A Cross Sectional Serologic and Epidemiological Study of Dengue Virus Infection in North Central Area of Trinidad and Tobago

Abstract

Aims: This study was carried out to determine the observed serological and significant epidemiological risk factors for dengue fever infection in a cross-section of the population in Trinidad and Tobago. Study Design: This was an observational cross sectional study. Place and Duration of Study: The study was carried out in the department of Paraclinical Sciences of the University of the West Indies, St. Augustine Campus, Trinidad and Tobago, over a period of 10 months, October 2016 to July 2017. Materials and Methods:  Over 450 individuals from a cross section of the population residing in the northern part of Trinidad Island were surveyed. These included individuals suspected of having dengue fever that presented to the healthcare facilities with complaints of fever along with some other symptoms suggestive of dengue viral illness. There was no age, gender or ethnic bias. A standardized questionnaire was used to obtain epidemiological data. Blood samples taken from consented participants were analyzed using rapid immune chromatographic tests (ICTs) – Panbio, SD Bioline and Enzyme Linked Immunosorbent Assays (ELISA).  The samples were also tested for baseline blood parameters such as platelets and haemoglobulin. The epidemiological data were analysed using SPSS version 21. Results: Analysis of 380 individuals who fulfilled study criteria revealed that there were no demographic characteristics (age, gender, locality, etc.) that showed statistical significance with having a dengue infection. Retro-orbital pain, headaches and respiratory symptoms (e.g., cough, cold) showed differences that were significant with those having a dengue infection. No statistical significance was found in any comorbidity (diabetes, hypertension and asthma) factors considered and patients with dengue infections. Evaluation of platelet counts showed that only 5.4% samples had abnormal range, while 80% of those that tested positive were not significant either. Monitoring of platelet levels is still very important, but it showed that it is not an indicator of worsening dengue because 95.3% of the positive cases were within normal levels. Conclusions: Except for nonspecific symptoms observed among patients suspected of dengue fever, there were no other significant factors that were exclusive in identifying dengue infection among the subjects studied. Platelet monitoring may not be the only parameter to use in determining deteriorating dengue patients. Vector eradication activities should be intensified with other efforts such as education program.