Monitoramento dos casos de arboviroses no Estado de Goiás da semana epidemiológica 01 a 06 de 2024 / Monitoring of arbovirus cases in Goiás in epidemiological week of 06 at 24 de 2024

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalies

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica de 01 a 50 de 2023 / Epidemiological bulletin: monitoring of arbovirus cases in Goiás from epidemiological week 01 to 50 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalies

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 a 44 de 2023 / Epidemiological bulletin: monitoring of arbovirus cases in Goiás from epidemiological week 01 to 44 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalies

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 a 25 de 2023 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás from the epidemiological week 01 to 25 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também é apresentado dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The epidemiological bulletin of arboviruses aims to present the epidemiological situation of cases in the state, using as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. It also presents data related to the congenital syndrome associated with Zika Virus infection, available in the Public Health Event Registration System (RESP) - Microcephaly

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 a 18 de 2023 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás from the epidemiological week 01 to 18 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, e utiliza como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também é apresentado dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The epidemiological bulletin of arboviruses aims to present the epidemiological situation of cases in the state, and uses as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. It also presents data related to Congenital Syndrome associated with Zika Virus infection, available in the Public Health Event Registration System (RESP) ­ Microcephaly

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 de 2022 até a semana epidemiológica 14 de 2023 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás from epidemiological week 01 of 2022 to epidemiological week 14 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. Este boletim uma produção mensal, com o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Adicionalmente, também é apresentado dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

The arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. This bulletin is a monthly production, with the objective of presenting the epidemiological situation of the cases in the state, using as a source of data the records of suspected cases and confirmed occurrences in recent years, available on Sinan Online and Sinan Net. In addition, data on the Congenital Syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) ­ Microcephaly

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 52 de 2022 até a semana epidemiológica 04 de 2023 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás from epidemiological week 52 of 2022 to epidemiological week 04 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. Este boletim é uma produção mensal, com o objetivo de apresentar a situação epidemiológica dos casos no estado de Goiás, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Adicionalmente, foi apresentado dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

The arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. This bulletin is a monthly production, with the objective of presenting the epidemiological situation of the cases in the state of Goiás, using the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. Additionally, data on the Congenital Syndrome associated with Zika Virus infection was presented, available on the Public Health Event Registration System (RESP) ­ Microcephaly

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás até a semana epidemiológica 47 de 2022 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás until epidemiological week 47 of 2022

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses é uma produção mensal, objetivando apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The epidemiological bulletin of arboviruses is a monthly production, aiming to present the epidemiological situation of cases in the state, using as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás até a semana epidemiológica 50 de 2022 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás until epidemiological week 50 of 2022

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses é uma produção mensal, objetivando apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Adicionalmente, apresentamos dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The epidemiological bulletin of arboviruses is a monthly production, aiming to present the epidemiological situation of cases in the state, using as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. Additionally, we present data related to Congenital Syndrome associated with Zika Virus infection, available in the Event Registration System in Public Health (RESP) ­ Microcephaly

Plano de contingência para controle arboviroses - 2023/2024 (Dengue - Chikungunya - Zika) / Contingency Plan for Arbovirus Control - 2023/2024 (Dengue - Chikungunya - Zika)

O quadro epidemiológico atual das arboviroses no estado de Goiás caracteriza-se pela ampla distribuição do Aedes aegypti em todas as regiões, com circulação simultânea de sorotipos virais 1 e 2 da dengue e confirmação de casos de zika e chikungunya, objetivando a prevenção e controle de epidemias das arboviroses: dengue, chikungunya e zika a Secretaria de Estado da Saúde de Goiás apresenta o Plano de contingência para o controle de arboviroses 2023 - 2024

The current epidemiological picture of arboviruses in the state of Goiás is characterized by the wide distribution of Aedes aegypti in all regions, with simultaneous circulation of viral serotypes 1 and 2 of dengue and confirmation of cases of zika and chikungunya, aiming at the prevention and control of epidemics of arboviruses: dengue, chikungunya and zika the State Department of Health of Goiás presents the Plan of contingency for the control of arboviruses 2023 - 2024

