Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12879-016-1662-4
Title: Epidemiological risk factors for adult dengue in Singapore: An 8-year nested test negative case control study
Authors: Yung, C.F
Chan, S.P 
Thein, T.L
Chai, S.C
Leo, Y.S 
Keywords: adult
Article
blood sampling
case control study
controlled study
dengue
female
gender
health center
human
laboratory diagnosis
longitudinal study
major clinical study
Malay (people)
male
mosquito bite
prospective study
reverse transcription polymerase chain reaction
risk factor
self report
serology
Singapore
tertiary care center
traffic and transport
travel
worker
age distribution
aged
clinical trial
demography
dengue
Dengue virus
fever
isolation and purification
middle aged
multicenter study
regression analysis
risk factor
sex ratio
workplace
young adult
Adult
Age Distribution
Aged
Case-Control Studies
Dengue
Dengue Virus
Female
Fever
Humans
Male
Middle Aged
Prospective Studies
Regression Analysis
Residence Characteristics
Risk Factors
Sex Distribution
Singapore
Travel
Workplace
Young Adult
Issue Date: 2016
Publisher: BioMed Central Ltd.
Citation: Yung, C.F, Chan, S.P, Thein, T.L, Chai, S.C, Leo, Y.S (2016). Epidemiological risk factors for adult dengue in Singapore: An 8-year nested test negative case control study. BMC Infectious Diseases 16 (1) : 323. ScholarBank@NUS Repository. https://doi.org/10.1186/s12879-016-1662-4
Abstract: Background: Understanding changes in the ecology and epidemiology of dengue is important to ensure resource intensive control programmes are targeted effectively as well as to inform future dengue vaccination strategies. Methods: We analyzed data from a multicentre longitudinal prospective study of fever in adults using a nested test negative case control approach to identify epidemiological risk factors for dengue disease in Singapore. From April 2005 to February 2013, adult patients presenting with fever within 72 h at selected public primary healthcare clinics and a tertiary hospital in Singapore were recruited. Acute and convalescent blood samples were collected and used to diagnose dengue using both PCR and serology methods. A dengue case was defined as having a positive RT-PCR result for DENV OR evidence of serological conversion between acute and convalescent blood samples. Similarly, controls were chosen from patients in the cohort who tested negative for dengue using the same laboratory methods. Results: The host epidemiological factors which increased the likelihood of dengue disease amongst adults in Singapore were those aged between 21 and 40 years old (2 fold increase) while in contrast, Malay ethnicity was protective (OR 0.57, 95%CI 0.35 to 0.91) against dengue disease. Spatial factors which increased the odds of acquiring dengue was residing at a foreign workers dormitory or hostel (OR 3.25, 95 % CI 1.84 to 5.73) while individuals living in the North-West region of the country were less likely to get dengue (OR 0.50, 95%CI 0.29 to 0. 86). Other factors such as gender, whether one primarily works indoors or outdoors, general dwelling type or floor, the type of transportation one uses to work, travel history, as well as self-reported history of mosquito bite or household dengue/fever were not useful in helping to inform a diagnosis of dengue. Conclusions: We have demonstrated a test negative study design to better understand the epidemiological risk factors of adult dengue over multiple seasons. We were able to discount other previously speculated factors such as gender, whether one primarily works indoors or outdoors, dwelling floor in a building and the use of public transportation as having no effect on one's risk of getting dengue. © 2016 The Author(s).
Source Title: BMC Infectious Diseases
URI: https://scholarbank.nus.edu.sg/handle/10635/174266
ISSN: 14712334
DOI: 10.1186/s12879-016-1662-4
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