title: Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction.
abstract: BACKGROUND
  Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction.
  
  
  METHODS
  A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years.
  
  
  RESULTS
  A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n=1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3-10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent.
  
  
  CONCLUSIONS
  These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.
authors.affiliation: Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. Electronic address: mcarabali@ivi.int.
authors.forename: Mabel
authors.initials: M
authors.lastname: Carabali
authors.affiliation: Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea.
authors.forename: Jacqueline Kyungah
authors.initials: JK
authors.lastname: Lim
authors.affiliation: Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Diana Carolina
authors.initials: DC
authors.lastname: Velez
authors.affiliation: Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Trujillo
authors.affiliation: Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Jorge
authors.initials: J
authors.lastname: Egurrola
authors.affiliation: Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea.
authors.forename: Kang Sung
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea.
authors.forename: Luiz Jacinto
authors.initials: LJ
authors.lastname: DaSilva
authors.affiliation: Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Ivan Dario
authors.initials: ID
authors.lastname: Velez
authors.affiliation: Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia; Department of Pathobiological Sciences, University of Wisconsin, Madison, Wisconsin, USA.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Osorio
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral; D002648:Child; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology* / Q000821:virology; D053059:Dengue Vaccines; D003716:Dengue Virus / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D015995:Prevalence; D000069078:Seroconversion; D016036:Seroepidemiologic Studies; D065288:Serogroup; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D053059:Dengue Vaccines
keywords: Colombia; Dengue; Dengue burden; Dengue prevalence; Dengue seroconversion; Serological survey