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Dengue cases rose to record levels during 2023-2024. We investigated dengue in Valle del Cauca, Colombia, to determine if specific virus serotypes or lineages caused its large outbreak. We detected all 4 serotypes and multiple lineages, suggesting that factors such as climatic conditions were likely responsible for increased dengue in Colombia.
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Vírus da Dengue , Dengue , Surtos de Doenças , Sorogrupo , Colômbia/epidemiologia , Humanos , Dengue/epidemiologia , Dengue/virologia , Vírus da Dengue/genética , Vírus da Dengue/classificação , Filogenia , História do Século XXIRESUMO
Contexto e objetivo: A transmissão de doenças por mosquitos afeta a população e a economia de todo o mundo. Há um número considerável de doenças que podem ser transmitidas por mosquitos, com destaque para a malária e a dengue, endêmica em regiões tropicais. Evidentemente, medidas preventivas são imprescindíveis para a redução da transmissão. Avaliar as evidências de efetividade das telas de proteção com e sem inseticida para prevenção de doenças transmitidas por mosquitos. Métodos: Trata-se de sinopse baseada em evidências. Procedeu-se à busca por estudos que associavam o uso de telas de proteção contra mosquitos à redução do contágio de doenças transmitidas por mosquitos em três bases de dados: PubMed (1966-2024), Portal BVS (1982-2024) e Epistemonikos (2024) e também no metabuscador de evidências TRIP DATABASE (2024). O desfecho de análise envolveu a efetividade das telas de proteção na redução de doenças transmitidas por mosquitos. Resultados: Foram encontradas 307 citações. Seis estudos (1 revisão sistemática e 5 ensaios clínicos) foram incluídos. Discussão: A maioria dos estudos envolveu a colocação de telas de proteção com inseticida, havendo evidência de alta certeza para redução de mortalidade por malária e redução na entrada de mosquitos nas habitações, mesmo com redes sem inseticida. Conclusões: Embora não haja robustez na evidência da efetividade das telas de proteção sem inseticidas contra mosquitos transmissores de doenças, o que demanda a necessidade de realização de novos estudos prospectivos, parece lícita e benéfica a utilização de telas de proteção em regiões endêmicas para doenças transmitidas por esses vetores.
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Revisão , Prática Clínica Baseada em Evidências , Dengue , Malária , CulicidaeRESUMO
Dengue is a disease with a high-impact on public health worldwide. Many researches have focused on the cell receptors involved in its pathogenesis. The role of soluble isoforms of DC-SIGN (Dendritic Cell-Specific ICAM-3 Grabbing Non-integrin) receptor in the process of Dengue Virus (DENV) infection is not well understood. This work proposes to evaluate changes in the infection process of Immature Dendritic Cells (iDCs) by DENV in the presence of DC-SIGN recombinant soluble isoforms 8, 10, and 12. The recombinant isoforms were built by heterologous expression, the DENV-2 was multiplied in the Aedes albopictus C6/36 cells and quantified in BHK-21 cells, and the iDCs were produced from the THP-1 strain. Infection assays were performed in the presence of iDCs, DENV-2, and isoforms 8, 10, and 12 separately at 25, 50 and 100 ng/mL. The final viral load was estimated by qPCR and statistical analysis was performed by Kruskal-Wallis and ANOVA tests. The iDC profile was confirmed by increasing expression of CD11c, CD86, and CD209 surface markers and maintaining CD14 expression. Infection assays demonstrated a 23-fold increase in DENV viral load in the presence of isoforms 8 and 10 at 100 ng/mL compared to the viral control (p < 0.05), while isoform 12 did not alter the viral load. It was possible to conclude that at 100 ng/mL isoforms (8 and 10) can interact with DENV, increasing viral infection, and potentially acting as opsonins.
