RESUMEN
About 97% of the human cases of the American visceral leishmaniasis (VL) occur in Brazil. In the last few years, the disease expanded to medium- and large-sized cities, in which surveillance and control actions have been intensified, in an effort to control VL spreading. Our two-year study was conducted in Belo Horizonte, the sixth most populous city in Brazil, which is endemic for VL. We focused in two particular districts of recent transmission of the disease, with no reported human cases and submitted to minor surveillance and control actions. Our aim was to draw an epidemiological profile of the local situation concerning Lutzomyia vector, Leishmania parasites, and the main domestic reservoirs (dogs). Lutzomyia longipalpis comprised 96.5% of the total phlebotomine sand flies captured and displayed an expressive minimal infection rate by Leishmania infantum (16.7%). Positive correlations were found between the population densities of L. longipalpis, rainfall and temperature. L. infantum was also detected in the cortelezzii complex and, for the first time, in Lutzomyia lloydi. Leishmania braziliensis, an etiological agent of the American cutaneous leishmaniasis, was also identified in L. longipalpis. Among the 1408 dogs serologically tested by standard enzyme-linked and fluorescence immune assays (ELISA/IFA) 3.6% were positive for VL. L. infantum DNA and Leishmania parasites were identified in 100% and 72.5% of the seropositive dogs, respectively. The co-positivity of other diagnostic tests for VL-Leishmania-nested PCR, imprint and myeloculture-was compared to the standard serology. Both symptomatic or asymptomatic dogs displayed an equal average number of positive diagnostic tests for VL. The districts studied display favorable conditions for the rapid spreading of human infection, in terms of L. longipalpis population density, and presence of L. infantum in both vector and main reservoir.
Asunto(s)
Reservorios de Enfermedades/veterinaria , Enfermedades de los Perros/epidemiología , Insectos Vectores/parasitología , Leishmaniasis Cutánea/veterinaria , Leishmaniasis Visceral/veterinaria , Psychodidae/parasitología , Animales , Animales Domésticos/parasitología , Brasil/epidemiología , Ciudades , Reservorios de Enfermedades/parasitología , Enfermedades de los Perros/parasitología , Enfermedades de los Perros/transmisión , Perros , Femenino , Leishmania braziliensis/genética , Leishmania braziliensis/aislamiento & purificación , Leishmania infantum/genética , Leishmania infantum/aislamiento & purificación , Leishmaniasis Cutánea/epidemiología , Leishmaniasis Cutánea/transmisión , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/transmisión , Masculino , Reacción en Cadena de la PolimerasaRESUMEN
More than 600,000 football fans, coming from all over the world, were expected to visit Brazil during the FIFA World Cup 2014. International travel can become a public health problem when the visitors start to become sick, needing medical intervention and eventually hospitalization. The occurrence of dengue fever infections in Brazil is persistent and has been increasing since the 1980s, and the health authorities were expected to take preventive measures and to warn the visitors about the risks during the tournament period. Before the World Cup started, studies have been published stating that dengue could be a significant problem in some of the Brazilian cities hosting the games. These conclusions were taken after a brief observation of the available data, analyzing its mean and standard deviation only, or based on seasonal climate forecasts, causing alarm for the world cup in Brazil. Here, with a more careful data analysis, we show that the seasonality of the disease plays a major role in dengue transmission. The density of dengue cases in Brazil is residual during winter in the Southern hemisphere (mid June to mid September) and the fans of football were not likely to get dengue during the tournament period.
Asunto(s)
Dengue/epidemiología , Vacaciones y Feriados , Brasil/epidemiología , Bases de Datos Factuales , Dengue/transmisión , Humanos , Salud Pública , Riesgo , Estaciones del Año , Fútbol , ViajeRESUMEN
OBJECTIVE: To entomologically monitor Aedes spp. and correlate the presence of these vectors with the recent epidemic of dengue in Divinopolis, Minas Gerais State, Brazil. METHODS: Ovitraps were installed at 44 points in the city, covering six urban areas, from May 2011 to May 2012. After collection, the eggs were incubated until hatching. In the 4th stage of development, the larvae were classified as Ae. aegypti or Ae. albopictus. RESULTS: In total, 25 633 Aedes spp. eggs were collected. February was the month with the highest incidence, with 5635 eggs collected and a hatching rate of 46.7%. Ae. aegypti eggs had the highest hatching rate, at 72.3%, whereas Ae. albopictus eggs had 27.7%. Climate and population density influenced the number of eggs found. Indicators of vector presence were positively correlated with the occurrence of dengue cases. CONCLUSION: These data reinforce the need for entomological studies, highlight the relevance of Ae. albopictus as a possible disease vector and demonstrate its adaptation. Ae. albopictus, most commonly found in forested areas, comprised a substantial proportion of the urban mosquito population.
