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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/476| Co-circulation and misdiagnosis led to underestimation of the 2015-2017 Zika epidemic in the Americas | |
| Alex Perkins Guido Espana Rachel J Oidtman | |
| Novel Coronavirus | |
| Acceso Abierto | |
| Atribución | |
| 10.1101/19010256 | |
| During the 2015-2017 Zika epidemic, dengue and chikungunya -- two other viral diseases with the same vector as Zika -- were also in circulation. Clinical presentation of these diseases can vary from person to person in terms of symptoms and severity, making it difficult to differentially diagnose them. Under these circumstances, it is possible that numerous cases of Zika could have been misdiagnosed as dengue or chikungunya, or vice versa. Given the importance of surveillance data for informing epidemiological analyses, our aim was to quantify the potential extent of misdiagnosis during this epidemic. Using basic principles of probability and empirical estimates of diagnostic sensitivity and specificity, we generated revised estimates of Zika incidence that accounted for the accuracy of diagnoses made on the basis of clinical presentation with or without molecular confirmation. Applying this method to weekly incidence data from 43 countries throughout Latin America and the Caribbean, we estimated that 1,062,821 (95% CrI: 1,014,428-1,104,794) Zika cases occurred during this epidemic, which is 56.4% (95% CrI: 49.3-62.6%) more than the 679,743 cases diagnosed as Zika. Our results imply that misdiagnosis was more common in countries with proportionally higher incidence of dengue and chikungunya, such as Brazil. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement RJO acknowledges support from an Arthur J. Schmitt Leadership Fellowship in Science and Engineering and an Eck Institute for Global Health Fellowship. GE acknowledges support from Grant TL1TR00107 (A Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award (https://www.indianactsi.org). TAP acknowledges support from a Young Faculty Award from the Defense Advanced Research Projects Agency (D16AP00114), a RAPID Award from the National Science Foundation (DEB 1641130), and Grant P01AI098670 (T Scott, PI) from the National Institutes of Health, National Institute of Allergy and Infectious Disease. The authors thank Dr. Ann Raiho for helpful comments on the manuscript. ### Author Declarations All relevant ethical guidelines have been followed and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Not Applicable Any clinical trials involved have been registered with an ICMJE-approved registry such as ClinicalTrials.gov and the trial ID is included in the manuscript. Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant Equator, ICMJE or other checklist(s) as supplementary files, if applicable. Not Applicable Data available on GitHub at https://github.com/roidtman/zika_misdiagnosis. <https://github.com/roidtman/zika_misdiagnosis> | |
| Cold Spring Harbor Laboratory Press | |
| 2019 | |
| Preimpreso | |
| https://www.medrxiv.org/content/10.1101/19010256v1 | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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| Co-Circulation and misdiagnosis.pdf | 1.35 MB | Adobe PDF | Visualizar/Abrir |