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1.
N Engl J Med ; 381(21): 2009-2019, 2019 11 21.
Artículo en Inglés | MEDLINE | ID: mdl-31693803

RESUMEN

BACKGROUND: Dengue, a mosquito-borne viral disease, was designated a World Health Organization top 10 threat to global health in 2019. METHODS: We present primary efficacy data from part 1 of an ongoing phase 3 randomized trial of a tetravalent dengue vaccine candidate (TAK-003) in regions of Asia and Latin America in which the disease is endemic. Healthy children and adolescents 4 to 16 years of age were randomly assigned in a 2:1 ratio (stratified according to age category and region) to receive two doses of vaccine or placebo 3 months apart. Participants presenting with febrile illness were tested for virologically confirmed dengue by serotype-specific reverse-transcriptase polymerase chain reaction. The primary end point was overall vaccine efficacy in preventing virologically confirmed dengue caused by any dengue virus serotype. RESULTS: Of the 20,071 participants who were given at least one dose of vaccine or placebo (safety population), 19,021 (94.8%) received both injections and were included in the per-protocol analysis. The overall vaccine efficacy in the safety population was 80.9% (95% confidence interval [CI], 75.2 to 85.3; 78 cases per 13,380 [0.5 per 100 person-years] in the vaccine group vs. 199 cases per 6687 [2.5 per 100 person-years] in the placebo group). In the per-protocol analyses, vaccine efficacy was 80.2% (95% CI, 73.3 to 85.3; 61 cases of virologically confirmed dengue in the vaccine group vs. 149 cases in the placebo group), with 95.4% efficacy against dengue leading to hospitalization (95% CI, 88.4 to 98.2; 5 hospitalizations in the vaccine group vs. 53 hospitalizations in the placebo group). Planned exploratory analyses involving the 27.7% of the per-protocol population that was seronegative at baseline showed vaccine efficacy of 74.9% (95% CI, 57.0 to 85.4; 20 cases of virologically confirmed dengue in the vaccine group vs. 39 cases in the placebo group). Efficacy trends varied according to serotype. The incidence of serious adverse events was similar in the vaccine group and placebo group (3.1% and 3.8%, respectively). CONCLUSIONS: TAK-003 was efficacious against symptomatic dengue in countries in which the disease is endemic. (Funded by Takeda Vaccines; TIDES ClinicalTrials.gov number, NCT02747927.).


Asunto(s)
Vacunas contra el Dengue/inmunología , Virus del Dengue/inmunología , Dengue/prevención & control , Enfermedades Endémicas/prevención & control , Adolescente , Américas/epidemiología , Anticuerpos Neutralizantes/sangre , Anticuerpos Antivirales/sangre , Asia/epidemiología , Niño , Preescolar , Dengue/epidemiología , Dengue/inmunología , Vacunas contra el Dengue/efectos adversos , Virus del Dengue/aislamiento & purificación , Método Doble Ciego , Femenino , Humanos , Incidencia , Masculino , Serogrupo , Resultado del Tratamiento
2.
BMC Health Serv Res ; 19(1): 699, 2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31615484

RESUMEN

BACKGROUND: Dengue is an emerging vector disease with frequent outbreaks in Nepal that pose a major threat to public health. Dengue control activities are mostly outbreak driven, and still lack systematic interventions while most people have poor health-related knowledge and practices. Mobile Short Message Service (SMS) represents a low-cost health promotion intervention that can enhance the dengue prevention knowledge and practices of the affected communities. This study aimed to explore the acceptability, appropriateness, and effectiveness of mobile SMS intervention in improving dengue control practices. METHODS: This study was an implementation research that used mixed-methods design with intervention. A total of 300 households were divided into three groups, i.e. one control group, one dengue prevention leaflet (DPL) only intervention group and one DPL with mobile SMS intervention group (DPL + SMS). We used a structured questionnaire to collect information regarding participants' knowledge and practice of dengue prevention. We conducted in-depth interviews with key informants to measure acceptability and appropriateness of intervention. Mean difference with standard deviation (SD), one-way ANOVA, paired t-test and regression analyses were used to assess the effectiveness of the interventions. Thematic analysis was used to assess the acceptability, and appropriateness as well as barriers and enablers of the intervention. RESULTS: The DPL + SMS intervention produced significantly higher mean knowledge difference (32.7 ± 13.7 SD vs. 13.3 ± 8.8 SD) and mean practice difference (27.9 ± 11.4 SD vs 4.9 ± 5.4 SD) compared to the DPL only group (p = 0.000). Multivariate analysis showed that the DPL + SMS intervention was effective to increase knowledge by 28.6 points and practice by 28.1 points compared to the control group. The intervention was perceived as acceptable and appropriate by the study participants and key stakeholders. Perceived barriers included reaching private network users and poor network in geographically remote areas, while enabling factors included mobile phone penetration, low cost, and shared responsibility. CONCLUSIONS: Mobile SMS is an effective, acceptable and appropriate health intervention to improve dengue prevention practices in communities. This intervention can be adopted as a promising tool for health education against dengue and other diseases.