Asunto(s)
Aedes/crecimiento & desarrollo , Dengue/transmisión , Insectos Vectores/crecimiento & desarrollo , Animales , Brasil/epidemiología , Dengue/epidemiología , Brotes de Enfermedades , Entomología , Humanos , Larva/crecimiento & desarrollo , Estaciones del Año , Temperatura , Salud UrbanaRESUMEN
BACKGROUND: Dengue is a widely spread arboviral disease in tropical and subtropical regions of the world. Dengue fever presents clinical characteristics similar to other febrile illness. Thus laboratory diagnosis is important for adequate management of the disease. OBJECTIVES: The present study was designed to evaluate the diagnostic performance of real-time PCR and serological methods for dengue in a real epidemic context. STUDY DESIGN: Clinical data and blood samples were collected from consecutive patients with suspected dengue who attended a primary health care unit in Belo Horizonte, Brazil. Serologic methods and real-time PCR were performed in serum samples to confirm dengue diagnosis. RESULTS: Among the 181 consecutive patients enrolled in this study with suspected dengue, 146 were considered positive by serological criteria (positive NS1 ELISA and/or anti-dengue IgM ELISA) and 138 were positive by real-time PCR. Clinical criteria were not sufficient for distinguishing between dengue and non-dengue febrile illness. The PCR reaction was pre-optimized using samples from patients with known viral infection. It had similar sensitivity compared to NS1 ELISA (88% and 89%, respectively). We also evaluated three commercial lateral flow immunochromatographic tests for NS1 detection (BIOEASY, BIORAD and PANBIO). All three tests showed high sensitivity (94%, 91% and 81%, respectively) for dengue diagnosis. CONCLUSION: According to our results it can be suggested that lateral flow tests for NS1 detection are the most feasible methods for early diagnosis of dengue.
Asunto(s)
Cromatografía de Afinidad/métodos , Técnicas de Laboratorio Clínico/métodos , Dengue/diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Adulto , Anticuerpos Antivirales/sangre , Antígenos Virales/sangre , Brasil , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Humanos , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , ARN Viral/genética , Sensibilidad y Especificidad , Análisis de Secuencia de ADNRESUMEN
Dengue virus (DENV) is the most prevalent arbovirus in the world, found mainly in tropical regions. As clinical manifestations present frequently as nonspecific febrile illness, laboratory diagnosis is essential to confirm DENV infections and for epidemiological studies. Recombinant envelope (E) antigens of four serotypes of DENV were used to develop an immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA). To evaluate the IgG-ELISA, a panel of serum samples that had been tested previously by a plaque reduction neutralization test (PRNT) was investigated for the presence of anti-E antibodies against the four DENV serotypes. IgG-ELISA was found to have a sensitivity (91%) and specificity (98%) at a receiver-operating characteristic (ROC) optimized cutoff and demonstrated high performance as well as good indexes. A concordance of 97% was achieved between both assays, and only 21/704 (3%) samples were not concordant. The results of the present study demonstrate a moderate correlation between neutralizing antibody titers and IgG-ELISA values. These findings indicate that the recombinant protein-based IgG-ELISA is a suitable method for routine serodiagnosis, monitoring and seroepidemiological studies of DENV infections.
