背景:2023年,布基纳法索经历了非洲有史以来最大的登革热流行。这项研究旨在估计症状的患病率,亚临床,和无症状登革热,并确定中部地区成人登革热接触者的相关因素,布基纳法索。
方法:这项横断面研究在2022-2023年通过整群抽样纳入了登革热可能病例的接触者。这些检测呈阳性的疑似病例是从五个医疗机构(PissyCMA,SaabaCM,KossodoCMA,萨曼丁CM,和MarcoussisCSPS)报告了每个地区2021年的最高病例数。所有参与者都接受了登革热和疟疾快速诊断测试(RDT)。通过逆转录聚合酶链反应(RT-PCR)测试非结构1蛋白抗原(AgNS1)和/或免疫球蛋白M(IgM)阳性的样品用于血清型检测。进行了二元逻辑回归来确定无症状的决定因素,亚临床,以及可能登革热病例的接触者有症状的登革热。
结果:共包括484名联系人,主要在2023年(75.2%)。大多数参与者是女性(58.6%),在Saaba居住(24.3%)并通过白天(23.1%)。登革热的总体患病率估计为15.1%[95%置信区间(CI):12.0-18.6%],代表不在医院寻求治疗的病例。无症状病例占2.9%(95%CI:1.6-4.8%)。亚临床和有症状的病例占6.0%(95%CI:4.1-8.5%)和6.2%(95%CI:4.2-8.7%),分别。在通过RT-PCR检测的58个样本中,在2023年确认了10个血清型3。疟疾病例估计为5.6%(95%CI:3.7-8.0%)。调整后,声称病毒传播登革热的参与者更有可能患有无症状登革热[校正比值比(aOR)=7.1,95%CI:2.4~21.0].从多变量分析来看,亚临床登革热在统计学上与2023年纳入研究(aOR=30.2,95%CI:2.0~455.5)和白天在第4区(aOR=11.5,95%CI:1.0~131.0)相关.调整后,有症状的登革热与距耕地50m以下(aOR=2.8,95%CI:1.1-6.9)和距一段水域50m以下(aOR=0.1,95%CI:0.0-0.6)有关。
结论:没有在医院寻求治疗的人群中,登革热的总体负担相当高,很少有无症状病例。管理登革热病例的努力还应针对非医院病例,并提高人们的意识。2023年的流行可能是由于登革热病毒(DENV)-3。
BACKGROUND: In 2023, Burkina Faso experienced the largest dengue epidemic ever in Africa. This study aimed to estimate the prevalence of symptomatic, subclinical, and asymptomatic dengue and determine the associated factors among adult contacts of dengue in the Central Region, Burkina Faso.
METHODS: This cross-sectional study included contacts of dengue probable cases through cluster sampling in 2022-2023. These suspected cases that tested positive were identified from the five health facilities (Pissy CMA, Saaba CM, Kossodo CMA, Samandin CM, and Marcoussis CSPS) that reported the highest number of cases in 2021 per district. All participants underwent dengue and malaria rapid diagnostic tests (RDT). Samples positive for non-structural 1 protein antigen (AgNS1) and/or immunoglobulin M (IgM) were tested for serotype detection by reverse transcription polymerase chain reaction (RT-PCR). Binary logistic regression was done to identify the determinants of asymptomatic, subclinical, and symptomatic dengue among contacts of probable dengue cases.
RESULTS: A total of 484 contacts were included, mostly in 2023 (75.2%). Most participants were females (58.6%), residing (24.3%) and passing their daytime (23.1%) in Saaba. The overall prevalence of dengue was estimated at 15.1% [95% confidence interval (CI): 12.0-18.6%], representing cases not seeking care in hospitals. Asymptomatic cases represented 2.9% (95% CI: 1.6-4.8%). Subclinical and symptomatic cases accounted for 6.0% (95% CI: 4.1-8.5%) and 6.2% (95% CI: 4.2-8.7%), respectively. Of the 58 samples tested by RT-PCR, 10 were confirmed for serotype 3 in 2023. Malaria cases were estimated at 5.6% (95% CI: 3.7-8.0%). After adjustment, participants claiming that a virus transmits dengue were likelier to have asymptomatic dengue [adjusted odds ratio (aOR) = 7.1, 95% CI: 2.4-21.0]. From the multivariable analysis, subclinical dengue was statistically associated with being included in the study in 2023 (aOR = 30.2, 95% CI: 2.0-455.5) and spending the daytime at Arrondissement 4 (aOR = 11.5, 95% CI: 1.0-131.0). After adjustment, symptomatic dengue was associated with living less than 50 m away from cultivated land (aOR = 2.8, 95% CI: 1.1-6.9) and living less than 50 m from a stretch of water (aOR = 0.1, 95% CI: 0.0-0.6).
CONCLUSIONS: The overall burden of dengue among populations not seeking care in hospitals was quite high, with few asymptomatic cases. Efforts to manage dengue cases should also target non-hospital cases and raise population awareness. The 2023 epidemic could be due to dengue virus (DENV)-3.