Asunto(s)
Teléfono Celular/estadística & datos numéricos , Dengue/prevención & control , Promoción de la Salud/métodos , Adulto , Análisis de Varianza , Servicios de Salud Comunitaria/métodos , Servicios de Salud Comunitaria/normas , Femenino , Estado de Salud , Humanos , Masculino , Nepal , Proyectos Piloto , Encuestas y Cuestionarios , Mensaje de Texto/estadística & datos numéricos
3.
Afr Health Sci ; 19(2): 2000-2007, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31656483

RESUMEN

Background: In the last five decades, dengue has emerged as one of the most important infectious diseases, following a 30-fold increase in global incidence throughout tropical and sub-tropical regions of the world. The actual numbers of dengue cases are under-reported and many cases are misclassified. Objectives: This article describes the epidemiology, pathophysiology, clinical features and management of dengue. It also explores the implications of infection with this flavivirus for Nigeria, and similar countries. Methods: The literature search for publications on dengue in West Africa was performed using PubMed, African Journals Online (AJOL), Google Scholar, Web of Science, databases and grey literature to identify all published papers regarding the topic. A snowballing strategy was adopted to identify additional publications. Results: Recent reports suggest that dengue is a growing public health problem in Nigeria, the magnitude of which needs to be more clearly defined. Nigeria, the most populous country in Africa has an abundance of the Aedes aegypti mosquito which is known to transmit dengue, Zika, as well as chikungunya (CHIKV) and West Nile viruses. Conclusion: This article provides practical suggestions for strengthening the dengue virus control programme in Nigeria. The Nigerian health system shares similarities with health systems in many other sub-Saharan countries. Therefore, the practical suggestions provided at the end of this review are likely to be applicable to many other African countries.


Asunto(s)
Aedes/virología , Virus del Dengue/aislamiento & purificación , Dengue/prevención & control , Control de Mosquitos , Mosquitos Vectores/virología , Animales , Dengue/diagnóstico , Humanos , Nigeria
5.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1333-1339, out.-dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1022140

RESUMEN

Objective: The study's purpose has been to identify the actions to fight the dengue fever vector, and also the way that patients bearing the symptoms have being handled. Methods: This research describes the semiological and pathophysiological aspects of dengue fever through the perception of health professionals, who assisted the patients bearing the symptoms of this disease. Furthermore, this study addresses the perception of endemic diseases combat agents and community health agents regarding the efficiency of vector control measures. Results: The health professionals are working according to the World Health Organization recommendations. The majority of the population contributes to the mosquito breeding sites elimination. The elevated number of closed properties and houses with difficult access has been the greatest obstacle to control the vector. Conclusion: These services need to be aware of the disease trends in order to quickly detect changes in its profile and guide control actions


Objetivo: Identificar as ações adotadas de combate ao vetor e as formas de manejo dos pacientes com sinais e sintomas de alarme para dengue grave. Métodos: Estudo que descreve, na percepção dos profissionais de saúde que atenderam pacientes com suspeita de dengue, os aspectos semiológicos e fisiopatológicos da doença. Apresenta a percepção dos Agentes de Combate a Endemias e Agentes Comunitários de Saúde sobre a eficiência das medidas de controle do vetor. Resultados: Os profissionais de saúde procedem o cuidado conforme orientações da Organização Mundial da Saúde. A maior parte da população contribui com a eliminação dos criadouros do mosquito. Imóveis fechados e o difícil acesso têm sido os principais desafios para o controle do vetor. Conclusão: Esses serviços precisam estar atentos às tendências dessa doença para rapidamente conseguir detectar mudanças em seu perfil e orientar ações de controle