Asunto(s)
Anticuerpos Antivirales/sangre , Virus del Dengue/inmunología , Dengue/diagnóstico , Ensayo de Inmunoadsorción Enzimática , Proteínas del Envoltorio Viral/inmunología , Anticuerpos Neutralizantes/sangre , Anticuerpos Antivirales/inmunología , Antígenos Virales/inmunología , Dengue/inmunología , Dengue/virología , Virus del Dengue/clasificación , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Pruebas de Neutralización , Proteínas Recombinantes/inmunología , Sensibilidad y Especificidad , Estudios Seroepidemiológicos , Pruebas SerológicasRESUMEN
Introdução: a urbanização desordenada caracteriza-se pela existência de agregados espaciais com diferentes condições socioeconômicas e ambientais e que apresentam condições propícias à proliferação de insetos, vetores de várias doenças, especialmente da dengue. O presente estudo descreveu e comparou a incidência da dengue em determinadas áreas (denominadas estratos) com diferentes níveis de infestação e de resultados em relação às intervenções em curso em Belo Horizonte. Objetivo: determinar e quantificar a associação entre a ocorrência da dengue e indicadores de infestação vetorial e de intervenção no município de Belo Horizonte. Métodos: adotou-se estudo observacional com delineamento ecológico. Foi realizada análise univariada entre as taxas estimadas de incidência de dengue e as categorias dos indicadores entomológicos e de intervenção utilizando-se o modelo binomial negativo. Utilizaram-se subdivisões geográficas do município (estratos) como unidade geográfica de análise. Resultados: verificou-se heterogeneidade nas taxas de incidência de dengue entre os estratos (mínimo de 276,4 e máximo de 9398,1/100.000), com média de 3285,5. Estratos com índice de infestação predial (IIP) ?3% apresentaram RR=2,9 (IC95%: 1,3?6,4), quando contrastados a estrados com IIP <2%. Em estratos com média de ovos ? 20, RR=3,3 (IC95%: 1,5?7,3), quando contrastados com aqueles com <10. Locais não acessados por recusa ou ausência de morador num percentual entre 10,0 e 24,9 apresentaram RR=7,9 (IC95%: 4,4?14,4) em relação àqueles cujo percentual de não acesso foi inferior a 10,0%. Já a cobertura de imóveis vistoriados em relação à meta não teve associação com a taxa de incidência da doença. Conclusões: índices de infestação e imóveis não acessados para o tratamento focal associaram-se ao elevado risco de ocorrência de dengue nos distritos sanitários e estratos de Belo Horizonte, ocorrendo ainda heterogeneidade entre estratos quanto à incidência da dengue...
Introduction: Unplanned, uncontrolled urbanization is characterized by areas with different socioeconomic and environmental conditions that are conductive to the proliferation of insects, vectors of several diseases, especially dengue. This study describes and compares dengue incidence in selected areas (called strata) with different levels of both infestation and results of active prevention measures carried out in Belo Horizonte. Objective: To determine and quantify the association of dengue incidence with indicators of vectorial infestation and preventive measures in the Municipality of Belo Horizonte. Methods: This is an observational study with ecological approach. Univariate analysis was carried out to assess the estimated rates of dengue incidence and the categories of entomological and active prevention indicators using a negative binomial model. The municipality geographic subdivisions (strata) were used as geographic unit of analysis. Results: The results point to heterogeneous rates of dengue incidence across strata (minimum of 276.4, and maximum of 9398.1/100,000), with mean of 3285.5. The strata with house infestation rate (HIR) ? 3 % had RR = 2.9 (IC95%: 1.3?6.4) when compared to strata with HIR < 2 %. In strata with mean of eggs ? 20, RR = 3.3 (IC95%: 1.5?7.3) when compared to those strat with < 10. Areas with 10.0 ? 24.9 % of no access because of dweller?s refusal or absence had RR = 7.9 (IC95%: 4.4?14.4) in relation to those with nonaccess rate lower than 10.0 %. The coverage of counties examined in relation to the target had no association with the incidence rate of the disease. Conclusions: Rates of infestation and non-accessed estates for focal treatment are associated with the high risk of dengue occurrence in the surveillance districts and strata in Belo Horizonte. Dengue incidence is heterogeneous across the strata...
Asunto(s)
Humanos , Dengue/epidemiología , Factores de Riesgo , Notificación de Enfermedades , Área Urbana , BrasilRESUMEN
This study considers the dengue occurrence in the city of Belo Horizonte over the last fifteen years. Approximately 186,000 cases registered from 1996 to 2011 were analyzed. The home address of individuals whose dengue case was notified was used as a proxy for exposure location. For determining possible outbreaks of disease and the specific patterns of dengue cases, spatial statistics used included Kernel's estimation. The occurrence of waves of dengue outbreaks was correlated with climatic and vector presence data. Outbreaks had different durations and intensities: case clustering, thinned out both spatially and temporally. These findings may be useful for public health professionals responsible for fighting the disease providing some tools for improving evaluation of interventions such as vector control and patient care, minimizing the collective and individual burden of the disease.
