Antenatal Seroprevalence of Zika and Chikungunya Viruses, Kingston Metropolitan Area, Jamaica, 2017–2019

Anzinger, Joshua J.; Mears, Chadwic De'sean; Ades, AE; Francis, Keisha; Phillips, Yakima; Leys, Ynolde E; Spyer, Moira; Brown, David W.; Filippis, Ana María Bispo de; Nastouli, Eleni; Byrne, Thomas; Bailey, Heather; Palmer, P.; Bryan, Lenroy; Webster-Kerr, Karen; Giaquinto, Carlo; Thorne, Claire; Christie, Celia D. C.

doi:10.3201/eid2802.211849

Cited by 10 publications

(13 citation statements)

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“…A meta-analysis from the South East and non-South East Asia showed that primary DENV-3 infection and secondary infection with DENV-2, 3 and 4 increased the risk of severe dengue infections ( 34 ). During the 2016 ZIKV epidemic in Jamaica, DENV was co-circulating with ZIKV and was predominantly of the DENV-3 serotype ( 12 , 13 ). Yet, severe disease and case fatality rates in DENV-infected Jamaican children during 2019 were much higher than in 2016, suggesting that secondary DENV infection after a primary ZIKV infection could have impacted disease severity.…”

Section: Discussionmentioning

confidence: 99%

“…In Jamaica, an upper middle-developing Caribbean islandnation, with population 2.97 million, national surveillance data are available from 1977 for dengue epidemics, where seroprevalence rates approach 99-100% in pregnancy, which is a readily-accessible representative Jamaican subpopulation (8). In 2014, an epidemic with several thousands of suspected cases of chikungunya virus (CHIKV) infections were reported with an 83.6% seropositivity (9)(10)(11)(12). In 2016, Jamaica experienced its maiden Zika virus (ZIKV) epidemic, when all three arboviruses co-circulated endemically (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

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Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

et al. 2022

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ObjectiveIn 2019, dengue was among the “top-ten threats to global health,” with 3.1 million cases reported from the Americas, the highest ever. Simultaneously, Jamaica reported its largest dengue outbreak in 40 years, following Chikungunya and Zika virus epidemics, in 2014 and 2016–2017, respectively. We describe dengue in children admitted to five hospitals in Jamaica during August 2018 through September 2019.MethodsHospitalized children and adolescents aged 0 to 15 years with dengue were managed using PAHO/WHO criteria. Data were extracted from questionnaires, entered into a dataset on Microsoft Excel version 2016, exported to SPSS version 20 and analyzed. Groups were compared using Student's t-test for normally distributed parametric data. Chi-square analysis, or Fisher's exact test was used for categorical variables. A p-value < 0.05 was considered statistically significant.ResultsThere were 339 children, 245 (72.3%) aged 1–10 years, males:females 1:1. Classification was “dengue without warning signs” 53 (15.3%), “dengue with warning signs” 218 (64.3%) and “severe dengue” 68 (20%). Co-morbidities were reported in 88 (26%). Hemoglobin SC disease was associated with severe dengue with hemorrhage (p = 0.005). Organ-system involvement occurred in 334 (98.5%) including gastrointestinal 317 (93.5%), hematologic 311 (91.7%) and musculoskeletal 180 (53.1%). Thirty-nine (11.5%) had 5–7 organ-systems involved. Metabolomics emphasized increased hepatic transaminases 245 (72.3%), lactate dehydrogenase 164 (48.4%) and creatine phosphokinase 84 (24.8%) approaching the high thousands (121,560 u/L), both were markers for severe disease (p < 0.002). Thirteen (3.8%) received intensive care. Dengue was laboratory-confirmed in 220 (78.9%): NS1 antigen-positive (218); RT-PCR-positive (23), with an overlap of NS1 antigen and RT-PCR positive (21); DENV-3 serotype (20). Seventeen (5%) died, 16 (94.1%) had severe dengue and 11 (64.7%) succumbed within 24 to 48 h of admission despite resuscitation and transfusion of blood products.ConclusionSevere dengue with increased attributable mortality occurred in hospitalized children after Jamaica's maiden Zika epidemic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

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“…Freitas, Laura Pezzi, Luciano P.G. Cavalcanti, Fabrice Simon To the Editor: We read with great interest the recent article by Anzinger et al (1), who found a seroprevalence of 83.6% for chikungunya in pregnant women in the metropolitan region of Kingston, Jamaica. These data are similar to the seroprevalence found nationwide by the Jamaica Health and Lifestyle Survey III, 2016-2017 (Ministry of Health and Welfare, Jamaica), which was 82% among women, 78.5% among men, and 80.4% overall.…”

Section: Seroprevalence Of Chikungunya Virus Jamaica and New Tools Fo...mentioning

confidence: 99%

Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance

Freitas¹,

Pezzi²,

Cavalcanti³

et al. 2022

Emerg. Infect. Dis.