Objetivo: Identificar la satisfacción de los pacientes seguidos en un ambulatorio de Educación para la Salud y evaluar el efecto de las variables antecedentes sobre el nivel de satisfacción de los pacientes. Método: Se trata de un estudio transversal realizado en un ambulatorio la Educación para la Salud. La muestra estuvo constituida por todos los pacientes cardíacos en el ambulatorio (17 pacientes). La satisfacción del paciente se evaluó a través del Instrumento de Satisfacción del Paciente (ISP). Resultados: Todos los pacientes informaron un alto nivel de satisfacción. Los dominios con los puntajes más altos y más bajos fueron el profesional y el educacional, respectivamente. No hubo correlación significativa entre los niveles de satisfacción con cualquiera de las variables antecedentes. Conclusión: Pacientes informaron un alto nivel de satisfacción y no hubo correlación significativa entre variables y los niveles de satisfacción


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Satisfacción del Paciente , Agentes Comunitarios de Salud , Enfermedades Endémicas/prevención & control , Dengue/prevención & control , Aedes/patogenicidad , Monitoreo Epidemiológico
6.
Clinics (Sao Paulo) ; 74: e675, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31508718

RESUMEN

The present study aimed to review literature on studies of dengue cases conducted over 30 years in the state of Ceará.Between November 2015 and January 2016, articles published in Portuguese and English in 7 databases were searched using keywords and a Boolean operator. A total of 191 articles were identified in the databases; 133 were excluded according to the exclusion criteria, and 58 were included in the study.Of the 58 articles analyzed, 6 reported data from Brazil; including the Northeast region and the state of Ceará; 41 reported data for only the city of Fortaleza; 7 reported data for the state of Ceará; 4 reported data for cities in the interior of the state; and 3 included only children. The studies adopted different approaches and focused on different aspects of the disease. Study outcomes included the identification of serological, epidemiological, clinical, and laboratory characteristics; potential larvicides and biological predators of mosquitoes; potential antiviral agents; vector density characteristics; and educational dengue prevention and control strategies. Additionally, one vaccine trial was included.Although studies on dengue in the state of Ceará are scarce, they are encompassing, including several lines of research, and the number of studies and reports on dengue in the state of Ceará continues to increase.


Asunto(s)
Aedes/clasificación , Dengue/epidemiología , Enfermedades Endémicas/estadística & datos numéricos , Mosquitos Vectores/fisiología , Aedes/fisiología , Animales , Brasil/epidemiología , Dengue/prevención & control , Dengue/transmisión , Enfermedades Endémicas/prevención & control , Humanos , Conducta Predatoria , Proyectos de Investigación , Especificidad de la Especie
7.
PLoS Negl Trop Dis ; 13(9): e0007665, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31525199

RESUMEN

Dengue is one of the most serious mosquito-borne infectious diseases in the world. Aedes albopictus is the most invasive mosquito and one of the primary vectors of dengue. Vector control using insecticides is the only viable strategy to prevent dengue virus transmission. In Guangzhou, after the 2014 pandemic, massive insecticides have been implemented. Massive insecticide use may lead to the development of resistance, but few reports are available on the status of insecticide resistance in Guangzhou after 2014. In this study, Ae. albopictus were collected from four districts with varied dengue virus transmission intensity in Guangzhou from 2015 to 2017. Adult Ae. albopictus insecticide susceptibility to deltamethrin (0.03%), permethrin(0.25%), DDT(4%), malathion (0.8%) and bendiocarb (0.1%) was determined by the standard WHO tube test, and larval resistance bioassays were conducted using temephos, Bacillus thuringiensis israelensis (Bti), pyriproxyfen (PPF) and hexaflumuron. Mutations at the voltage-gated sodium channel (VGSC) gene and acetylcholinesterase (AChE) gene were analyzed. The effect of cytochrome P450s on the resistance of Ae. albopictus to deltamethrin was tested using the synergistic agent piperonyl butoxide (PBO). The results showed that Ae. albopictus populations have rapidly developed very high resistances to multiple commonly used insecticides at all study areas except malathion, Bti and hexaflumuron. We found 1534 codon mutations in the VGSC gene that were significantly correlated with the resistance to pyrethroids and DDT, and 11 synonymous mutations were also found in the gene. The resistance to deltamethrin can be significantly reduced by PBO but may generated cross-resistance to PPF. Fast emerging resistance in Ae. albopictus may affect mosquito management and threaten the prevention and control of dengue, similar to the resistance in Anopheles mosquitoes has prevented the elimination of malaria and call for timely and guided insecticide management.