RESUMEN
INTRODUCTION: To detect dengue virus, eggs of Aedes sp were collected in the city of Belo Horizonte, Brazil, in 2007. METHODS: Egg samples were subsequently hatched and the larvae were tested for the presence of dengue virus RNA by RT-PCR. RESULTS: Among the Aedes aegypti larvae samples, 163 (37.4%) out of 435 were positive, including 32 (10.9%) of 293 individual larvae samples concomitantly positive for two serotypes. CONCLUSIONS: Virological surveillance detecting coinfected vectors in the field could represent an important strategy for understanding the numerous factors involved in the transmission and clinical presentation of dengue.
Asunto(s)
Aedes/virología , Virus del Dengue/aislamiento & purificación , Insectos Vectores/virología , Aedes/clasificación , Animales , Dengue/transmisión , Dengue/virología , Virus del Dengue/clasificación , Virus del Dengue/genética , Insectos Vectores/clasificación , Larva/virología , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
INTRODUCTION: To detect dengue virus, eggs of Aedes sp were collected in the city of Belo Horizonte, Brazil, in 2007. METHODS: Egg samples were subsequently hatched and the larvae were tested for the presence of dengue virus RNA by RT-PCR. RESULTS: Among the Aedes aegypti larvae samples, 163 (37.4 percent) out of 435 were positive, including 32 (10.9 percent) of 293 individual larvae samples concomitantly positive for two serotypes. CONCLUSIONS: Virological surveillance detecting coinfected vectors in the field could represent an important strategy for understanding the numerous factors involved in the transmission and clinical presentation of dengue.
INTRODUÇÃO: Para a detecção do vírus da dengue, ovos de Aedes sp foram coletados em Belo Horizonte, Brasil, em 2007. MÉTODOS: Amostras de ovos eclodiram e suas larvas foram testadas para a presença de RNA do vírus dengue por RT-PCR. RESULTADOS: Das amostras de larvas de Aedes aegypti, 163 (37,4 por cento) de 435 foram positivas, incluindo 32 (10,9 por cento) das 293 amostras individuais que foram concomitantemente positivas para dois sorotipos. CONCLUSÕES: A vigilância virológica de vetores no campo poderia representar uma estratégia importante para a compreensão dos diversos fatores envolvidos na transmissão e apresentação clínica da dengue.
Asunto(s)
Animales , Aedes/virología , Virus del Dengue/aislamiento & purificación , Insectos Vectores/virología , Aedes/clasificación , Virus del Dengue/clasificación , Virus del Dengue/genética , Dengue/transmisión , Dengue/virología , Insectos Vectores/clasificación , Larva/virología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , ARN Viral/análisisRESUMEN
OBJECTIVE: To determine the seroprevalence of dengue fever serotypes in three sanitary districts in the city of Belo Horizonte and investigate the association of seroprevalence with contextual and individual variables. METHOD: The survey was conducted in the sanitary districts of Venda Nova, Leste and Centro-Oeste between June 2006 and March 2007. All residents aged 1 year or older were eligible for the study. Participants answered a questionnaire and had a 5 mL blood sample collected to determine the presence of anti-dengue types 1, 2, and 3 virus antibodies by seroneutralization. The questionnaire covered demographic aspects, socioeconomic status, physical characteristics of the home, residential mobility between cities, previous history of signs and symptoms associated with dengue fever, and knowledge concerning dengue fever prevention measures, among others. RESULTS: Seroprevalence was 11.9% (95%CI: 9.7-14.6) among the 709 individuals included in the study, and it was not associated with sex, age, family income, and having moved to another town in the past 10 years. Seropositivity was associated with type of construction (apartment or house/shanty, with apartment being a protection factor) and with an elevated health vulnerability index where the dwelling was located. CONCLUSIONS: In this study, seroprevalence was lower than in previous studies carried out in mid-size and large Brazilian cities. This suggests that Belo Horizonte has employed efficient control measures. However, heterogeneity within the city was observed in terms of dengue fever transmission, which was largely associated with contextual indicators of vulnerability. The number of susceptibles is still high, and the control of dengue fever remains a difficult public health issue.
