Dengue serotype-specific seroprevalence among 5- to 10-year-old children in India: a community-based cross-sectional study.
BACKGROUND
Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243).


METHODS
A convenience sample of 2609 healthy children aged 5-10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire.


RESULTS
Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7-61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype.


CONCLUSIONS
The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India.
Maulana Azad Medical College, 2 Bahadur Shah Zafar Marg, New Delhi 110002, India. Electronic address: gargsuneela@gmail.com.
Suneela
S
Garg
Maulana Azad Medical College, 2 Bahadur Shah Zafar Marg, New Delhi 110002, India.
Anita
A
Chakravarti
College of Medicine and JNM Hospital, Kalyani, India.
Ritesh
R
Singh
Kempegowda Institute of Medical Sciences, Bangalore, India.
N R Ramesh
NR
Masthi
JN Medical College, Wardha, India.
Ram Chandra
RC
Goyal
SHARE INDIA - MediCiti Institute of Medical Sciences, Hyderabad, India.
Guru Rajesh
GR
Jammy
SHARE INDIA - MediCiti Institute of Medical Sciences, Hyderabad, India.
Enakshi
E
Ganguly
Maulana Azad Medical College, 2 Bahadur Shah Zafar Marg, New Delhi 110002, India.
Nandini
N
Sharma
Maulana Azad Medical College, 2 Bahadur Shah Zafar Marg, New Delhi 110002, India.
M M
MM
Singh
Sanofi Pasteur Global Epidemiology, Lyon, France.
Germano
G
Ferreira
Sanofi Pasteur, Marcy l'Etoile, France.
Annick
A
Moureau
Sanofi-Synthelabo (India) Pvt Ltd, Mumbai, India.
Sujeet
S
Ojha
Sanofi Pasteur Asia & JPAC Region, Singapore.
Joshua
J
Nealon
D000293:Adolescent; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003715:Dengue / Q000097:blood / Q000453:epidemiology / Q000821:virology*; D003716:Dengue Virus / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007194:India / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D065288:Serogroup
D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007074:Immunoglobulin G
Children; Community-based study; Dengue; India; Seroprevalence; Socio-economic factors