Asunto(s)
Aedes/genética , Resistencia a los Insecticidas , Insecticidas , Animales , China , Dengue/prevención & control , Dengue/transmisión , Larva/efectos de los fármacos , Larva/genética , Control de Mosquitos , Mosquitos Vectores , Mutación
8.
BMC Med ; 17(1): 172, 2019 09 09.
Artículo en Inglés | MEDLINE | ID: mdl-31495336

RESUMEN

BACKGROUND: Wolbachia-infected mosquitoes reduce dengue virus transmission, and city-wide releases in Yogyakarta city, Indonesia, are showing promising entomological results. Accurate estimates of the burden of dengue, its spatial distribution and the potential impact of Wolbachia are critical in guiding funder and government decisions on its future wider use. METHODS: Here, we combine multiple modelling methods for burden estimation to predict national case burden disaggregated by severity and map the distribution of burden across the country using three separate data sources. An ensemble of transmission models then predicts the estimated reduction in dengue transmission following a nationwide roll-out of wMel Wolbachia. RESULTS: We estimate that 7.8 million (95% uncertainty interval [UI] 1.8-17.7 million) symptomatic dengue cases occurred in Indonesia in 2015 and were associated with 332,865 (UI 94,175-754,203) lost disability-adjusted life years (DALYs). The majority of dengue's burden was due to non-severe cases that did not seek treatment or were challenging to diagnose in outpatient settings leading to substantial underreporting. Estimated burden was highly concentrated in a small number of large cities with 90% of dengue cases occurring in 15.3% of land area. Implementing a nationwide Wolbachia population replacement programme was estimated to avert 86.2% (UI 36.2-99.9%) of cases over a long-term average. CONCLUSIONS: These results suggest interventions targeted to the highest burden cities can have a disproportionate impact on dengue burden. Area-wide interventions, such as Wolbachia, that are deployed based on the area covered could protect people more efficiently than individual-based interventions, such as vaccines, in such dense environments.


Asunto(s)
Aedes/microbiología , Dengue/prevención & control , Modelos Teóricos , Control Biológico de Vectores/métodos , Wolbachia , Animales , Costo de Enfermedad , Dengue/epidemiología , Dengue/transmisión , Virus del Dengue , Humanos , Indonesia/epidemiología
9.
Math Biosci Eng ; 16(4): 3195-3214, 2019 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-31499609

RESUMEN

The only rubella vaccine available in North America is the RA27/3 strain (isolated from the kidney of a rubella-infected fetus and attenuated) licensed in 1979, which substituted HPV77/DE5 strain vaccine due to concerns about waning immunity. The first dengue vaccine (Dengvaxia CYDTDV) was first registered in Mexico in December, 2015, which is a live recombinant tetravalent dengue vaccine. Rubella vaccine was applied since 1969, but tetravalent dengue vaccine is being used in large scale nowadays. In the past, based on unavailable information regarded to rubella vaccine, mathematical models were used to design vaccination schemes in order to avoid congenital rubella syndrome (CRS). Currently, knowing that vaccine does not result in CRS, rubella vaccination is modelled as usual childhood infection. This experience of updated biological knowledge that influenced mathematical modellings of rubella vaccination is taken into account to reflect about the tetravalent dengue vaccine. We also address a discussion about the security of vaccination strategies.


Asunto(s)
Vacunas contra el Dengue , Dengue , Modelos Teóricos , Vacuna contra la Rubéola , Rubéola (Sarampión Alemán) , Anticuerpos Antivirales/inmunología , Niño , Dengue/inmunología , Dengue/prevención & control , Vacunas contra el Dengue/inmunología , Humanos , Rubéola (Sarampión Alemán)/inmunología , Rubéola (Sarampión Alemán)/prevención & control , Vacuna contra la Rubéola/inmunología , Vacunación
10.
Artículo en Inglés | MEDLINE | ID: mdl-31480254

RESUMEN

Climate variability is highly impacting on mosquito-borne diseases causing malaria and dengue fever across the globe. Seasonal variability change in temperature and rainfall patterns are impacting on human health. Mosquitoes cause diseases like dengue fever, yellow fever, malaria, Chikungunya, West Nile and Japanese encephalitis. According to estimations by health organizations, annually one million human deaths are caused by vector-borne diseases, and dengue fever has increased about 30-fold over the past 50 years. Similarly, over 200 million cases of malaria are being reported annually. Mosquito-borne diseases are sensitive to temperature, humidity and seasonal variability. Both conventional (environmental, chemical, mechanical, biological etc.) and nanotechnology-based (Liposomes, nano-suspensions and polymer-based nanoparticles) approaches are used for the eradication of Malaria and dengue fever. Now green approaches are used to eradicate mosquitoes to save human health without harming the environment. In this review, the impact of climatic conditions on mosquito-borne diseases along with conventional and nanotechnology-based approaches used for controlling malaria and dengue fever have been discussed. Important recommendations have been made for people to stay healthy.