Boletim Epidemiológico: monitoramento dos casos de arboviroses em Goiás até a semana epidemiológica 25 de 2022 / Epidemiological Bulletin: monitoring of arbovirus cases in Goiás until epidemiological week 25 of 2022

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico produção mensal, objetivando das arboviroses é uma apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Adicionalmente, apresentamos dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The monthly production epidemiological bulletin, aiming at arboviruses, is to present the epidemiological situation of cases in the state, using as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. Additionally, we present data related to Congenital Syndrome associated with Zika Virus infection, available in the Public Health Event Registration System (RESP) ­ Microcephaly

Boletim Epidemiológico: monitoramento dos casos de arboviroses em Goiás até a semana epidemiológica 22 de 2022 / Epidemiological Bulletin: monitoring of arbovirus cases in Goiás until epidemiological week 22 of 2022

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico produção mensal, objetivando das arboviroses é uma apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Adicionalmente, apresentamos dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The monthly production epidemiological bulletin, aiming at arboviruses, is to present the epidemiological situation of cases in the state, using as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. Additionally, we present data related to Congenital Syndrome associated with Zika Virus infection, available in the Public Health Event Registration System (RESP) ­ Microcephaly

Constructing and validating a transferable epidemic risk index in data scarce environments using open data: A case study for dengue in the Philippines.

Epidemics are among the most costly and destructive natural hazards globally. To reduce the impacts of infectious disease outbreaks, the development of a risk index for infectious diseases can be effective, by shifting infectious disease control from emergency response to early detection and prevention. In this study, we introduce a methodology to construct and validate an epidemic risk index using only open data, with a specific focus on scalability. The external validation of our risk index makes use of distance sampling to correct for underreporting of infections, which is often a major source of biases, based on geographical accessibility to health facilities. We apply this methodology to assess the risk of dengue in the Philippines. The results show that the computed dengue risk correlates well with standard epidemiological metrics, i.e. dengue incidence (p = 0.002). Here, dengue risk constitutes of the two dimensions susceptibility and exposure. Susceptibility was particularly associated with dengue incidence (p = 0.048) and dengue case fatality rate (CFR) (p = 0.029). Exposure had lower correlations to dengue incidence (p = 0.193) and CFR (p = 0.162). Highest risk indices were seen in the south of the country, mainly among regions with relatively high susceptibility to dengue outbreaks. Our findings reflect that the modelled epidemic risk index is a strong indication of sub-national dengue disease patterns and has therefore proven suitability for disease risk assessments in the absence of timely epidemiological data. The presented methodology enables the construction of a practical, evidence-based tool to support public health and humanitarian decision-making processes with simple, understandable metrics. The index overcomes the main limitations of existing indices in terms of construction and actionability.

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás até a semana epidemiológica 42 de 2022 / Epidemiological bulletin: monitoring of arbovirus cases in Goiás until epidemiological week 42 of 2022

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses é uma produção mensal, objetivando apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Adicionalmente, apresentamos dados relativos à Síndrome Congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) ­ Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The epidemiological bulletin of arboviruses is a monthly production, aiming to present the epidemiological situation of cases in the state, using case records as a data source. Suspected and confirmed events in recent years, available on Sinan Online and Sinan Net. Additionally, we present data related to Congenital Syndrome associated with Zika Virus infection, available in the Public Health Event Registration System (RESP) ­ Microcephaly

Prevention and control of dengue and chikungunya in Colombia: A cost-effectiveness analysis.

