Estimating the burden of dengue, chikungunya and Zika in Latin America

Recent high-profile outbreaks of the mosquito-borne viral diseases of dengue, chikungunya and Zika in Latin America have forced countries to reassess how they document and control these arboviruses. These decisions are based on the number of suspected or confirmed cases from routine hospital-based surveillance. Evidence from community-based surveys, however, suggests that passive surveillance may under-represent the burden, particularly among people who are asymptomatic, clinically complex and also have chronic diseases.

I will estimate the true arboviral burden in Latin America by adjusting for the main biases in passive surveillance data. Models applied to community-based prevalence data will give insight into age biases and the under-recognition of mild disease, while analysis of laboratory testing data will measure the specificity of clinical diagnosis. By combining these different data sources, the burden of the three diseases can be estimated for different areas and years. Feedback from meetings with ministries of health, facilitated by the World Health Organization, will then be used to iteratively improve the analyses.

These burden estimates will provide a valuable evidence base upon which to design future arbovirus control strategies. These strategies could make a significant improvement to public health in Latin America and be reapplied globally for new and emerging arboviral threats.