Asunto(s)
Cambio Climático , Dengue/prevención & control , Malaria/prevención & control , Control de Mosquitos/métodos , Mosquitos Vectores , Nanotecnología/métodos , Clima
11.
PLoS Negl Trop Dis ; 13(8): e0007659, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31415559

RESUMEN

BACKGROUND: The reported incidence of dengue fever increased dramatically in recent years in China. This study aimed to investigate and to assess the effectiveness of intervention implemented in a dengue outbreak in Ningbo City, Zhejiang Province, China. METHODS: Data of a dengue outbreak were collected in Ningbo City in China by a field epidemiological survey according to a strict protocol and case definition. Serum specimens of all cases were collected for diagnosis and the virological characteristics were detected by using polymerase chain reaction (PCR) and gene sequencing. Vector surveillance was implemented during the outbreak to collect the larva and adult mosquito densities to calculate the Breteau Index (BI) and human biting rate (HBR), respectively. Data of monthly BI and light-trap density in 2018 were built to calculate the seasonality of the vector. A transmission mathematical model was developed to dynamic the incidence of the disease. The parameters of the model were estimated by the data of the outbreak and vector surveillance data in 2018. The effectiveness of the interventions implemented during the outbreak was assessed by the data and the modelling. RESULTS: From 11 August to 8 September, 2018, a dengue outbreak was reported with 27 confirmed cases in a population of 5536-people community (community A) of Ningbo City. Whole E gene sequences were obtained from 24 cases and were confirmed as dengue virus type 1 (DENV-1). The transmission source of the outbreak was origin from community B where a dengue case having the same E gene sequence was onset on 30 July. Aedes albopictus was the only vector species in the area. The value of BI and HBR was 57.5 and 12 per person per hour respectively on 18 August, 2018 and decreased dramatically after interventions. The transmission model fitted well (χ2 = 6.324, P = 0.388) with the reported cases data. With no intervention, the total simulated number of the cases would be 1728 with a total attack rate (TAR) of 31.21% (95%CI: 29.99%- 32.43%). Case isolation and larva control (LC) have almost the same TAR and duration of outbreak (DO) as no intervention. Different levels of reducing HBR (rHBR) had different effectiveness with TARs ranging from 1.05% to 31.21% and DOs ranging from 27 days to 102 days. Adult vector control (AVC) had a very low TAR and DO. "LC+AVC" had a similar TAR and DO as that of AVC. "rHBR100%+LC", "rHBR100%+AVC", "rHBR100%+LC+AVC" and "rHBR100%+LC+AVC+Iso" had the same effectiveness. CONCLUSIONS: Without intervention, DENV-1 could be transmitted rapidly within a short period of time and leads to high attack rate in community in China. AVC or rHBR should be recommended as primary interventions to control rapid transmission of the dengue virus at the early stage of an outbreak.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Dengue/epidemiología , Brotes de Enfermedades , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Mosquitos/métodos , Adolescente , Adulto , Aedes/crecimiento & desarrollo , Anciano , Anciano de 80 o más Años , Animales , Niño , China/epidemiología , Ciudades/epidemiología , Dengue/prevención & control , Dengue/transmisión , Dengue/virología , Virus del Dengue/clasificación , Virus del Dengue/genética , Virus del Dengue/aislamiento & purificación , Métodos Epidemiológicos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Modelos Teóricos , Mosquitos Vectores/crecimiento & desarrollo , Adulto Joven
12.
BMC Infect Dis ; 19(1): 750, 2019 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-31455279

RESUMEN

BACKGROUND: Dengue is an arbovirus that has rapidly spread worldwide, and the incidence of dengue has greatly increased in recent decades. The actual numbers of dengue cases are underreported, and many cases are not classified correctly. Recent estimates indicate that 390 million dengue infections occur per year (95% CI, 284-528 million), of which 96 million (67-136 million) are symptomatic infections of any severity. One of the goals of the World Health Organization is to reduce dengue mortality by 50% by the year 2020. The use of a vaccine can be an important strategy to achieve this goal. Vaccines for dengue are in various stages of development; in Brazil, only one commercial formulation is available (CYD-TDV), which was developed by Sanofi Pasteur. METHODS: To evaluate the efficacy of Dengue vaccine, a systematic review with a meta-analysis was conducted using randomized controlled clinical trials published between 2000 and 2017 that were identified in the MEDLINE databases via PubMed, LILACS, Cochrane Library, and EMBASE. The selection was performed by two reviewers independently, with disagreements resolved by a third reviewer. RESULTS: Seven clinical trials were included, with a total of 36,371 participants (66,511 person-years) between the ages of 2 and 45 years. The meta-analysis using the random-effects model estimated the efficacy of the vaccine at 44%, with a range from 25 to 59% and high heterogeneity (I2 = 80.1%). The serotype-stratified meta-analysis was homogeneous, except for serotype 2, with the heterogeneity of 64.5%. Most of the vaccinated individuals had previous immunity for at least one serotype, which generated safety concerns in individuals without previous immunity. CONCLUSIONS: Compared with other commercially available vaccines, the dengue vaccine showed poor efficacy.


