Difficulties inherent in the identification of immune correlates of protection or severe disease have challenged the development and evaluation of dengue vaccines. There persist substantial gaps in knowledge about the complex effects of age and sequential dengue virus (DENV) exposures on these correlations. To address these gaps, we are conducting a novel family-based cohort-cluster study for DENV transmission in Kamphaeng Phet, Thailand. The study began in 2015 and is funded until at least 2023. As of May 2019, 2870 individuals in 485 families are actively enrolled. The families comprise at least one child born into the study as a newborn, one other child, a parent, and a grandparent. The median age of enrolled participants is 21 years (range 0 - 93 years). Active surveillance is performed to detect acute dengue illnesses and annual blood draws identify subclinical seroconversions. Extended follow-up of this cohort will detect sequential infections and correlate antibody kinetics and sequence of infections with disease outcomes. The central goal of this prospective study is to characterize how different DENV exposure histories within multigenerational family units, from DENV-naïve infants to grandparents with multiple prior DENV exposures, impact transmission, disease, and protection at the level of the individual, household, and community.
Anderson KB, Buddhari D, Srikiatkhachorn A, Ponlawat A, Gromowski GD, Iamsirithaworn S, Weg AL, Ellison DW, Macareo L, Cummings DAT, Yoon IK, Nisalak A, Thomas SJ, Fernandez S, Jarman RG, Rothman AL, Endy TP. (2020). An Innovative Prospective Hybrid Cohort-Cluster Study Design To Characterize Dengue Virus Transmission In Multigenerational Households In Kamphaeng Phet, Thailand. American journal of epidemiology