Incidence and risk factors for Dengue virus (DENV) infection in the first 2 years of life in a Brazilian prospective birth cohort

Abstract

This study assessed the incidence and risk factors for dengue virus (DENV) infection among children in a prospective birth cohort conducted in the city of Recife, a hyperendemic dengue area in Northeast Brazil. Healthy pregnant women (n = 415) residing in Recife who agreed to have their children followed were enrolled. Children were followed during their first 24 months of age (May/2011-June/2014), before the 2015 Zika virus outbreak. DENV infection was detected by reverse-transcriptase polymerase chain reaction and/or serology (anti-DENV IgM/IgG). The incidence rates per 1000 person-years (py) and its association with risk factors by age bands (0-12, >12-30 months) were estimated through Poisson regression models. Forty-nine dengue infections were detected; none progressed to severe forms. The incidence rates were 107·6/1000py (95% CI 76·8-150·6) and 93·3/1000py (95% CI 56·1-154·4) in the first and second years of age, respectively. Male children (risk ratios (RR) = 2·33; 95% CI 1·09-4·98) and those born to DENV-naïve mothers (RR = 2·42; 95% CI 1·01-5·80) were at greater risk of infection in the first year of age. In the second year, children born to Caucasian/Asian descent skin colour mothers had a threefold higher risk of infection (RR = 3·34; 95% CI: 1·08-10·33). These data show the high exposure of children to DENV infection in our setting and highlight the role of biological factors in this population's susceptibility to infection.

Retrospective cross-sectional observational study on the epidemiological profile of dengue cases in Pernambuco state, Brazil, between 2015 and 2017

“…Different ethnicities have been related to the risk of DENV infection. In Brazil, another study performed in Pernambuco identified that children born to mothers of Caucasian/Asian descent had a high risk of dengue [12]. In Singapore, Malay ethnicity was related to protection against DENV infections in a study with patients diagnosed between 2005 and 2013 [11].…”

“…Several studies have also associated socioenvironmental aspects with the number of dengue cases. Age, gender, ethnicity, education level or socioeconomic status, for example, have already been related to the risk of DENV infections [8][9][10][11][12][13][14][15]. In relation to environmental factors, uncontrolled urbanization and climatic conditions, such as temperature and rainfall, capable of influencing the population of vector mosquitoes, mainly Aedes aegypti and Ae.…”

Seroprevalence and incidence of primary dengue infections among children in a rural region of Maharashtra, Western India

“…The overall incidence reported in the present study is much lower than that reported in other studies. A study from a Brazilian birth cohort in the city of Recife which followed the children for first two years of life has reported an incidence of 107.6/1000 person years [18]. The Nicaraguan pediatric cohort study conducted in the city of Managua has reported an overall incidence of 90.2 infections/1000 person years.…”

Dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean: a systematic review

“…Some studies reported other associations, such as the presence and persistence of rheumatic pain and aging for CHIKV ( 30 ), and the possibility of death with DENV ( 29 , 31 ) and CHIKV ( 32 ) infections. Being a male child and an elderly man have been associated with DENV and CHIKV infections ( 33 , 34 ), but other studies have described an increased risk of CHIKV infection in older women ( 35 ) and increased risk of ZIKV and DENV infections in children of both sexes ( 36 , 37 ).…”