Asunto(s)
Vacunas contra el Dengue/farmacología , Dengue/prevención & control , Adolescente , Adulto , Brasil , Niño , Preescolar , Dengue/inmunología , Vacunas contra el Dengue/inmunología , Humanos , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Serogrupo
14.
Cien Saude Colet ; 24(8): 2983-2992, 2019 Aug 05.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31389545

RESUMEN

Aedes aegypti is currently a critical disease agent and is responsible for viruses such as Zika, Chikungunya and Dengue's four serotypes. This mosquito's relevance to the current social body has come to the fore and triggered urgent EcoHealth investigations since this approach aims to articulate different theoretical fields to understand the historical linkages between nature, society and health. Based on an ethnographic premise, this study considered the unequal and unfair conditions that make women's health vulnerable to dengue, analyzing their practices and perceptions about the potential breeding grounds in the public space. A semi-structured interview and participant observation, as well as a field diary, were used to compose the study. The research included the participation of ten women living in the outskirts of Fortaleza, Ceará, Brazil, from January to August 2014. The category "Social inequality, context and practices in the public space" emerged from the content analysis. The narratives revealed that unstable living conditions and evident social inequality might influence in a context permeated by waste, with great potential for dengue's mosquito proliferation.


Asunto(s)
Fiebre Chikungunya/prevención & control , Dengue/prevención & control , Control de Mosquitos/métodos , Infección por el Virus Zika/prevención & control , Adulto , Aedes/virología , Anciano , Animales , Brasil , Fiebre Chikungunya/transmisión , Dengue/transmisión , Femenino , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Mosquitos Vectores/virología , Factores Socioeconómicos , Adulto Joven , Infección por el Virus Zika/transmisión
15.
Biomed Res Int ; 2019: 3092073, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31321232

RESUMEN

Introduction: Limited awareness and nonsystematized health education programmes have contributed adversely to the increase in dengue incidence at schools due to limited attention which has positively contributed to the increase in vector receptivity. The current study was conducted to evaluate the existing level of awareness of dengue infection among a selected group of school children and to assess the effectiveness of dengue awareness programmes to improve the existing knowledge and preventive practices on dengue. Methods: A cohort of 2,194 students (13-15 years old) from 10 schools at Kelaniya educational zone, Gampaha District, Western Province of Sri Lanka, was enrolled for the current study, which was conducted during 2015-2016. A self-administered questionnaire, comprising 20 questions, was used to evaluate the present knowledge of the students on various aspects of dengue. A structured awareness programme (2 hours) was conducted for students, followed by a reassessment. General Linear Model (GLM) and chi-square test of independence were used to investigate the variations in knowledge levels. Results: The majority of students were characterized by "Good" (46.31%, n= 1016) and "Moderate" (42.62%, n= 935) awareness, while only 2.92% (n= 64) of students fell into the "Excellent" (>80%) category prior to the awareness programme. Even though, existing knowledge of students about dengue ranged between "Moderate" and "Good" categories, awareness of "symptoms & patient care" and "control & prevention practices" were limited. After the programme, the awareness level reached the "Excellent" (41.84%, n=918) level indicating a significant increase by 38.92%, according to the chi-square test (p<0.05 at 95% level of confidence). Conclusion: We recommend implementing school-based educational programmes in order to raise the awareness and to translate knowledge into sound practice to control dengue disease epidemics in these areas.


