The Immunogenicity and Safety of the Live-Attenuated CYD-Tetravalent Dengue Vaccine ( CYD-TDV ) in Children and Adolescents : A Systematic Review of Randomized Controlled Trials
Raksheeth Agarwal a , Oliver Emmanuel b , Sharon Hanmy Angel c , Angga Wiratama d
a ) Universitas Indonesia – (+ 62 ) 85777808310 , raksheeth @ hotmail . com
b ) Universitas Indonesia – (+ 62 ) 818635925 , oliveremmanuel @ hotmail . com
c ) Universitas Indonesia – (+ 62 ) 81362873803 , sharonhanmyangel @ gmail . com d )
Introduction :
The incidence of dengue disease is increasing dramatically across the world , with about 3.9 billion people from 128 countries at risk of infection . Indonesia , an endemic region , experienced dengue outbreaks in 12 regencies that resulted in 608 cases and 34 deaths in early 2016 . Moreover , studies show that the constantly increasing global temperatures enhances the growth and spread of both virus and its vector . This calls for a more effective prevention strategy for dengue disease . Vaccination , when integrated into current vector control methods , has the potential to significantly improve dengue prevention . A tetravalent dengue vaccine , CYD-TDV ( Dengvaxia ), has the antigens of all 4 serotypes of dengue virus . The purpose of this review is to assess the immunogenicity and safety of CYD-TDV in children .
Methods :
Comprehensive literature searches were conducted on databases Pubmed , The Cochrane Library , Scopus , ProQuest , EBSCOhost and ScienceDirect . Randomizedcontrolled trials on children with CYD-TDV as intervention were selected . Trials were further filtered using inclusion and exclusion criteria . Data extracted from selected trials include safety of vaccine and immunogenicity in terms of Geometric Mean Titres ( GMT ) of antibodies .
Results :
Six clinical trials were selected based on preset criteria . GMT values were obtained using 50 % Plaque Reduction Neutralization Test ( PRNT ) and safety was semiquantitatively assesed based on adverse effects . Additional processing of data was done to better understand the trends among trials , including fold increase of GMT from baseline to post dose 3 and peak GMT values achieved .