{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:56:41Z","timestamp":1790344601735,"version":"4.1.0"},"reference-count":61,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,5]]},"abstract":"<jats:p>Flaviviruses such as Zika, dengue, and yellow fever cause epidemics throughout the tropics and account for substantial global morbidity and mortality. Although malaria and other vector-borne diseases have long been appreciated in Africa, flavivirus epidemiology is incompletely understood. Despite the existence of an effective vaccine, yellow fever continues to cause outbreaks and deaths, including at least 42 fatalities in the Democratic Republic of the Congo (DRC) in 2016. Here, we leveraged biospecimens collected as part of the nationally representative 2013\u20132014 Demographic and Health Survey in the DRC to examine serological evidence of flavivirus infection or vaccination in children aged 6 months to 5 years. Even in this young stratum of the Congolese population, we find evidence of infection by dengue and Zika viruses based on results from enzyme-linked immunosorbent assay and neutralization assay. Surprisingly, there was remarkable discordance between reported yellow fever vaccination status and results of serological assays. The estimated seroprevalences of neutralizing antibodies against each virus are yellow fever, 6.0% (95% confidence interval [CI] = 4.6\u20137.5%); dengue, 0.4% (0.1\u20130.9%); and Zika, 0.1% (0.0\u20130.5%). These results merit targeted, prospective studies to assess effectiveness of yellow fever vaccination programs, determine flavivirus seroprevalence across a broader age range, and investigate how these emerging diseases contribute to the burden of acute febrile illness in the DRC.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0156","type":"journal-article","created":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T07:00:37Z","timestamp":1531206037000},"page":"756-763","source":"Crossref","is-referenced-by-count":43,"title":["Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo"],"prefix":"10.4269","volume":"99","author":[{"given":"Alexandra C.","family":"Willcox","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew H.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, Hope Clinic of the Emory Vaccine Center, Emory School of Medicine, Decatur, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Jadi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Keeler","sequence":"additional","affiliation":[{"name":"Department of Geography, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B.","family":"Parr","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieudonn\u00e9","family":"Mumba","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale, Kinshasa, Democratic Republic of the Congo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melchior","family":"Kashamuka","sequence":"additional","affiliation":[{"name":"Ecole de Sant\u00e9 Publique, Facult\u00e9 de M\u00e9decine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette","family":"Tshefu","sequence":"additional","affiliation":[{"name":"Ecole de Sant\u00e9 Publique, Facult\u00e9 de M\u00e9decine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravinda M.","family":"de Silva","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Meshnick","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"453","article-title":"Dengue","volume":"385","author":"Guzman","year":"2015"},{"key":"b2","series-title":"PLoS Med","first-page":"e1002203","article-title":"Zika virus infection as a cause of congenital brain abnormalities and Guillain\u2013Barr\u00e9 Syndrome: systematic review","volume":"14","author":"Krauer","year":"2017"},{"key":"b3","series-title":"Bull World Health Organ","first-page":"775","article-title":"A century of progress in combating yellow fever","volume":"64","author":"Br\u00e8s","year":"1986"},{"key":"b4","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"215","article-title":"Transmission of Zika virus through sexual contact with travelers to areas of ongoing transmission\u2014continental United States, 2016","volume":"65","author":"Hills","year":"2016"},{"key":"b5","series-title":"Clin Microbiol Rev","first-page":"487","article-title":"Zika virus","volume":"29","author":"Musso","year":"2016"},{"key":"b6","series-title":"Emerg Infect Dis","first-page":"1349","article-title":"Dengue virus infection in Africa","volume":"17","author":"Amarasinghe","year":"2011"},{"key":"b7","series-title":"PLoS One","first-page":"e0185689","article-title":"Zika beyond the Americas: travelers as sentinels of Zika virus transmission. 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