Asunto(s)
Concienciación , Virus del Dengue/patogenicidad , Dengue/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Niño , Dengue/prevención & control , Dengue/virología , Femenino , Educación en Salud , Humanos , Masculino , Factores de Riesgo , Instituciones Académicas , Sri Lanka/epidemiología , Estudiantes , Encuestas y Cuestionarios
16.
PLoS Negl Trop Dis ; 13(7): e0007420, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31295250

RESUMEN

BACKGROUND: Vector control remains the primary method to prevent dengue infections. Environmental interventions represent sustainable and safe methods as there are limited risks of environmental contamination and toxicity. The objective of this study is to perform a systematic review and meta-analysis of the effectiveness of the following environmental methods for dengue vector control. METHODOLOGY/PRINCIPAL FINDINGS: Following the PRISMA guidelines, a systematic literature search was conducted using the databases PubMed, EMBASE, LILACS, the Cochrane Library and Google Scholar. Quality assessment was done using the CONSORT 2010 checklist. For the meta-analysis the difference-in-differences (DID) and the difference-of-endlines (DOE) were calculated according to the Schmidt-Hunter method for the Breteau index (BI) and the pupae per person index (PPI). Nineteen studies were eligible for the systematic review, sixteen contributed data to the meta-analysis. The following methods were evaluated: (a) container covers with and without insecticides, (b) waste management and clean-up campaigns, and (c) elimination of breeding sites by rendering potential mosquito breeding sites unusable or by eliminating them. Study quality was highest for container covers with insecticides, followed by waste management without direct garbage collection and elimination of breeding places. Both, systematic review and meta-analysis, showed a weak effect of the interventions on larval populations, with no obvious differences between the results of each individual method. For the meta-analysis, both, container covers without insecticides (BI: DID -7.9, DOE -5) and waste management with direct garbage collection (BI: DID -8.83, DOE -6.2) achieved the strongest reductions for the BI, whereas for the PPI results were almost opposite, with container covers with insecticides (PPI: DID -0.83, DOE 0.09) and elimination of breeding places (PPI: DID -0.95, DOE -0.83) showing the strongest effects. CONCLUSIONS: Each of the investigated environmental methods showed some effectiveness in reducing larval and pupal densities of Aedes sp. mosquitoes. However, there is a need for more comparable high-quality studies at an adequate standard to strengthen this evidence.


Asunto(s)
Dengue/prevención & control , Microbiología Ambiental , Insecticidas , Control de Mosquitos/métodos , Mosquitos Vectores/virología , Aedes/virología , Animales , Larva/virología , Pupa/virología , Salud Urbana , Abastecimiento de Agua
17.
PLoS Negl Trop Dis ; 13(7): e0007528, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31276467

RESUMEN

Extreme weather events affect the development and survival of disease pathogens and vectors. Our aim was to investigate the potential effects of heat waves on the population dynamics of Asian tiger mosquito (Aedes albopictus), which is a major vector of dengue and Zika viruses. We modeled the population abundance of blood-fed mosquito adults based on a mechanistic population model of Ae. albopictus with the consideration of diapause. Using simulated heat wave events derived from a 35-year historical dataset, we assessed how the mosquito population responded to different heat wave characteristics, including the onset day, duration, and the average temperature. Two important observations are made: (1) a heat wave event facilitates the population growth in the early development phase but tends to have an overall inhibitive effect; and (2) two primary factors affecting the development are the unusual onset time of a heat wave and a relatively high temperature over an extended period. We also performed a sensitivity analysis using different heat wave definitions, justifying the robustness of the findings. The study suggests that particular attention should be paid to future heat wave events with an abnormal onset time or a lasting high temperature in order to develop effective strategies to prevent and control Ae. albopictus-borne diseases.


Asunto(s)
Aedes/fisiología , Calor Extremo , Mosquitos Vectores/fisiología , Aedes/virología , Animales , Fiebre Chikungunya/prevención & control , Fiebre Chikungunya/transmisión , Dengue/prevención & control , Dengue/transmisión , Mosquitos Vectores/virología , Dinámica Poblacional , Infección por el Virus Zika/prevención & control , Infección por el Virus Zika/transmisión
18.
PLoS Negl Trop Dis ; 13(7): e0007482, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31260441

