Background
Estimates of dengue transmission intensity remain ambiguous. Since the majority of infections
are asymptomatic, surveillance systems substantially underestimate true rates of infection.
With advances in the development of novel control measures, obtaining robust
estimates of average dengue transmission intensity is key for assessing both the burden of
disease from dengue and the likely impact of interventions.
Methodology/Principal Findings
The force of infection (λ) and corresponding basic reproduction numbers (R0) for dengue
were estimated from non-serotype (IgG) and serotype-specific (PRNT) age-stratified seroprevalence
surveys identified from the literature. The majority of R0 estimates ranged from
1–4. Assuming that two heterologous infections result in complete immunity produced up to
two-fold higher estimates of R0 than when tertiary and quaternary infections were included.
λ estimated from IgG data were comparable to the sum of serotype-specific forces of infection
derived from PRNT data, particularly when inter-serotype interactions were allowed for.
Conclusions/Significance
Our analysis highlights the highly heterogeneous nature of dengue transmission. How underlying
assumptions about serotype interactions and immunity affect the relationship between
the force of infection and R0 will have implications for control planning. While PRNT
data provides the maximum information, our study shows that even the much cheaper
ELISA-based assays would provide comparable baseline estimates of overall transmission
intensity which will be an important consideration in resource-constrained settings.