Asunto(s)
Dengue/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antivirales/sangre , Brasil/epidemiología , Niño , Preescolar , Dengue/transmisión , Virus del Dengue/clasificación , Virus del Dengue/inmunología , Virus del Dengue/aislamiento & purificación , Femenino , Humanos , Renta , Lactante , Masculino , Persona de Mediana Edad , Características de la Residencia , Estudios Seroepidemiológicos , Serotipificación , Factores Socioeconómicos , Salud Urbana , Adulto JovenRESUMEN
Objetivo: Determinar a soroprevalência para sorotipos virais da dengue em três distritos sanitários de Belo Horizonte e investigar a associação com variáveis de contexto e individuais. Métodos: O inquérito foi conduzido nos distritos sanitários de Venda Nova, Leste e Centro-Oeste entre junho de 2006 e março de 2007. Foram incluídos todos os residentes com idade 1 ano. Os participantes responderam a questionário; foi também coletada uma amostra de sangue (5 mL) para determinar a presença de anticorpos contra vírus da dengue dos tipos 1, 2 e 3 por soroneutralização. O questionário abrangeu questões demográficas, posição socioeconômica, características físicas do local de moradia, mobilidade de moradia entre cidades, história pregressa de sinais e sintomas associados à dengue e conhecimento sobre medidas de prevenção da dengue, dentre outros. Resultados: Entre os 709 indivíduos estudados, encontrou-se soroprevalência para dengue de 11,9 por cento (IC95 por cento: 9,7 a 14,6), não associada ao sexo, idade, renda familiar e mudança de município nos últimos 10 anos. Houve associação da soropositividade com tipo de moradia (apartamento ou casa/barracão, sendo apartamento fator de proteção) e com índice elevado de vulnerabilidade da saúde do local de moradia. Conclusão: A soroprevalência neste estudo foi mais baixa do que a encontrada em outros inquéritos realizados em cidades brasileiras de porte grande e médio, sugerindo que Belo Horizonte tem utilizado estratégias eficazes de controle. Entretanto, foi observada uma heterogeneidade intraurbana na transmissão da dengue, em grande parte associada a indicadores contextuais de vulnerabilidade. Permanece ainda elevado o número de suscetíveis, e a dengue como questão de saúde pública de difícil controle.
Objective: To determine the seroprevalence of dengue fever serotypes in three sanitary districts in the city of Belo Horizonte and investigate the association of seroprevalence with contextual and individual variables. Method: The survey was conducted in the sanitary districts of Venda Nova, Leste and Centro-Oeste between June 2006 and March 2007. All residents aged 1 year or older were eligible for the study. Participants answered a questionnaire and had a 5 mL blood sample collected to determine the presence of anti-dengue types 1, 2, and 3 virus antibodies by seroneutralization. The questionnaire covered demographic aspects, socioeconomic status, physical characteristics of the home, residential mobility between cities, previous history of signs and symptoms associated with dengue fever, and knowledge concerning dengue fever prevention measures, among others. Results: Seroprevalence was 11.9 percent (95 percent CI: 9.7-14.6) among the 709 individuals included in the study, and it was not associated with sex, age, family income, and having moved to another town in the past 10 years. Seropositivity was associated with type of construction (apartment or house/shanty, with apartment being a protection factor) and with an elevated health vulnerability index where the dwelling was located. Conclusions: In this study, seroprevalence was lower than in previous studies carried out in mid-size and large Brazilian cities. This suggests that Belo Horizonte has employed efficient control measures. However, heterogeneity within the city was observed in terms of dengue fever transmission, which was largely associated with contextual indicators of vulnerability. The number of susceptibles is still high, and the control of dengue fever remains a difficult public health issue.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Dengue/epidemiología , Anticuerpos Antivirales/sangre , Brasil/epidemiología , Virus del Dengue/clasificación , Virus del Dengue/inmunología , Virus del Dengue/aislamiento & purificación , Dengue/transmisión , Renta , Características de la Residencia , Estudios Seroepidemiológicos , Serotipificación , Factores Socioeconómicos , Salud Urbana , Adulto JovenAsunto(s)
Virus del Dengue , Estudios Seroepidemiológicos , Vulnerabilidad en Salud , Vivienda , Brasil , Renta , Demografía , Factores Socioeconómicos , Salud Urbana , Dengue , Estudios Seroepidemiológicos , Vivienda , Anticuerpos Antivirales , Serotipificación , Adulto Joven , Vulnerabilidad en Salud , BrasilRESUMEN
This study aimed to describe and evaluate dengue patterns after the implementation of the National Dengue Control Plan (PNCD). Incidence rates were analyzed and correlated with previous rates and climatic, demographic, and socioeconomic variables for the Brazilian municipalities that were targeted for priority dengue control. We conducted descriptive studies of epidemiological indicators after the implementation of the national plan and a statistical analysis considering the incidence rates from the previous period and climatic, demographic, and socioeconomic variables, using multiple linear regression. We found a significant association between dengue incidence during the period following implementation of the PNCD (2003-2006) as compared to pre-implementation (2001-2002), after adjusting for geographic and climatic indicators. Our findings suggest that the plan's objectives were not fully achieved. In conclusion, the persistent occurrence of dengue epidemics requires changes and reevaluation of current strategies, along with improvements in the dengue surveillance system.