RESUMEN

The tetravalent dengue vaccine CYD-TDV (Dengvaxia) is the first licensed vaccine against dengue, but recent findings indicate an elevated risk of severe disease among vaccinees without prior dengue virus (DENV) exposure. The World Health Organization currently recommends CYD-TDV only for individuals with serological confirmation of past DENV exposure. Our objective was to evaluate the potential health impact and cost-effectiveness of vaccination following serological screening. To do so, we used an agent-based model to simulate DENV transmission with and without vaccination over a 10-year timeframe. Across a range of values for the proportion of vaccinees with prior DENV exposure, we projected the proportion of symptomatic and hospitalized cases averted as a function of the sensitivity and specificity of serological screening. Scenarios about the cost-effectiveness of screening and vaccination were chosen to be representative of Brazil and the Philippines. We found that public health impact depended primarily on sensitivity in high-transmission settings and on specificity in low-transmission settings. Cost-effectiveness could be achievable from the perspective of a public payer provided that sensitivity and the value of a disability-adjusted life-year were both high, but only in high-transmission settings. Requirements for reducing relative risk and achieving cost-effectiveness from an individual perspective were more restricted, due to the fact that those who test negative pay for screening but receive no benefit. Our results predict that cost-effectiveness could be achieved only in high-transmission areas of dengue-endemic countries with a relatively high per capita GDP, such as Panamá (13,680 USD), Brazil (8,649 USD), México (8,201 USD), or Thailand (5,807 USD). In conclusion, vaccination with CYD-TDV following serological screening could have a positive impact in some high-transmission settings, provided that screening is highly specific (to minimize individual harm), at least moderately sensitive (to maximize population benefit), and sufficiently inexpensive (depending on the setting).


Asunto(s)
Análisis Costo-Beneficio , Vacunas contra el Dengue/economía , Dengue/prevención & control , Tamizaje Masivo/economía , Salud Pública/economía , Vacunación/economía , Anticuerpos Neutralizantes , Anticuerpos Antivirales/sangre , Simulación por Computador , Dengue/economía , Humanos , Pruebas Serológicas/economía , Factores de Tiempo , Vacunación/efectos adversos , Cobertura de Vacunación/estadística & datos numéricos , Organización Mundial de la Salud
19.
Rev Soc Bras Med Trop ; 52: e20180341, 2019 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-31271613

RESUMEN

INTRODUCTION: Areas at risk of transmission of arboviruses have been monitored using ovitraps. This study aimed to evaluate the spatial distribution of Aedes aegypti in vulnerable areas for the transmission of arboviruses and assess the influence of climatic conditions on the infestation of these culicids. METHODS: Ovitraps were installed in Agrestina, Pernambuco, Northeastern Brazil. RESULTS: Overall, 44,936 eggs were collected, and the indexes of infestation varied. Relative humidity was significantly associated with the infestations. CONCLUSIONS: Using ovitraps, entomologic indexes and analysis of climatic factors might be good strategies for monitoring vulnerable areas for the transmission of arboviruses.


Asunto(s)
Arbovirus , Fiebre Chikungunya/prevención & control , Dengue/prevención & control , Control de Mosquitos/métodos , Oviposición , Infección por el Virus Zika/prevención & control , Aedes/fisiología , Animales , Brasil , Fiebre Chikungunya/transmisión , Dengue/transmisión , Humanos , Humedad , Mosquitos Vectores/fisiología , Lluvia , Características de la Residencia , Estaciones del Año , Análisis Espacial , Temperatura Ambiental , Infección por el Virus Zika/transmisión
20.
PLoS Negl Trop Dis ; 13(7): e0007555, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31356617

RESUMEN

Targeted environmental and ecosystem management remain crucial in control of dengue. However, providing detailed environmental information on a large scale to effectively target dengue control efforts remains a challenge. An important piece of such information is the extent of the presence of potential dengue vector breeding sites, which consist primarily of open containers such as ceramic jars, buckets, old tires, and flowerpots. In this paper we present the design and implementation of a pipeline to detect outdoor open containers which constitute potential dengue vector breeding sites from geotagged images and to create highly detailed container density maps at unprecedented scale. We implement the approach using Google Street View images which have the advantage of broad coverage and of often being two to three years old which allows correlation analyses of container counts against historical data from manual surveys. Containers comprising eight of the most common breeding sites are detected in the images using convolutional neural network transfer learning. Over a test set of images the object recognition algorithm has an accuracy of 0.91 in terms of F-score. Container density counts are generated and displayed on a decision support dashboard. Analyses of the approach are carried out over three provinces in Thailand. The container counts obtained agree well with container counts from available manual surveys. Multi-variate linear regression relating densities of the eight container types to larval survey data shows good prediction of larval index values with an R-squared of 0.674. To delineate conditions under which the container density counts are indicative of larval counts, a number of factors affecting correlation with larval survey data are analyzed. We conclude that creation of container density maps from geotagged images is a promising approach to providing detailed risk maps at large scale.


Asunto(s)
Cruzamiento , Dengue/prevención & control , Mapeo Geográfico , Control de Mosquitos/métodos , Mosquitos Vectores/fisiología , Aedes/fisiología , Animales , Dengue/transmisión , Vectores de Enfermedades , Larva/fisiología , Mosquitos Vectores/virología , Densidad de Población , Pupa/fisiología , Tailandia
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