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Introducción: Los brotes recurrentes de dengue subrayan la necesidad de abordajes más efectivos en la prevención y control de vectores. A menudo, las intervenciones se centran en un enfoque biomédico y de promoción de la salud desde un enfoque individual, sin integrar factores socioambientales ni ser evaluados científicamente Objetivo: Evaluar el impacto de la recolección de residuos domésticos de gran tamaño sobre potenciales criaderos de mosquitos transmisores del dengue en Asunción, Paraguay durante los años 2017 a 2021. Material y métodos: Estudio cuasiexperimental, longitudinal, donde se encuestaron 350 hogares, como línea de base durante el 2017 y una línea de cierre en 108 hogares en 2021. Se utilizó el método de Diferencia en Diferencia (DID) para comparar la presencia de criaderos antes y después de la intervención en 43 hogares intervenidos y 65 no intervenidos. Resultados: La recolección diferenciada fue utilizada principalmente por aquellos hogares que tenían una gran cantidad de residuos sólidos de gran tamaño, pero no para deshacerse de todos estos objetos, sino sólo de una parte (DID de -52% en el número total de criaderos y DID de 1% en número de hogares con criaderos). Encontramos una reducción significativa en el número de total de criaderos de gran tamaño, pero no observamos diferencias en el número total de hogares con criaderos. Factores subjetivos, como la creencia de que los objetos en desuso podrían llegar a ser útiles en el futuro explicaban en gran medida su presencia en los hogares, incluso con el servicio disponible. Conclusiones: El enfoque de la gestión municipal en los residuos voluminosos puede contribuir a la prevención del dengue por el hecho de que no constituyen residuos de generación rápida en los hogares, y su eliminación puede tener un impacto relativamente duradero. El factor subjetivo relacionado con la presencia de estos criaderos en los hogares debe ser objeto de mayores estudios.
Introduction: Recurrent dengue outbreaks underscore the need for more effective approaches to vector prevention and control. Often, interventions focus on a biomedical and health promotion approach from an individual approach, without integrating socio-environmental factors or being scientifically evaluated. Objetive: To evaluate the impact of large household waste collection on potential breeding sites of dengue-transmitting mosquitoes in Asuncion, Paraguay during the years 2017 to 2021. Material and methods: Quasi-experimental, longitudinal study, where 350 households were surveyed, as a baseline during 2017 and a closing line in 108 households in 2021. The Difference-in-Difference (DID) method was used to compare the presence of breeding sites before and after the intervention in 43 intervened and 65 non-intervened households. Results: Differentiated collection was mainly used by those households that had a large amount of large solid waste, but not to dispose of all these objects, but only part of them (DID of -52% in the total number of breeding sites and DID of 1% in the number of households with breeding sites). We found a significant reduction in the total number of large breeding sites but did not observe differences in the total number of households with breeding sites. Subjective factors, such as the belief that disused objects could become useful in the future, were largely responsible for the reduction in the number of large breeding sites. Conclusions: The municipal management approach to bulky waste can contribute to dengue prevention because it does not constitute rapidly generated waste in households, and its disposal can have a relatively long-lasting impact. The subjective factors related to the presence of these breeding sites in households warrant further study.
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BACKGROUND: Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial-temporal impact of Wolbachia interventions on dengue incidence using a large battery of quasi-experimental methods and assesses each method's validity. METHODS: A systematic search for Wolbachia intervention data was conducted via PUBMED. Efficacy was reassessed using commonly-used quasi-experimental approaches with extensive robustness checks, including geospatial placebo tests and a simulation study. Intervention efficacies across multiple study sites were computed using high-resolution aggregations to examine heterogeneities across sites and study periods. We further designed a stochastic simulation framework to assess the methods' ability to estimate intervention efficacies (IE). RESULTS: Wolbachia interventions in Singapore, Malaysia, and Brazil significantly decreased dengue incidence, with reductions ranging from 48.17% to 69.19%. IEs varied with location and duration. Malaysia showed increasing efficacy over time, while Brazil exhibited initial success with subsequent decline, hinting at operational challenges. Singapore's strategy was highly effective despite partial saturation. Simulations identified Synthetic Control Methods (SCM) and its variant, count Synthetic Control Method (cSCM), as superior in precision, with the smallest percentage errors in efficacy estimation. These methods also demonstrated robustness in placebo tests. CONCLUSIONS: Wolbachia interventions exhibit consistent protective effects against dengue. SCM and cSCM provided the most precise and robust estimates of IEs, validated across simulated and real-world settings.