Asunto(s)
Dengue , Brotes de Enfermedades , Programas Nacionales de Salud , Animales , Brasil/epidemiología , Dengue/epidemiología , Dengue/prevención & control , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Humanos , Incidencia , Programas Nacionales de Salud/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Estaciones del Año , Factores SocioeconómicosRESUMEN
Este estudo teve como objetivo descrever os padrões das epidemias de dengue após a implantação do Plano Nacional de Controle da Dengue (PNCD) e avaliar os resultados, considerando, como parâmetro, as metas alcançadas em municípios definidos como prioritários pelo PNCD. Para tanto, foram feitos estudos descritivos dos indicadores epidemiológicos após a implantação do PNCD e análise estatística considerando as taxas de incidência de dengue do período anterior, dados climáticos, demográficos e sócio-econômicos, utilizando regressão linear e múltipla. Detectamos associação estatisticamente significativa entre a ocorrência de dengue no período pós PNCD (2003-2006) e a incidência pré PNCD (2001-2002), após ajustamento para indicadores geográficos e climáticos. Os resultados indicam que não foram integralmente alcançadas as metas estabelecidas pelo PNCD. A situação atual da doença, com repetidas epidemias sazonais, sugere a necessidade de alterações nas estratégias atualmente utilizadas e aprimoramento das ações de vigilância.
This study aimed to describe and evaluate dengue patterns after the implementation of the National Dengue Control Plan (PNCD). Incidence rates were analyzed and correlated with previous rates and climatic, demographic, and socioeconomic variables for the Brazilian municipalities that were targeted for priority dengue control. We conducted descriptive studies of epidemiological indicators after the implementation of the national plan and a statistical analysis considering the incidence rates from the previous period and climatic, demographic, and socioeconomic variables, using multiple linear regression. We found a significant association between dengue incidence during the period following implementation of the PNCD (2003-2006) as compared to pre-implementation (2001-2002), after adjusting for geographic and climatic indicators. Our findings suggest that the plan's objectives were not fully achieved. In conclusion, the persistent occurrence of dengue epidemics requires changes and reevaluation of current strategies, along with improvements in the dengue surveillance system.
Asunto(s)
Animales , Humanos , Dengue , Brotes de Enfermedades , Programas Nacionales de Salud , Brasil/epidemiología , Dengue/epidemiología , Dengue/prevención & control , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Incidencia , Programas Nacionales de Salud/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Estaciones del Año , Factores SocioeconómicosRESUMEN
Introdução: o controle da febre amarela urbana pressupõe a erradicação ou controle do vetor, pela monitorização dos índices de infestação pelo Aëdes aegypti e aplicação da vacina da febre amarela. Objetivo: este estudo avalia a mortalidade e a ocorrência da febre amarela (FA) no Brasil entre 2001 e 2006 e suas implicações, especialmente para o estado de Minas Gerais. Casuística e Métodos: foi utilizado o banco de dados do Sistema de Informação de Agravos de Notificação (SINAN), sendo analisados os dados disponíveis para tabulação no sítio (http://dtr2004.saude.gov.br/sinanweb/novo/). As taxas de incidência e letalidade de cada unidade federada foram comparadas e mapeados os municípios onde ocorreram infecções por FA. Resultados: os achados refletem gradativo aumento da ocorrência da doença nas chamadas áreas de transição, na qual se inclui Minas Gerais. Estudos realizados em municípios de Minas Gerais, em 2004 e 2005, indicavam conhecimento deficiente sobre a FA entre a população e baixas coberturas vacinais. Maior incidência no verão; coberturas vacinais inadequadas; reservatórios do vírus ao longo das matas ciliares de rios; epizootias; deslocamento de pessoas de regiões diversas para áreas de risco; presença de vetores transmissores. Conclusões: estes resultados sugerem medidas imediatas de prevenção:intensificação vacinal local e de viajantes; intensificação da vigilância epidemiológica, entomológica e de primatas; informes à população sobre a doença, eficácia e necessidade de vacinação.
