Author ORCID Identifier

Date of Award

Fall 11-27-2023

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Christine Elizabeth Stauber

Second Advisor

Dr. Lisa Casanova



In the Americas, dengue disease which is associated with the Dengue virus has the highest incidence of all mosquito-borne viruses with cyclic epidemics every 3 to 5 years. It is estimated that the number of dengue cases is underreported globally as most cases of infection are asymptomatic, affecting both clinical surveillance and timeliness (Angelo et al., 2020). Wastewater-based epidemiology has recently gained much attention and has the potential to provide a snapshot view of community health (Irene Xagoraraki, 2019). Research into the feasibility of wastewater monitoring for the detection of viral outbreaks has been emerging. Detection of non-waterborne viruses including arboviruses Zika, West Nile virus, Dengue virus, and yellow fever virus in urine samples which suggests the concept of wastewater-based epidemiology could be used in the future (Irene Xagoraraki, 2019).


In the current study, we investigate the concentration and presence of dengue virus nucleic acid in various fluids of infected patients. The hope is to further contribute to the growing data on the feasibility of the use of WBE to monitor DENV infections as a tool for community-level public health surveillance.


De-identified secondary data was obtained from a community-based enhanced surveillance study in Pau da Lima community, Salvador, Brazil and included the results of analysis of serum, oral fluid, and urine. Literature review and evidence gap mapping was completed to inform on existing research and gaps in knowledge.


A total of 96 participants were confirmed positive for dengue virus in laboratory testing. Of these, 53 (55%) were positive in acute-phase serum, 5 (5%) in acute-phase urine, 2 (3.5%) in convalescent-phase urine, and 1 (2%) in acute-phase oral fluid. There were no observed statistically significant associations between demographic and clinical manifestations and positive nucleic test detection of dengue virus RNA in acute-phase urine.


Testing of acute- and convalescent-phase urine resulted in an overall 7% positivity across all confirmed positive patients via serum. Higher frequencies of detection in urine were seen during the acute-phase (days 0-7 days) than in the convalescent-phase (days 10-40 days). Future research into detection rates and viral shedding in feces or the use other highly sensitive assays could provide valuable information for in the feasibility of wastewater surveillance.


File Upload Confirmation


Available for download on Thursday, December 05, 2024