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Aedes , Dengue , Wolbachia , Wolbachia/fisiologia , Dengue/prevenção & controle , Dengue/epidemiologia , Animais , Aedes/microbiologia , Aedes/virologia , Humanos , Brasil/epidemiologia , Singapura/epidemiologia , Malásia/epidemiologia , Incidência , Controle de Mosquitos/métodos , Mosquitos Vetores/microbiologia , Simbiose , Controle Biológico de Vetores/métodos , Controle Biológico de Vetores/estatística & dados numéricosRESUMO
The number of dengue cases has increased dramatically in recent years. In Latin America, the number of cases and deaths in 2023 was the highest ever recorded. We report on a patient who had been infected with dengue virus during his stay in Costa Rica in September 2023, and developed the disease after returning to Japan. Plasma obtained from the patient was used for diagnosis and dengue virus serotyping by real-time PCR. The nucleotide sequence of the envelope region of dengue virus was then determined by the direct sequencing method, and this sequence was used for phylogenetic analyses. The patient was found to be infected with dengue virus type 3 genotype III. The sequence from the present case was more homologous with sequences registered in Florida, USA, associated with travel to Cuba in 2022 than with sequences registered in Costa Rica 10 years ago. The Pan American Health Organization reported that only dengue virus type 1 and 2 cases were reported in Costa Rica in 2019-2021, whereas dengue virus type 3 and 4 cases started being reported in 2022. In 2023, the reported numbers of cases with dengue virus types 3 and 4 exceeded those of dengue virus types 1 and 2. In addition, regional differences in endemic strains have been observed in Costa Rica. Our findings suggest that the dengue virus type 3 that infected the patient was more likely an influx of a strain that had been circulating in Caribbean countries such as Cuba in recent years, rather than a re-emergence of an indigenous virus in Costa Rica. The serotypes of dengue virus prevalent in Costa Rica have been changing since 2022. All four serotypes were prevalent in 2023, with a particularly sharp increase in the number of cases of dengue virus types 3 and 4. Future monitoring and surveillance are essential because changes in endemic serotypes can cause antibody-dependent enhancement, which can lead to severe dengue disease presentations.
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Introduction: Human Erythrovirus (parvovirus) B19 infection can produce symptoms similar to those produced by Dengue, Chikungunya, and Zika viruses, making clinical diagnosis difficult. The importance of erythrovirus B19 in human pathology has been increased and reported in numerous studies published globally. Methods: The B19V infection was investigated by real-time PCR in sera samples from patients with signs and symptoms related to classic arboviral symptoms. This study was conducted to provide information on the genetic diversity of Human Erythrovirus B19 (B19V) circulating in the state of Mato Grosso do Sul, Midwest region of Brazil, from 2017 to 2022. A total of 773 sera samples of patients with negative diagnostic results for Dengue, Chikungunya, and Zika, during the study period were analyzed. Results: Erythrovirus DNA was found in 10.6% (82/773) of patients, among them 10 were pregnant women. Four samples were completely sequenced, and the other five partially, to genotype by phylogenetic reconstruction. All samples belong to worldwide dispersed genotype 1, subgenotype 1a. Discussion: The findings of the study demonstrate the importance of including B19V in differential laboratory diagnosis for epidemiological purposes and appropriate patient management. The diagnosis for B19V should be performed, particularly among pregnant women, immunocompromised patients, and individuals with hemolytic diseases, given that the infection is more severe in these cases.
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Background: Dengue fever (DF) is a mosquito-borne illness with substantial economic and societal impact. Understanding laboratory trends of hospitalized Dominican Republic (DR) pediatric patients could help develop screening procedures in low-resourced settings. We sought to describe laboratory findings over time in DR children with DF and DF severity from 2018 to 2020. Methods: Clinical information was obtained prospectively from recruited children with DF. Complete blood count (CBC) laboratory measures were assessed across Days 1-10 of fever. Participants were classified as DF-negative and DF-positive and grouped by severity. We assessed associations of DF severity with demographics, clinical characteristics, and peripheral blood studies. Using linear mixed-models, we assessed if hematologic values/trajectories differed by DF status/severity. Results: A total of 597 of 1101 with a DF clinical diagnosis were serologically evaluated, and 574 (471 DF-positive) met inclusion criteria. In DF, platelet count and hemoglobin were higher on earlier days of fever (p < = 0.0017). Eighty had severe DF. Severe DF risk was associated with thrombocytopenia, intraillness anemia, and leukocytosis, differing by fever day (p < = 0.001). Conclusions: In a pediatric hospitalized DR cohort, we found marked anemia in late stages of severe DF, unlike the typically seen hemoconcentration. These findings, paired with clinical symptom changes over time, may help guide risk-stratified screenings for resource-limited settings.
