title: Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola.
abstract: During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test-positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6 weeks after the peak of the epidemic. Of 173 case cluster participants, 16 (9%) exhibited evidence of recent DENV infection. Of 247 random cluster participants, 25 (10%) had evidence of recent DENV infection. Of 13 recently infected participants who had a recent febrile illness, 7 (54%) had sought medical care, and 1 (14%) was hospitalized with symptoms consistent with severe dengue; however, none received a diagnosis of dengue. Behavior associated with protection from DENV infection included recent use of mosquito repellent or a bed net. These findings suggest that the 2013 dengue epidemic was larger than indicated by passive surveillance data.
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Sharp
authors.forename: Rosa
authors.initials: R
authors.lastname: Moreira
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Soares
authors.forename: Lúis
authors.initials: L
authors.lastname: Miguel da Costa
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mann
authors.forename: Mark
authors.initials: M
authors.lastname: DeLorey
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hunsperger
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Muñoz-Jordán
authors.forename: Candimar
authors.initials: C
authors.lastname: Colón
authors.forename: Harold S
authors.initials: HS
authors.lastname: Margolis
authors.forename: Adelaide
authors.initials: A
authors.lastname: de Caravalho
authors.forename: Kay M
authors.initials: KM
authors.lastname: Tomashek
mesh_terms: D000328:Adult; D000368:Aged; D000810:Angola / Q000453:epidemiology; D000914:Antibodies, Viral / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology*; D058872:Epidemics / Q000266:history*; D005260:Female; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral
keywords: Angola; Dengue; cluster; epidemic; surveillance