Multicounty analysis of dengue and Zika virus burden, immunogenicity, and population level risk

While most African and Asian countries have suitable vectors and conditions for Dengue fever and Zika virus (DENV/ZIKV) there are challenges in accurate diagnosis, surveillance and major gaps in knowledge including infection rates, disease burden, immune status, cross-reactivity, and the drivers of transmission in different settings. We are a multi-disciplinary multi-country team with an established track record in DENV/ZIKV research, viral surveillance, immunity, and genomics. We will systematically address these gaps across nine countries in Africa and Asia including countries where both viruses are co-circulating. Leveraging our existing south-south collaborations we aim to establish clinical burden, population level exposure and immune response across both continents. We will evaluate neutralizing antibodies, DENV/ZIKV cross-reactivity, and T-cell responses by country and exposure type. We will utilize both the ISARIC protocol and a susceptibility forecasting tool to gather population level data that can be used to predict clinical and environmental factors that influence disease severity and population burden. Finally, to aid future research and vaccine development we will establish a biorepository of well characterized samples with synergized metadata across all nine countries. This multi-pronged approach will inform vaccine development needs regionally and if a one-size fits all approach is relevant.