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Vírus da Dengue , Dengue , Humanos , República Dominicana/epidemiologia , Dengue/epidemiologia , Dengue/sangue , Dengue/virologia , Dengue/diagnóstico , Masculino , Feminino , Pré-Escolar , Contagem de Células Sanguíneas , Lactente , Vírus da Dengue/isolamento & purificação , Criança , Epidemias , Anemia/epidemiologia , Anemia/sangue , Trombocitopenia/epidemiologia , Trombocitopenia/sangue , Trombocitopenia/virologia , Estudos ProspectivosRESUMO
Despite successful vaccination efforts, the emergence of new SARS-CoV-2 variants poses ongoing challenges to control COVID-19. Understanding humoral responses regarding SARS-CoV-2 infections and their impact is crucial for developing future vaccines that are effective worldwide. Here, we identified 41 immunodominant linear B-cell epitopes in its spike glycoprotein with an SPOT synthesis peptide array probed with a pool of serum from hospitalized COVID-19 patients. The bioinformatics showed a restricted set of epitopes unique to SARS-CoV-2 compared to other coronavirus family members. Potential crosstalk was also detected with Dengue virus (DENV), which was confirmed by screening individuals infected with DENV before the COVID-19 pandemic in a commercial ELISA for anti-SARS-CoV-2 antibodies. A high-resolution evaluation of antibody reactivity against peptides representing epitopes in the spike protein identified ten sequences in the NTD, RBD, and S2 domains. Functionally, antibody-dependent enhancement (ADE) in SARS-CoV-2 infections of monocytes was observed in vitro with pre-pandemic Dengue-positive sera. A significant increase in viral load was measured compared to that of the controls, with no detectable neutralization or considerable cell death, suggesting its role in viral entry. Cross-reactivity against peptides from spike proteins was observed for the pre-pandemic sera. This study highlights the importance of identifying specific epitopes generated during the humoral response to a pathogenic infection to understand the potential interplay of previous and future infections on diseases and their impact on vaccinations and immunodiagnostics.
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Anticorpos Antivirais , COVID-19 , Reações Cruzadas , Vírus da Dengue , Epitopos de Linfócito B , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus , Glicoproteína da Espícula de Coronavírus/imunologia , Humanos , Reações Cruzadas/imunologia , SARS-CoV-2/imunologia , COVID-19/imunologia , COVID-19/virologia , Anticorpos Antivirais/imunologia , Anticorpos Antivirais/sangue , Epitopos de Linfócito B/imunologia , Vírus da Dengue/imunologia , Dengue/imunologia , Dengue/virologia , Anticorpos Facilitadores/imunologia , Pandemias , Epitopos Imunodominantes/imunologiaRESUMO
Neglected diseases such as leishmaniasis, dengue, and chikungunya pose significant challenges to public health due to their high prevalence and wide geographic distribution in the Southern Cone region. These diseases are transmitted through insect bites, which serve as natural reservoirs. While their imaging findings are not always conclusive, they can play a crucial role in the diagnosis and monitoring. This review provides a concise overview of the clinical manifestations, epidemiological context, and imaging findings associated with these diseases. The primary purpose of this article is to share our experience and offer valuable insights into the use of imaging for the diagnosis and monitoring of patients suspected to have these diseases.
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BACKGROUND: Nonspecific acute tropical febrile illnesses (NEATFI) are common in the Latin American tropics. Dengue, Chikungunya, Zika, Mayaro, and Usutu, among others, can coexist in the American tropics. This study aimed to surveil the arboviruses that cause| acute febrile syndrome in patients in the Meta department, Colombia. METHODS: Between June 2021 and February 2023, an epidemiological surveillance study was conducted in the Llanos of the Meta department in Eastern Colombia. RESULTS: One hundred patients in the acute phase with typical prodromal symptoms of NEATFI infection who attended the emergency department of the Villavicencio Departmental Hospital were included. ELISA tests were performed for Dengue, Usutu, Chikungunya, and Mayaro. RT-qPCR was performed to detect the arboviruses Usutu, Dengue, Zika, Mayaro, and Oropouche. The seroprevalence for the Chikungunya, Mayaro, and Usutu viruses was 41 % (28/68), 40 % (27/67), and 62 % (47/75), respectively. Seroconversion for Chikungunya was observed in one patient; two seroconverted to Mayaro and one to Usutu. The NS5 gene fragment of the Usutu virus was detected in nine febrile patients. RT-qPCR of the remaining arboviruses was negative. The clinical symptoms of the nine Usutu-positive patients were very similar to those of Dengue, Chikungunya, Zika, and Mayaro infections. CONCLUSIONS: The pervasive detection of unexpected viruses such as Usutu and Mayaro demonstrated the importance of searching for other viruses different from Dengue. Because Usutu infection and Mayaro fever have clinical features like Dengue, a new algorithm should be proposed to improve the accuracy of acute tropical fevers.
