Point-of-care testing to determine dengue serostatus: a field evaluation study in Timor-Leste

Background

Dengue is a viral disease vectored by Aedes mosquitoes. It is endemic in more than 125 countries throughout tropical and sub-tropical regions of the world. Increase in international travel and urbanisation, and climate change have led to a rapid increase in the global incidence of dengue in the last 50 years.

Outbreaks of dengue occur annually in Timor-Leste, resulting in child and adult morbidity and mortality. Dengue has been identified as a national health priority by the Timor-Leste Ministry of Health (MoH). As such, innovative methods of dengue surveillance and control (including potential vaccination) are of high priority for the Timor-Leste MoH. The live-attenuated tetravalent CYD-TDV vaccine (Dengvaxia) is the first effective vaccine against dengue. It is currently registered for use in people 9–45 years of age living in endemic areas. However, the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunisation has recommended that countries use a ‘pre-vaccination screening strategy’ when considering the roll out of Dengvaxia.

Aim

This study will evaluate the field performance of lateral flow assays (LFAs) to detect previous dengue infection in the Timorese population. If favourable, the findings will represent a model for performing pre-vaccination screening. This, combined with dengue seroprevalence data from the existing seroprevalence study, will enable MoH and WHO partners to decide whether Timor Leste is a suitable setting for the roll out of dengue vaccine.

Furthermore, the project team will investigate a novel method of undertaking serological surveillance of dengue using rapid diagnostics tests. This method has the potential to increase the reach of serological surveillance into remote areas. Understanding seroprevalence of dengue in remote areas will be crucial to the global effort to control this disease.

Method

Survey in households

Location

Dili, Timor-Leste

Impact

Findings from this project will provide essential information on the extent and nature of infection with and immunity to dengue virus in Timor-Leste.

Study outputs will directly inform disease surveillance in Timor-Leste, including possible introduction of the dengue vaccine. This project will provide data that will not only be beneficial to the local population but also be applicable to other remote settings.

The project team will work with and train local researchers in the areas of epidemiology, survey design, sample size calculation, field technology evaluation, operation and interpretation of point of contact assays, laboratory serological analysis, clinical validation of assays, statistical analysis, manuscript preparation and project management.

Project team

Principal investigator: Dr Josh Francis (Menzies School of Health Research)
Study team: Menzies School of Health Research team

Resources

Progress reports and other study findings will be shared on this page when they become available.

Enquiries

To find out more, please email the ARIA secretariat

ARIA Secretariat, NCIRS, Kids Research, Sydney Children’s Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead NSW 2145 Tel (612) 9845 1433 | Fax (612) 9845 1418 | ABN 53 188 579 090

We acknowledge that the National Centre for Immunisation Research & Surveillance (NCIRS) is on the land of the traditional owners the Aboriginal and Torres Strait Islander peoples, the First Australians, and recognise their culture, history, diversity and their deep connection to the land. Together, through partnership, we aim to move to a place of equity for all. NCIRS also acknowledges and pays respect to other Aboriginal and Torres Strait Islander nations from which our research, staff and community are drawn.