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BMC Public Health. 2012; 12: 262.
Published online Apr 2, 2012. doi:  10.1186/1471-2458-12-262
PMCID: PMC3353184
A prospective cohort study to evaluate peridomestic infection as a determinant of dengue transmission: Protocol
Ruth Aralí Martínez-Vega,1 Rogelio Danis-Lozano,2 Jorge Velasco-Hernández,3 Fredi Alexander Díaz-Quijano,4 Mariana González-Fernández,5 René Santos,6 Susana Román,6 Jorge Argáez-Sosa,7 Miguel Nakamura,8 and José Ramos-Castañedacorresponding author1
1Centro de Investigaciones sobre Enfermedades Infecciosas (CISEI), Instituto Nacional de Salud Pública (INSP), (Av. Universidad 655), Cuernavaca, (62100), México
2Departamento de Control de Vectores, INSP, (19 Calle Poniente, esquina 4ta Norte s/n), Tapachula, (30700), México
3Programa de Investigación en Matemáticas aplicadas y computación, Instituto Mexicano del Petróleo, (Eje Central Lázaro Cárdenas Norte 152), Ciudad de México, (07730), México
4Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), (Av. Búcaros No. 2-108 Laureles C-60), Bucaramanga, (680005), Colombia
5Centro Regional de Control de Vectores de Cuautla, Servicios de Salud de Morelos (SSM), (Callejón Borda No.3), Cuernavaca, (62000), México
6Subdirección de Geografía Médica y Sistemas, INSP, (Av. Universidad 655), Cuernavaca, (62100), México
7Centro de Investigación en Matemáticas (estadística aplicada), Universidad Autónoma de Yucatán, (Periférico Norte Tablaje 13615), Mérida, (97110), México
8Departamento de Probabilidad y estadística, Centro de Investigación en Matemáticas, Jalisco S/N, Guanajuato, (36240), México
corresponding authorCorresponding author.
Ruth Aralí Martínez-Vega: rutharam/at/yahoo.com; Rogelio Danis-Lozano: rdanis/at/correo.insp.mx; Jorge Velasco-Hernández: jx.velasco/at/gmail.com; Fredi Alexander Díaz-Quijano: fre_diazq/at/yahoo.com; Mariana González-Fernández: Irina_1180/at/yahoo.com.mx; René Santos: rsantos/at/insp.mx; Susana Román: sroman/at/insp.mx; Jorge Argáez-Sosa: argasosa/at/uady.mx; Miguel Nakamura: nakamura/at/cimat.mx; José Ramos-Castañeda: jramos/at/insp.mx
Received December 6, 2011; Accepted April 2, 2012.
Abstract
Background
Vector control programs, which have focused mainly on the patient house and peridomestic areas around dengue cases, have not produced the expected impact on transmission. This project will evaluate the assumption that the endemic/epidemic transmission of dengue begins around peridomestic vicinities of the primary cases. Its objective is to assess the relationship between symptomatic dengue case exposure and peridomestic infection incidence.
Methods/Design
A prospective cohort study will be conducted (in Tepalcingo and Axochiapan, in the state of Morelos, Mexico), using the state surveillance system for the detection of incident cases. Paired blood specimens will be collected from both the individuals who live with the incident cases and a sample of subjects residing within a 25-meter radius of such cases (exposed cohort), in order to measure dengue-specific antibodies. Other subjects will be selected from areas which have not presented any incident cases within 200 meters, during the two months preceding the sampling (non-exposed cohort). Symptomatic/asymptomatic incident infection will be considered as the dependent variable, exposure to confirmed dengue cases, as the principal variable, and the socio-demographic, environmental and socio-cultural conditions of the subjects, as additional explanatory variables.
Discussion
Results indicating a high infection rate among the exposed subjects would justify the application of peridomestic control measures and call for an evaluation of alternate causes for insufficient program impact. On the other hand, a low incidence of peridomestic-infected subjects would support the hypothesis that infection occurs outside the domicile, and would thus explain why the vector control measures applied in the past have exerted such a limited impact on cases incidence rates. The results of the present study may therefore serve to reassess site selection for interventions of this type.
Keywords: Dengue, Transmission, Peridomestic, Cohort, Immunity
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