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Infecções por Arbovirus , Arbovírus , Monitoramento Epidemiológico , Humanos , Colômbia/epidemiologia , Masculino , Feminino , Arbovírus/isolamento & purificação , Arbovírus/genética , Infecções por Arbovirus/epidemiologia , Infecções por Arbovirus/virologia , Infecções por Arbovirus/diagnóstico , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Febre/epidemiologia , Febre/virologia , Criança , Anticorpos Antivirais/sangue , Pré-Escolar , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/diagnóstico , Idoso , Ensaio de Imunoadsorção EnzimáticaRESUMO
BACKGROUND: To assess whether the 'economic boom' in the tropical seaport city of Barranquilla improved tapped water supplies to socio-economically poor neighbourhoods resulting in: (1) their reduced use for domestic water-storage in large (> 1,000-litre) custom-made cement tanks which are their principal Aedes aegypti breeding sites and (2) their pupae/person index (PPI) values to below their established 0.5-1.5 PPI arbovirus transmission-threshold value, compared to matched neighbourhoods in the: (a) pre-economic boom (2004) period in Barranquilla and (b) economically-neglected seaport city of Buenaventura. METHODS: The simple, accurate and robust water surface sweep-net/calibration factor or total count methods were used to determine the total Ae. aegypti pupae numbers in greater or less than 20-litre water-holding container types located 'inside' or 'outside' these neighbourhood premises. The women residents also participated in questionnaire-based responses about their domestic water supplies, water-storage and maintenance and mosquito life stages and disease transmission knowledge, to subsequently plan appropriate resident education programmes. Microsoft Excel 8.0 with OpenEpi was used to determine the samples sizes and the statistical values. RESULTS: Tapped water supplies to the three poor Barranquilla neighbourhoods were dramatically increased from 2004 to 2023 resulting in their residents significantly reducing their: (a) large cement water-storage tanks from 1 per 6.9 (2004) to 1 per 31.2 (2020) premises (z = 10.5: p = 0) and (b) PPI values to 0.16, 0.19 and 0.53 (mean: 0.29: 95% CI ± 0.4) in each study neighbourhood. In contrast, tapped water supplies remained inadequate in the Buenaventura neighborhoods, thereby resulting in their continued use of many large (> 1,000-litre) water-storage containers (Barranquilla: 1 per 31.2 and Buenaventura: 1 per 1.5 premises: z = - 9.26: p = 0), with unacceptably high 0.81, 0.88 and 0.99 PPI values in each study neighbourhood (mean 0.89: 95% CI ± 0.12). CONCLUSIONS: Improved tapped water supplies resulted in reduced numbers of large custom-made stoneware water-containers, as are employed by poor residents throughout the world, as well as their Ae. aegypti PPI transmission threshold values which, together with appropriate residents' education programmes, are also urgently to reduce to prevent/reduce Ae. aegypti transmitted human diseases globally.
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Aedes , Abastecimento de Água , Animais , Humanos , Feminino , Mosquitos Vetores , Infecções por Arbovirus/transmissão , Pupa , Dengue/transmissão , Controle de Mosquitos/métodos , Colômbia , Adulto , Características de Residência/estatística & dados numéricosRESUMO
It is estimated that there are over 500 species of arboviruses worldwide, with more than 150 of them directly associated with human diseases, the majority of which are zoonotic. Among the main arboviruses circulating in Brazil, dengue, Zika, and chikungunya stand out, all transmitted through a common vector, Aedes aegypti. Given this scenario, the development and implementation of more efficient surveillance strategies become urgent. This study aims to compare and evaluate the efficiency of beetroot peel, Beta vulgaris, as an attractant for Ae. aegypti oviposition under field conditions in the municipality of Agrestina, State of Pernambuco, Brazil. Beetroot peel extract is a cheap and accessible source of geosmin, which holds significant potential as an attractant for mosquitoes due to its resemblance to microbial volatiles found in water bodies rich in organic material. During the study period (November 2023 to April 2024), 40 traps were set in each neighborhood, with 20 of each attractant. Two traps were used per property, one following the traditionally used model (beer yeast infusion) and another containing beetroot peel. Overall, in both analyzed neighborhoods (Campo Novo and Cohab), beetroot peel appeared to be a more efficient attractant for the oviposition of culicids. Beetroot peel showed the highest values in egg abundance and in the analyzed indices.
