title: Estimates of dengue force of infection in children in Colombo, Sri Lanka.
abstract: 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.
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Clarence C
authors.initials: CC
authors.lastname: Tam
authors.forename: Hasitha
authors.initials: H
authors.lastname: Tissera
authors.forename: Aravinda M
authors.initials: AM
authors.lastname: de Silva
authors.forename: Aruna Dharshan
authors.initials: AD
authors.lastname: De Silva
authors.forename: Harold S
authors.initials: HS
authors.lastname: Margolis
authors.forename: Ananda
authors.initials: A
authors.lastname: Amarasinge
mesh_terms: D000818:Animals; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000453:epidemiology*; D003716:Dengue Virus / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D016036:Seroepidemiologic Studies; D013188:Sri Lanka / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G