Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias

Abstract The 2015–2016 Zika virus outbreak in the Americas presented significant challenges in understanding the transmission dynamics due to substantial reporting biases, as women of reproductive age (15–39 years) were disproportionately represented in the surveillance data when public awareness of...

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Main Authors: Tim K. Tsang, Diana P. Rojas, Fei Xu, Yanfang Xu, Xiaolin Zhu, M. Elizabeth Halloran, Ira M. Longini, Yang Yang
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-59655-9
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author Tim K. Tsang
Diana P. Rojas
Fei Xu
Yanfang Xu
Xiaolin Zhu
M. Elizabeth Halloran
Ira M. Longini
Yang Yang
author_facet Tim K. Tsang
Diana P. Rojas
Fei Xu
Yanfang Xu
Xiaolin Zhu
M. Elizabeth Halloran
Ira M. Longini
Yang Yang
author_sort Tim K. Tsang
collection DOAJ
description Abstract The 2015–2016 Zika virus outbreak in the Americas presented significant challenges in understanding the transmission dynamics due to substantial reporting biases, as women of reproductive age (15–39 years) were disproportionately represented in the surveillance data when public awareness of relationship between Zika and microcephaly increased. Using national surveillance data from Colombia during July 27, 2015–November 21, 2016, we developed a Bayesian hierarchical modeling framework to reconstruct the true numbers of symptomatic cases and estimate transmission parameters while accounting for differential reporting across age-sex groups. Our model revealed that the detection rate of symptomatic cases among women of reproductive age was 99% (95% CI: 98.7-100), compared to 85.4% (95% CI: 84.7-86.1) in other demographic groups. After correcting for these biases, our results showed that females aged 15–39 years remained 82.8% (95% CI: 80.2–85.2%) more susceptible to Zika symptomatic infection than males of the same age, independent of differential reporting areas. Departments with medium-high altitude, medium-high population density, low coverage of forest, or high dengue incidence from 2011–2015 exhibited greater Zika risk. This study underscores the importance of accounting for surveillance biases in epidemiological studies to better understand factors influencing Zika transmission and to inform disease control and prevention.
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spelling doaj-art-1b84e1368a7040ba8d67ba22b880ad032025-08-20T03:52:53ZengNature PortfolioNature Communications2041-17232025-05-011611910.1038/s41467-025-59655-9Estimating transmissibility of Zika virus in Colombia in the presence of surveillance biasTim K. Tsang0Diana P. Rojas1Fei Xu2Yanfang Xu3Xiaolin Zhu4M. Elizabeth Halloran5Ira M. Longini6Yang Yang7World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongDepartment of Epidemiology, University of FloridaDepartment of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic UniversityWorld Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongDepartment of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic UniversityVaccine and Infectious Disease Division, Fred Hutchinson Cancer CenterDepartment of Biostatistics, University of FloridaDepartment of Biostatistics, University of FloridaAbstract The 2015–2016 Zika virus outbreak in the Americas presented significant challenges in understanding the transmission dynamics due to substantial reporting biases, as women of reproductive age (15–39 years) were disproportionately represented in the surveillance data when public awareness of relationship between Zika and microcephaly increased. Using national surveillance data from Colombia during July 27, 2015–November 21, 2016, we developed a Bayesian hierarchical modeling framework to reconstruct the true numbers of symptomatic cases and estimate transmission parameters while accounting for differential reporting across age-sex groups. Our model revealed that the detection rate of symptomatic cases among women of reproductive age was 99% (95% CI: 98.7-100), compared to 85.4% (95% CI: 84.7-86.1) in other demographic groups. After correcting for these biases, our results showed that females aged 15–39 years remained 82.8% (95% CI: 80.2–85.2%) more susceptible to Zika symptomatic infection than males of the same age, independent of differential reporting areas. Departments with medium-high altitude, medium-high population density, low coverage of forest, or high dengue incidence from 2011–2015 exhibited greater Zika risk. This study underscores the importance of accounting for surveillance biases in epidemiological studies to better understand factors influencing Zika transmission and to inform disease control and prevention.https://doi.org/10.1038/s41467-025-59655-9
spellingShingle Tim K. Tsang
Diana P. Rojas
Fei Xu
Yanfang Xu
Xiaolin Zhu
M. Elizabeth Halloran
Ira M. Longini
Yang Yang
Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias
Nature Communications
title Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias
title_full Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias
title_fullStr Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias
title_full_unstemmed Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias
title_short Estimating transmissibility of Zika virus in Colombia in the presence of surveillance bias
title_sort estimating transmissibility of zika virus in colombia in the presence of surveillance bias
url https://doi.org/10.1038/s41467-025-59655-9
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