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Long-term services and supports and family caregiving. AARP Nursing Home Dashboard [cited 2022 Jan 11]. https://www.aarp.org/ppi/ issues/caregiving/info-2020/nursing-home-coviddashboard.html 2. Kaiser Family Foundation. Coronavirus (COVID-19). Nursing homes experienced steeper increase in COVID-19 cases and deaths in August 2021 than the rest of the country [cited 2022 Jan 11]. https://www.kff.org/coronaviruscovid-19/issue-brief/nursing-homes-experienced-steeperincrease-in-covid-19-cases-and-deaths-in-august-2021-thanthe-rest-of-the-country 3. Roth A, Feller S, Ruhnau A, Plamp L, Viereck U, Weber K, et al. Characterization of COVID-19 outbreaks in three nursing homes during the first wave in Berlin, Germany.

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“…National hospital-based surveillance revealed increased annual rates of severe microcephaly from 23.6 per 100,000 live births in 2010 (during the period of DENV outbreaks) to 41.7 per 100,000 live births in 2017 in association with the ZIKV epidemic [ 14 ], alongside surveillance reports of the congenital syndrome associated with ZIKV and related fetal brain disruption sequences temporally and spatially related to reported ZIKV cases [ 14 ]. The congenital syndrome was also being recognized simultaneously in 0.8% to 2.2% of the newborns in 3 urban public maternity hospitals [ 23 ], with a 15.6% ZIKV immunoglobulin G antibody seroprevalence in pregnancy reported [ 19 ]. Other complications included Guillain-Barré syndrome and varied neurological presentations in children and adults [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Jamaica has experienced several DENV outbreaks of increasing intensity, severity, and magnitude in recent years (2010, 2012, and 2018-2019), with increased attributable morbidity and mortality in the very young, including reported cases of neonatal microcephaly [11][12][13][14]. Jamaica also experienced an explosive CHIKV epidemic in 2014 [3,[15][16][17][18]: >80% of the general and antenatal populations were affected, with significant perinatal (maternal and newborn) illnesses, increased attributable neonatal morbidity and mortality [3,16,19], and >2500 deaths during the epidemic year nationally [18].…”

Section: Introductionmentioning

confidence: 99%

Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study

Ruiz-Burga¹,

Bruijning-Verhagen²,

Palmer³

et al. 2022

JMIR Form Res

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Background There is growing evidence of the benefits of mobile health technology, which include symptom tracking apps for research, surveillance, and prevention. No study has yet addressed arbovirus symptom tracking in pregnancy. Objective This study aimed to evaluate the use of a smartphone app (ZIKApp) to self-report arbovirus symptoms and pregnancy complications and to assess compliance with daily symptom diaries during pregnancy in a cohort of women in an arbovirus-endemic, subtropical, middle-income country (Jamaica). Methods Pregnant women aged ≥16 years, having a smartphone, and planning on giving birth at the recruiting center were enrolled between February 2020 and July 2020. ZIKApp comprised a daily symptom diary based on algorithms to identify potential episodes of arbovirus infection and pregnancy complications. Sociodemographic, epidemiological, and obstetric information was collected at enrollment, with additional review of medical records, and users’ perception was collected through an exit survey. Descriptive analyses and logistic regression analysis of possible factors associated with diary adherence were performed. Results Of the 173 women enrolled, 157 (90.8%) used ZIKApp for a median duration of 155 (IQR 127-173) days until pregnancy end, 6 (3.5%) used the app for <7 days, and 10 (5.8%) exited the study early. For each successive 30-day period from enrollment up to 150 days after enrollment, of these 157 women, 121 (77.1%) to 129 (82.2%) completed their daily symptom diary; 50 (31.8%) to 56 (35.7%) did so on the same day. Overall, 31.8% (50/157) of the women had good adherence to diary reporting (ie, they completed the task on the same day or 2 to 3 days later for ≥80% of the days enrolled). There were 3-fold higher odds of good adherence for participants aged >34 years versus those aged 25 to 29 years (adjusted odds ratio 3.14, 95% CI 1.10-8.98) and 2-fold higher odds for women with tertiary versus secondary education (adjusted odds ratio 2.26, 95% CI 1.06-4.83). Of the 161 women who ever made a diary entry, 5454 individual symptom reports were made (median 17 per woman; IQR 4-42; range 0-278); 9 (5.6%) women reported symptom combinations triggering a potential arbovirus episode (none had an adverse pregnancy outcome) and 55 (34.2%) reported painful uterine contractions or vaginal bleeding, mainly in the month before delivery. Overall, 51.8% (71/137) of the women rated the app as an excellent experience and were less likely to be poor diary adherers (P=.04) and 99.3% (138/139) reported that the app was easy to understand and use. Conclusions This pilot found a high adherence to ZIKApp. It demonstrated the feasibility and usability of the app in an arbovirus-endemic region, supporting its future development to contribute to surveillance and diagnosis of arbovirus infections in pregnancy and to optimize maternal care.

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Antenatal Seroprevalence of Zika and Chikungunya Viruses, Kingston Metropolitan Area, Jamaica, 2017–2019

Cited by 10 publications

References 10 publications

Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

Severity and Outcomes of Dengue in Hospitalized Jamaican Children in 2018–2019 During an Epidemic Surge in the Americas

Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance

Detection of Potential Arbovirus Infections and Pregnancy Complications in Pregnant Women in Jamaica Using a Smartphone App (ZIKApp): Pilot Evaluation Study

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