BACKGROUND: Chikungunya and dengue are emerging diseases that have caused large outbreaks in various regions of the world. Both are both spread by Aedes aegypti and Aedes albopictus mosquitos. We developed a dynamic transmission model of chikungunya and dengue, calibrated to data from Colombia (June 2014 -December 2017). METHODOLOGY/PRINCIPAL FINDINGS: We evaluated the health benefits and cost-effectiveness of residual insecticide treatment, long-lasting insecticide-treated nets, routine dengue vaccination for children aged 9, catchup vaccination for individuals aged 10-19 or 10-29, and portfolios of these interventions. Model calibration resulted in 300 realistic transmission parameters sets that produced close matches to disease-specific incidence and deaths. Insecticide was the preferred intervention and was cost-effective. Insecticide averted an estimated 95 chikungunya cases and 114 dengue cases per 100,000 people, 61 deaths, and 4,523 disability-adjusted life years (DALYs). In sensitivity analysis, strategies that included dengue vaccination were cost-effective only when the vaccine cost was 14% of the current price. CONCLUSIONS/SIGNIFICANCE: Insecticide to prevent chikungunya and dengue in Colombia could generate significant health benefits and be cost-effective. Because of limits on diagnostic accuracy and vaccine efficacy, the cost of dengue testing and vaccination must decrease dramatically for such vaccination to be cost-effective in Colombia. The vectors for chikungunya and dengue have recently spread to new regions, highlighting the importance of understanding the effectiveness and cost-effectiveness of policies aimed at preventing these diseases.

Caracterización y evolución temporal de la mortalidad por zoonosis bajo declaración obligatoria, entre los años 1997 y 2018 / Characterization and temporal evolution of mortality due to zoonoses under mandatory declaration, between the years 1997 and 2018

INTRODUCCIÓN: Las zoonosis son enfermedades transmitidas desde un hospedador animal al ser humano o viceversa. En Chile, las zoonosis de Notificación Obligatoria (NO) son: brucelosis, carbunco, triquinosis, hidatidosis, leptospirosis, dengue, enfermedad de Chagas, hantavirosis y rabia. OBJETIVO: Evaluar la tendencia y caracterizar la mortalidad por zoonosis de NO en Chile entre 1997-2018. METODOLOGÍA: Estudio ecológico de la mortalidad por zoonosis de NO. Se utilizaron bases de mortalidad y población oficiales. Se describió la mortalidad relativa, general y específica, según variables sociodemográficas. Se calcularon tasas de mortalidad anuales brutas (TMb) y ajustadas (TMa, método directo). Se evaluó la tendencia temporal con modelos de regresión de Prais-Winsten. Resultados: Entre 1997 y 2018 la mortalidad por zoonosis de NO correspondió al 0,12% (2.359 muertes) de la mortalidad total, siendo las principales causas la enfermedad de Chagas (59,8%), hidatidosis (23,9%) y hantavirosis (13,8%). La TMa general disminuyó significativamente (B: -0,017; IC95%: -0,024; -0,009) al igual que hidatidosis (B: -0,011; IC95%: -0,013; -0,008), sólo hantavirosis mostró un aumento (no significativo). CONCLUSIÓN: La mortalidad por zoonosis de NO disminuyó durante el período estudiado; solo la hantavirosis mostró un aumento en su tendencia. Se sugiere enfocar estrategias para prevenir la transmisibilidad y mortalidad por hanta, así como mejorar el acceso a tratamiento para las otras zoonosis.

BACKGROUND: Zoonoses are diseases transmitted from an animal host to humans or vice versa. In Chile, the zoonoses of mandatory notification are brucellosis, anthrax, trichinosis, hydatidosis, leptospirosis, dengue, Chagas disease, hantavirosis and rabies. AIM: To assess the trend and characterize the mortality from zoonoses of mandatory notification in Chile between 1997-2018. METHODS: An official mortality and population data were used. Relative, general and specific mortality rates were described according to sociodemographic variables. Crude and adjusted annual mortality rates (direct method) were calculated. Temporal trend was evaluated with the Prais-Winsten regression model. RESULTS: Between 1997 and 2018, the mortality rate due to zoonosis of mandatory notification corresponded to 0.13% (2152 deaths) of the total mortality, being Chagas disease (59.2%), hydatidosis (24.6%) and hantavirosis (13.5%) the main causes. The general adjusted mortality rate decreased significantly (B: -0.017; IC95%: -0.024; -0.009) as did hydatidosis (B: -0.011; IC95%: -0.013; -0.008), and only hantavirosis showed an increase trend (not significant). CONCLUSION: Mortality due to zoonoses decreased during the period; only hantavirosis showed an increasing trend. It is suggested to focus on strategies to prevent contagion and mortality by hantavirosis, as well as to improve access to treatment for the other zoonoses.

