de Salud Pública-INSP, Cuernavaca-62100, México.
authors.forename: Ruth Aralí
authors.initials: RA
authors.lastname: Martínez-Vega
authors.forename: Rogelio
authors.initials: R
authors.lastname: Danis-Lozano
authors.forename: Jorge
authors.initials: J
authors.lastname: Velasco-Hernández
authors.forename: Fredi Alexander
authors.initials: FA
authors.lastname: Díaz-Quijano
authors.forename: Mariana
authors.initials: M
authors.lastname: González-Fernández
authors.forename: René
authors.initials: R
authors.lastname: Santos
authors.forename: Susana
authors.initials: S
authors.lastname: Román
authors.forename: Jorge
authors.initials: J
authors.lastname: Argáez-Sosa
authors.forename: Miguel
authors.initials: M
authors.lastname: Nakamura
authors.forename: José
authors.initials: J
authors.lastname: Ramos-Castañeda
mesh_terms: D003715:Dengue / Q000517:prevention & control* / Q000635:transmission*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D006801:Humans; D007300:Insect Control / Q000379:methods*; D007306:Insecticides / Q000008:administration & dosage*; D008962:Models, Theoretical; D011446:Prospective Studies; D012107:Research Design; D012621:Seasons; D013997:Time Factors
chemical_list: D007306:Insecticides