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Aedes , Beta vulgaris , Controle de Mosquitos , Mosquitos Vetores , Oviposição , Animais , Brasil , Beta vulgaris/química , Feminino , ArbovírusRESUMO
Este artigo tem por objetivo identificar os fatores de risco de morte por dengue no Brasil. Para isso, por meio do Sistema de Informação de Agravos de Notificação (SINAN) e do Morbidade Hospitalar do Sistema Único de Saúde (SIH/SUS), foram levantados os dados referentes às mortes por dengue ocorridas no Brasil entre 1 de janeiro de 2014 a 11 de março de 2024. A partir desses dados, foram calculados os riscos relativos para as seguintes variáveis: sexo, raça, faixa etária, escolaridade e sorotipo, adotando-se o nível de significância de 5% e o intervalo de confiança de 95%. Em relação ao sexo, os homens apresentaram maior risco de morte (RR: 1,24; IC95%: 0,760,84) em comparação às mulheres. Quanto à raça, brancos (RR: 1,18; IC 95%: 1,121,25) e amarelos (RR: 1,33; IC95%: 1,071,66) exibiram um risco significativamente maior do que as demais. Pessoas com 60 anos ou mais apresentaram risco de morte 7,74 vezes maior (RR: 7,74; IC95%: 7,388,11) em comparação às outras faixas etárias. Pessoas analfabetas ou que estudaram só até a 4a série do ensino fundamental tiveram um risco três vezes maior (RR: 3,00; IC95%: 2,793,23) do que aquelas com mais anos de estudo. O sorotipo DENV-2, por sua vez, aumentou 1,61 vezes o risco de morte (RR: 1,61; IC95%: 1,431,80) em relação aos demais sorotipos, enquanto o DENV-3 aumentou 2,94 vezes (RR: 2,94; IC95%: 1,685,15). Foi possível deduzir que sexo, raça, faixa etária, escolaridade e sorotipo são fatores de risco de morte por dengue, devendo, portanto, ser considerados na elaboração de políticas públicas de combate à dengue.
This study investigated the dengue risk death factors in Brazil by analyzing data on dengue deaths between January 1st, 2014 to March 11, 2024, registered in the SINAN and SIH/SUS databases. Relative risks were calculated for the following variables: gender, race, age group, schooling level and serotype, adopting a 5% level of significance and 95% confidence interval. Regarding gender, men had a higher death risk (RR: 1.24; 95% CI: 0.760.84) than women. Whites (RR: 1.18; 95% CI: 1.121.25) and Asians (RR: 1.33; 95% CI: 1.071.66) showed a significantly higher risk than other ethnicities. People with 60 years of age or over presented death risk 7.74 times higher (RR: 7.74; IC 95%: 7.388.11) compared with other age groups. Illiterates or people with complete primary education had a 3 times higher risk (RR: 3.00; 95% CI: 2.793.23) than those with more years of study. The serotype DENV-2 increased in 1.61 times the risk of death (RR: 1.61; 95% CI: 1.431.80) compared with other serotypes, whereas DENV-3 serotype increased the risk by 2.94 times (RR: 2.94; 95% CI: 1.685.15). Gender, race, age group, schooling level and serotype are dengue death risk factors, thus they should be considered when elaborating public policies to fight the disease.
Este estudio tuvo por objetivo identificar los factores de riesgo de muerte por dengue en Brasil. Para ello, se recogieron datos de muertes por dengue en Brasil entre el 1 de enero de 2014 y el 11 de marzo de 2024 del Sistema de Información de Agravios de Notificación (SINAN) y del Sistema de Morbilidad Hospitalaria del Sistema Único de Salud (SIH/SUS). A partir de estos datos, se calcularon los riesgos relativos para las siguientes variables: sexo, raza, grupo de edad, nivel de estudios y serotipo, adoptando un nivel de significación del 5% y un intervalo de confianza del 95%. Con relación al sexo, los hombres presentaron un mayor riesgo de muerte (RR: 1,24; IC 95%: 0,76-0,84) en comparación con las mujeres. En cuanto a la raza, los blancos (RR: 1,18; IC 95%: 1,12-1,25) y los pardos (RR: 1,33; IC 95%: 1,07-1,66) tenían un riesgo significativamente mayor que los demás. Las personas de 60 años o más tenían un riesgo de muerte 7,74 veces mayor (RR: 7,74; IC 95%: 7,38-8,11) que otros grupos de edad. Las personas analfabetas o con hasta 4.º grado de la primaria tenían un riesgo 3 veces mayor (RR: 3,00; IC 95%: 2,79-3,23) que las que tenían más años de escolaridad. El serotipo DENV-2 aumentó el riesgo de muerte en 1,61 veces (RR: 1,61; IC 95%: 1,43-1,80) en comparación con los demás serotipos, mientras que el DENV-3 lo aumentó 2,94 veces (RR: 2,94; IC 95%: 1,68-5,15). El sexo, la raza, el grupo de edad, el nivel de estudios y el serotipo son factores de riesgo de muerte por dengue, por lo tanto, deben tenerse en cuenta en la elaboración de políticas públicas de lucha contra el dengue.