A Population-Based Cohort Study on Chronic Comorbidity Risk Factors for Adverse Dengue Outcomes.

The global burden of dengue is increasing against a background of rising global prevalence of chronic noncommunicable diseases (NCDs) and an epidemiological shift of dengue toward older age groups. The contribution of NCDs toward risk for adverse clinical and healthcare utilization outcomes was assessed in a national linked-database study. About 51,433 adult dengue cases between 2014 and 2015 were assessed for outpatient and inpatient claims data in Taiwan's National Health Insurance Research Database for the 30 days after their dengue diagnosis. A multivariable logistic regression with generalized estimating equations was used to estimate the probability of adverse dengue outcomes in patients with NCDs compared with dengue patients without underlying diseases. Rheumatoid arthritis and related disease were associated with the highest risk of hospitalization after dengue diagnosis (odds ratio: 1.78; 95% CI: 1.37-2.30), followed by stroke, chronic kidney disease (CKD), liver cirrhosis, asthma, coronary artery disease, chronic obstructive pulmonary disease, diabetes, congestive heart failure, hypertension, and malignancy. Chronic kidney disease and diabetes were associated with higher risks of hospitalization, intensive care unit (ICU) use, and all-cause mortality. After adjusting for socioeconomic status and other variables, the number of coexisting chronic diseases was associated with increasing risk of adverse dengue outcomes. Specific NCDs were associated with longer hospitalizations, ICU admission, and higher healthcare costs. Quantifying the risks of adverse dengue outcomes and health expenditures among dengue patients with preexisting NCDs provides insights for improved clinical management and essential inputs for health economic analyses on the cost-benefit of risk-based routine or catch-up immunization programs.

Clinical features of patients with Rocky Mountain spotted fever, dengue and chikungunya infection.

INTRODUCTION: Clinical distinction between arbovirus infections and those caused by rickettsia is crucial to initiate appropriate medical treatment. OBJECTIVE: To compare the differences between Rocky Mountain spotted fever (RMSF) and other vector-borne diseases (dengue and chikungunya) with similar clinical presentation, and to identify data that could aid rapid diagnosis of these diseases. METHODS: We evaluated sociodemographic, clinical and laboratory data of 399 patients from five hospitals and clinics of Sonora, Mexico, between 2004 and 2016, with laboratory-confirmed diagnosis of RMSF, dengue, or chikungunya. RESULTS: The RMSF group had the highest lethality (49/63 deaths, 77.8 %), followed by the chikungunya group (3/161, 1.9 %) and the dengue group (3/161, 1.9 %). Clinical differences included the presence of rash, edema, and pruritus; in addition, differences in multiple biomarkers such as platelets, hemoglobin, indirect bilirubin, and serum sodium levels were documented. CONCLUSION: Rash on the palms and soles, edema and absence of pruritus, together with high levels of direct bilirubin and severe thrombocytopenia could be useful indicators to differentiate patients at RMSF advanced stages from those with dengue and chikungunya.

INTRODUCCIÓN: La distinción clínica entre infecciones arbovirales y las provocadas por rickettsias es crucial para iniciar el tratamiento médico apropiado. OBJETIVO: Comparar las diferencias entre fiebre manchada de las montañas rocosas (FMMR) y otras enfermedades transmitidas por vector (dengue y chikungunya) con presentación clínica similar e identificar los datos que pudieran ayudar al diagnóstico rápido de esas enfermedades. MÉTODOS: Se evaluaron datos sociodemográficos, clínicos y de laboratorio de 399 pacientes de cinco hospitales y clínicas en Sonora, México, entre 2004 y 2016, con el diagnóstico confirmado por laboratorio de FMMR, dengue o chikungunya. RESULTADOS: El grupo con FMMR presentó la mayor letalidad (49/63 muertes, 77.8 %), seguido por el de chikungunya (3/161, 1.9 %) y el de dengue (3/161, 1.9 %). Las diferencias clínicas consistieron en la presencia de exantema, edema y prurito; además, se documentaron diferencias en múltiples biomarcadores como plaquetas, hemoglobina, bilirrubina indirecta y niveles de sodio sérico. CONCLUSIÓN: El exantema en palmas y plantas, edema y ausencia de prurito, aunados a niveles altos de bilirrubina directa y trombocitopenia severa pudieran ser indicadores útiles para diferenciar a pacientes con FMMR en etapas avanzadas de aquellos con dengue y chikungunya.

