University of Groningen. Dengue in Venezuela Velasco, Zoraida

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University of Groningen Dengue in Venezuela Velasco, Zoraida IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2014 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Velasco, Z. (2014). Dengue in Venezuela: A study on viral transmission, risk factors and clinical disease presentation [S.l.]: [S.n.] Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 20-11-2018

Dengue in Venezuela: A study on viral transmission, risk factors and clinical disease presentation Zoraida Isabel Velasco Salas

The research described in this thesis was performed at the Center of Biomedical Investigation (BIOMED) within the Carabobo University and at the Department of Medical Microbiology of the University Medical Center Groningen (UMCG) within the Groningen University Institute for Drug Exploration (GUIDE). This study received financial support from Shell de Venezuela, Venezolanas de Iluminacion IVISA, Ferretería Hermanos Fridegotto, PC Actual Valencia, according to the Organic Law of Science, Technology and Innovation (LOCTI), certification No DGCAFIDCTI/204-214-10, and by the Fondo Nacional de Ciencia y Tecnología e Innovación (FONACIT) Project number 2011000303 contract number 201100129, Venezuelan Ministry of Science, Technology and Innovation, Venezuela. The project was also partly financed by the Vollmer Foundation of Venezuela and the Department of Medical Microbiology, Molecular Virology Section, University of Groningen, University Medical Center Groningen. The printing of this thesis was financially supported by: Graduate School for Drug Exploration GUIDE, Groningen, The Netherlands Copyright 2014 by Zoraida Isabel Velasco Salas All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without written permission of the author and, when appropriate, the publisher holding the copyrights of the published articles. ISBN 978-90-367-7462-8 (hardcopy) 978-90-367-7461-1 (digital) Cover idea and design Benjamin Sanchez Rafael Di Guglielmo visualbenbang@gmail.com redg.1402@gmail.com Printed by NetzoDruk Groningen B.V., The Netherlands

Dengue in Venezuela: A study on viral transmission, risk factors and clinical disease presentation PhD thesis to obtain the degree of PhD at the University of Groningen on the authority of the Rector Magnificus Prof. E. Sterken and in accordance with the decision by the College of Deans. This thesis will be defended in public on Wednesday 17 December 2014 at 11.00 hours by Zoraida Isabel Velasco Salas born on 4 January 1970 in Caracas, Venezuela

Supervisor Prof. J.C. Wilschut Co-supervisor Dr. A. Tami, MD PhD Assessment committee Prof. J.L. Muñoz-Jordán Prof. T.S. van der Werf Prof. M. J. Postma Paranymphs Mayra Diosa José Herrera Oana Draghiciu

To my daughter Anahis...

CONTENTS Chapter 1 General Introduction, Scope and Summary of the Thesis Methodology Chapter 2 Dengue in Venezuela: Design of a Community-Based Cohort Study Chapter 3 Dengue in Venezuela: Design of an Observational Health Center-Based 9 35 59 Results Chapter 4 Dengue Seroprevalence and Risk Factors for Past and Recent Viral Transmission in Venezuela: A Comprehensive Community-Based Study American Jornal of Tropical Medicine and Hygiene. 2014;91(5):1039-1048 doi: 10.4269/ ajtmh.14-0127 Chapter 5 Spatial Analysis of Determinants of Dengue Transmission Within a Prospective Cohort Study in Venezuela Manuscript in preparation Chapter 6 Decision Tree Algorithm that Differentiates Dengue from other Febrile Illnesses at the Early Stage of the Disease Manuscript submitted Chapter 7 Health Seeking Behaviour and Treatment Intentions of Dengue and Fever: a Household Survey of Children and Adults in Venezuela Manuscript in preparation Chapter 8 Summary Discussion 75 103 117 143 175 Appendices Resumen de la Tesis Nederlandse Samenvatting Acknowledgements 187