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BACKGROUND AND OBJECTIVES: In Brazil, urban arboviruses, such as dengue virus (DENV), Zika virus (ZIKV) and chikungunya virus (CHIKV), constitute a major public health problem, and due to their endemicity and asymptomatic cases, they pose a potential threat to blood donations. Rio de Janeiro (RJ), Brazil, has been impacted by extensive DENV epidemics over the last 30 years and, after 2015, by CHIKV and ZIKV. MATERIALS AND METHODS: Urban arboviruses DENV, ZIKV and CHIKV were investigated in blood donations (n = 778) at the State Institute of Hematology, HEMORIO (RJ) from 2019 to 2022 by serological and molecular methods. RESULTS: An overall arbovirus exposure was observed in 26.1% of the blood donations. Anti-DENV IgM was detected in 4.0% of samples and two donations were DENV NS1 positive. Positive anti-CHIKV IgM was observed in 4.7% of the donations. Co-detection of anti-CHIKV IgM and anti-DENV IgM was observed in 1.0% of donors, and CHIKV prevalence was 21.3%. All blood donations tested were negative for the DENV, ZIKV and CHIKV RNA. CONCLUSION: IgM seroprevalence to the arboviruses analyzed here is an indicator of recent infection in asymptomatic donors, showing that the population of blood donors can be a vehicle for new infections, especially during epidemic periods.
Assuntos
Doadores de Sangue , Vírus da Dengue , Infecção por Zika virus , Humanos , Doadores de Sangue/estatística & dados numéricos , Brasil/epidemiologia , Feminino , Masculino , Adulto , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/sangue , Zika virus , Imunoglobulina M/sangue , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/sangue , Dengue/epidemiologia , Dengue/sangue , Estudos Soroepidemiológicos , Anticorpos Antivirais/sangue , Doenças Endêmicas , Pessoa de Meia-Idade , Infecções por Arbovirus/epidemiologia , Infecções por Arbovirus/sangue , Arbovírus , Vírus Chikungunya , Adolescente , Adulto Jovem , Doação de SangueRESUMO
BACKGROUND: Obesity is on the rise globally in adults and children, including in tropical areas where diseases such as dengue have a substantial burden, particularly in children. Obesity impacts risk of severe dengue disease; however, the impact on dengue virus (DENV) infection and dengue cases remains an open question. METHODS: We used 9 years of data from 5940 children in the Pediatric Dengue Cohort Study in Nicaragua to determine whether pediatric obesity is associated with increased susceptibility to DENV infection and symptomatic presentation. Analysis was performed using generalized estimating equations adjusted for age, sex, and preinfection DENV antibody titers. RESULTS: From 2011 to 2019, children contributed 26 273 person-years of observation, and we observed an increase in prevalence of overweight (from 12% to 17%) and obesity (from 7% to 13%). There were 1682 DENV infections and 476 dengue cases in the study population. Compared with participants with normal weight, participants with obesity had higher odds of DENV infection (adjusted odds ratio [aOR], 1.21; 95% confidence interval [CI]: 1.03-1.42) and higher odds of dengue in DENV-infected individuals (aOR, 1.59; 95% CI: 1.15-2.19). Children with obesity infected with DENV showed increased odds of presenting fever (aOR, 1.46; 95% CI: 1.05-2.02), headache (aOR, 1.51; 95% CI: 1.07-2.14), and rash (aOR, 2.26; 95% CI: 1.49-3.44) when compared with children with normal weight. CONCLUSIONS: Our results indicate that obesity is associated with increased susceptibility to DENV infection and dengue cases in children, independent of age, sex, and preinfection DENV antibody titers.