Mortality among Hospitalized Dengue Patients with Comorbidities in Mexico, Brazil, and Colombia.

Dengue patients with comorbidities may be at higher risk of death. In this cross-sectional study, healthcare databases from Mexico (2008-2014), Brazil (2008-2015), and Colombia (2009-2017) were used to identify hospitalized dengue cases and their comorbidities. Case fatality rates (CFRs), relative risk, and odds ratios (OR) for in-hospital mortality were determined. Overall, 678,836 hospitalized dengue cases were identified: 68,194 from Mexico, 532,821 from Brazil, and 77,821 from Colombia. Of these, 35%, 5%, and 18% were severe dengue, respectively. Severe dengue and age ≥ 46 years were associated with increased risk of in-hospital mortality. Comorbidities were identified in 8%, 1%, and 4% of cases in Mexico, Brazil, and Colombia, respectively. Comorbidities increased hospitalized dengue CFRs 3- to 17-fold; CFRs were higher with comorbidities regardless of dengue severity or age. The odds of in-hospital mortality were significantly higher in those with pulmonary disorders (11.6 [95% CI 7.4-18.2], 12.7 [95% CI 9.3-17.5], and 8.0 [95% CI 4.9-13.1] in Mexico, Brazil, and Colombia, respectively), ischemic heart disease (23.0 [95% CI 6.6-79.6], 5.9 [95% CI 1.4-24.6], and 7.0 [95% CI 1.9-25.5]), and renal disease/failure (8.3 [95% CI 4.8-14.2], 8.0 [95% CI 4.5-14.4], and 9.3 [95% CI 3.1-28.0]) across the three countries; the odds of in-hospital mortality from dengue with comorbidities was at least equivalent or higher than severe dengue alone (4.5 [95% CI 3.4-6.1], 9.6 [95% CI 8.6-10.6], and 9.0 [95% CI 6.8-12.0). In conclusion, the risk of death because of dengue increases with comorbidities independently of age and/or disease severity.

Assessing the reporting of Dengue, Chikungunya and Zika to the National Surveillance System in Colombia from 2014-2017: A Capture-recapture analysis accounting for misclassification of arboviral diagnostics.

BACKGROUND: Chikungunya, dengue, and Zika are three different arboviruses which have similar symptoms and are a major public health issue in Colombia. Despite the mandatory reporting of these arboviruses to the National Surveillance System in Colombia (SIVIGILA), it has been reported that the system captures less than 10% of diagnosed cases in some cities. METHODOLOGY/PRINCIPAL FINDINGS: To assess the scope and degree of arboviruses reporting in Colombia between 2014-2017, we conducted an observational study of surveillance data using the capture-recapture approach in three Colombian cities. Using healthcare facility registries (capture data) and surveillance-notified cases (recapture data), we estimated the degree of reporting by clinical diagnosis. We fit robust Poisson regressions to identify predictors of reporting and estimated the predicted probability of reporting by disease and year. To account for the potential misclassification of the clinical diagnosis, we used the simulation extrapolation for misclassification (MC-SIMEX) method. A total of 266,549 registries were examined. Overall arboviruses' reporting ranged from 5.3% to 14.7% and varied in magnitude according to age and year of diagnosis. Dengue was the most notified disease (21-70%) followed by Zika (6-45%). The highest reporting rate was seen in 2016, an epidemic year. The MC-SIMEX corrected rates indicated underestimation of the reporting due to the potential misclassification bias. CONCLUSIONS: These findings reflect challenges on arboviruses' reporting, and therefore, potential challenges on the estimation of arboviral burden in Colombia and other endemic settings with similar surveillance systems.