This study evaluates the mortality and incidence of Yellow Fever (FA/YF) between 2001 and 2006, especially in the Minas Gerais State. We analyze the available data for tabulation of the Information System of Agravos Notification (SINAN), available on the website(http://dtr2004.saude.gov.br/sinanweb/novo/). The rates of incidence and lethality of each State were compared and the municipalities where YF/FA infections occurred were mapped. The results reflect a gradual increase in the occurrence of the disease on the so called areas of transition, which includes Minas Gerais. Studies in Minas Gerais municipalities in 2004 and 2005 showed poor knowledge of the FA/YF among the population and low vaccine roofs. Increased incidence in the summer; inadequate vaccine roofing; reservoirs of the virus over the jungles gallery of rivers; livestock epidemics, displacement of people from various regions to risk areas, and presence of transmitter vectors, pointed out immediate prevention measures: stepping immunization and local travelers; stepping up epidemiological surveillance, entomological and primates; inform the population about the disease, effectiveness and need for vaccination.
Asunto(s)
Humanos , Fiebre Amarilla/epidemiología , Notificación de Enfermedades , Vacuna contra la Fiebre Amarilla , Aedes , Brasil , Estudios Retrospectivos , Fiebre Amarilla/prevención & control , Vectores de EnfermedadesRESUMEN
Em janeiro de 2000, a Secretaria Municipal de Saúde de Belo Horizonte, Estado de Minas Gerais, Brasil, realizou um estudo soro epidemiológico Inquérito de Soro prevalência do Dengue no Município de Belo Horizonte (ISDBH) com o objetivo de determinar e quantificar a soro positividade da infecção pelo vírus do dengue no Município. Este artigo apresenta a análise da infecção nos Distritos Sanitários pesquisados, em amostra probabilística de 627 indivíduos. A prevalência global de infecção foi de 23,3 por cento, com 95 por cento de nível de confiança. Dos soropositivos, 17,9 por cento foram infectados pelos sorotipos DEN-1 e DEN-2, 4,6 por cento somente pelo DEN-1 e 0,8 por cento somente pelo DEN-2. Indivíduos soropositivos, quando comparados aos soronegativos, eram mais freqüentemente moradores dos Distritos Sanitários Leste e de Venda Nova, não mudaram de Município e/ou bairro e/ou casa e moravam em edificações horizontais. Baixa renda associou-se à maior soro positividade, assim como habitações horizontais relacionaram-se à infestação de vetores e a falta de mobilidade espacial do indivíduo associou-se com a alta taxa de infecção.
Asunto(s)
Humanos , Masculino , Femenino , Dengue , Estudios SeroepidemiológicosRESUMEN
Foi realizado inquérito nutricional em amostra de 803 crianças de 0 a 6 anos, dos municípios de Inhaúma (distante cerca de 80 km da capital do Estado) e Datas, no Vale do Jequitinhonha (a 280 km de Belo Horizonte), no decorrer dos meses de março e abril de 1999. Após exclusäo dos registros com problemas foram avaliadas 339 crianças em Inhaúma (50,82 por cento da populaçäo estudada) e 433 crianças em Datas (51,20 por cento da populaçäo estudada). Em ambos os municípios, o estudo constou da mediçäo de peso e estatura das crianças residentes nas zonas urbana e rural, separadamente. A análise dos dados mostrou que, em Inhaúma, 17,7 por cento das crianças menores de 6 anos estavam abaixo do percentil 10, para o índice peso/idade e, em Datas, este índice foi de 30,2 por cento, caracterizando uma situaçäo de estado nutricional daquela faixa etária bem mais grave de um município em relaçäo ao outro. Já a relaçäo rural/urbana dentro dos municípios näo mostrou diferença significativa (Datas: rural - 30,1 por cento, urbana - 30,4 por cento e Inhaúma: rural - 14,9 por cento, urbana - 18,3 por cento).