Assuntos
Vírus da Dengue , Dengue , Obesidade Infantil , Humanos , Nicarágua/epidemiologia , Masculino , Feminino , Criança , Dengue/epidemiologia , Dengue/complicações , Pré-Escolar , Estudos de Coortes , Obesidade Infantil/epidemiologia , Obesidade Infantil/complicações , Adolescente , Prevalência , Fatores de Risco , LactenteRESUMO
In response to the 2015 Zika virus (ZIKV) epidemic that occurred in Brazil, numerous commercial serological assays have been developed for clinical and research applications. Diagnosis of recent infection in pregnant women remains challenging. Having standardized, comparative studies of ZIKV tests is important for implementing optimal diagnostic testing and disease surveillance. This is especially important for serology tests used to detect ZIKV infection given that antibodies against ZIKV can cross-react with other arboviruses in the same virus family, such as dengue virus (DENV), yellow fever virus (YFV) and West Nile virus (WNV). We looked at the sensitivity and specificity of tests detecting ZIKV antibodies (IgM, IgG) from multiple manufacturers using panels of samples previously collected with known exposure to ZIKV and other arboviruses. We found that performance of the IgM tests was highly variable, with only one test (Inbios 2.0 IgM capture ELISA) having both high sensitivity and specificity. All IgG tests showed good sensitivity; however, specificity was highly variable, with some assays giving false-positive results on samples infected by another flavivirus. Overall, the results confirmed that accurate ZIKV antibody testing is challenging, especially in specimens from regions endemic for multiple other flaviviruses, and highlight the importance of available and suitable reference samples to evaluate ZIKV diagnostics.
Assuntos
Anticorpos Antivirais , Imunoglobulina G , Imunoglobulina M , Sensibilidade e Especificidade , Testes Sorológicos , Infecção por Zika virus , Zika virus , Humanos , Zika virus/imunologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/imunologia , Infecção por Zika virus/sangue , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Testes Sorológicos/métodos , Testes Sorológicos/normas , Imunoglobulina M/sangue , Imunoglobulina G/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Ensaio de Imunoadsorção Enzimática/normas , Reações Cruzadas/imunologia , Feminino , Gravidez , BrasilRESUMO
BACKGROUND: Dengue fever remains a significant public health challenge in tropical and subtropical regions, with its transmission dynamics being influenced by both environmental factors and human mobility. The Dominican Republic, a biodiversity hotspot in the Caribbean, has experienced recurrent dengue outbreaks, yet detailed understanding of the virus's transmission pathways and the impact of climatic factors remains limited. This study aims to elucidate the recent transmission dynamics of the dengue virus (DENV) in the Dominican Republic, utilizing a combination of genomic sequencing and epidemiological data analysis, alongside an examination of historical climate patterns. METHODS: We conducted a comprehensive study involving the genomic sequencing of DENV samples collected from patients across different regions of the Dominican Republic over a two-year period. Phylogenetic analyses were performed to identify the circulation of DENV lineages and to trace transmission pathways. Epidemiological data were integrated to analyze trends in dengue incidence and distribution. Additionally, we integrated historical climate data spanning several decades to assess trends in temperature and their potential impact on DENV transmission potential. RESULTS: Our results highlight a previously unknown north-south transmission pathway within the country, with the co-circulation of multiple virus lineages. Additionally, we examine the historical climate data, revealing long-term trends towards higher theoretical potential for dengue transmission due to rising temperatures. CONCLUSION: This multidisciplinary study reveals intricate patterns of dengue virus transmission in the Dominican Republic, characterized by the co-circulation of multiple DENV lineages and a novel transmission pathway. The observed correlation between rising temperatures and increased dengue transmission potential emphasizes the need for integrated climate-informed strategies in dengue control efforts. Our findings offer critical insights for public health authorities in the Dominican Republic and similar settings, guiding resource allocation and the development of preparedness strategies to mitigate the impacts of climate change on dengue transmission.
Assuntos
Clima , Vírus da Dengue , Dengue , Filogenia , Sorogrupo , República Dominicana/epidemiologia , Dengue/epidemiologia , Dengue/transmissão , Dengue/virologia , Humanos , Vírus da Dengue/genética , Vírus da Dengue/classificação , Surtos de DoençasRESUMO
In Brazil, Dengue, Zika and Chikungunya viruses constitute a major threat to the public health system. Simultaneous circulation of these arboviruses occurs in many regions of the world due to the expansion of transmission vectors. The infection by these arboviruses triggers similar symptoms during their acute phase. However, in some cases, severe symptoms may occur, leading to different types of disabilities and even death. In this context, considering the similarity of the symptoms, the problems caused by the infection of these arboviruses, and the increasing risk of coinfection in humans, the differential diagnosis of these infections is essential for clinical management and epidemiological investigation. Thus, this study aimed to identify, through diagnosis via Quantitative Polymerase Chain Reaction with Reverse Transcription, arbovirus coinfection in patients from the Tocantins state (Northern Brazil). A total of 495 samples were analyzed, three from which were determined to be a coinfection of Dengue and Chikungunya viruses. The data obtained here indicate the co-circulation and coinfection by Dengue and Chikungunya viruses in the Tocantins state. These results highlight the importance of monitoring the circulation of these arboviruses for the development of health actions that aim their prevention and combat, as well as their clinical and therapeutic management.