Burden of dengue infection in India 2017 a cross sectional population based serosurvey

Dengue is a major public health problem in India. Outbreaks of dengue fever are reported from both urban as well as rural areas. Although dengue is a notifiable disease in India, studies and modelling estimates suggest that the disease is grossly under-reported. Existing public health surveillance systems are not sensitive; mild febrile illnesses are less likely to be diagnosed and reported. Given the limitation of available data to support policy for introduction of a dengue vaccine, we did a nationally representative survey among individuals aged 5–45 years to estimate age-specific seroprevalence of dengue infections in India.

We did a community-based survey in 240 clusters (118 rural, 122 urban), selected from 60 districts of 15 Indian states from 5 geographical regions. We enumerated each cluster, randomly selected (with an Andriod application developed specifically for the survey) 25 individuals from age groups of 5–8 years, 9–17 years, and 18–45 years, and sampled a minimum of 11 individuals from each age group (all the 25 randomly selected individuals in each age group were visited in their houses and individuals who consented for the survey were included in the study). Age was the only inclusion criterion; for the purpose of enumeration, individuals residing in the household for more than 6 months were included. Sera were tested centrally by a laboratory team of scientific and technical staff for IgG antibodies against the DENV with the use of indirect ELISA.