Perfil epidemiológico dos casos de dengue notificados em Ceres-Goiás, de 2014 a 2015 / Epidemiological profile of the dengue cases notified in Ceres-Goiás, from 2014 to 2015 / Perfil epidemiológico de los casos de dengue notificados en Ceres-Goiás de 2014 a 2015

Justificativa e Objetivos: A descrição do perfil epidemiológico é uma ferramenta importante na busca por soluções eficazes no que diz respeito, em especial, às doenças infecciosas e às alternativas de melhoria da saúde pública, sendo instrumento para o desenvolvimento de políticas adequadas às realidades locais. O presente artigo objetiva descrever o perfil epidemiológico dos casos de dengue notificados à Secretaria Municipal de Saúde (SMS) de Ceres-GO nos anos de 2014 e 2015. Métodos: Trata-se de um estudo observacional descritivo de corte transversal, desenvolvido através de pesquisa e interpretação de dados do Sistema de Notificação Compulsória de dengue. As informações coletadas foram digitadas em um banco de dados, onde os tipos de distribuição de cada variável (quantitativas e qualitativas) foram avaliados e distribuídos em forma de tabelas, sendo realizado cálculo das taxas de incidência por 100 mil habitantes. As variáveis estudadas incluíram dados sociodemográficos e dados laboratoriais, coletados no período de março a maio de 2017. Resultados: Durante os anos de 2014 e 2015 foram notificados um total de 3.374 possíveis casos de dengue no município de Ceres-GO, sendo destes, 189 referentes a 2014 e 3.185 a 2015, onde a taxa de incidência por 100 mil habitantes foi de 868 e 14.537, respectivamente. Comparando-se os registros dos respectivos anos, observa-se que houve um aumento significativo de notificações, representando um crescimento 16 vezes maior de um ano para o outro. Conclusão: Diversos aspectos evidenciam a gravidade da dengue, já que a inadequação de diversos fatores contribui para o maior acometimento populacional. O manejo inadequado e o gerenciamento ineficaz de casos resultam no progresso da doença, levando à sua rápida evolução e resultando muitas vezes em óbito.(AU)

Background and Objectives: The description of the epidemiological profile is an important tool in the search for effective solutions regarding, in particular, to infectious diseases and alternatives for improving public health, and it is an instrument for the development of policies appropriate to local realities. This article aims to describe the epidemiological profile of dengue cases notified to the Ceres-GO Municipal Health Department (SMS) from 2014 to 2015. Methods: This is a cross-sectional, observational, descriptive study, developed through investigation and data interpretation of the Compulsory Dengue Notification System. The information collected was typed into a database, where the types of distribution of each variable (quantitative and qualitative) were evaluated and distributed as tables, with a calculation of incidence rates per 100 thousand inhabitants. The variables studied included socio-demographic data and laboratory data collected from March to May 2017. Results: A total of 3,374 possible cases of dengue in the municipality of Ceres-GO were reported during 2014 and 2015, of which 189 referring to 2014 and 3185 to 2015, where the incidence rate per 100 thousand inhabitants was 868 and 14,537 respectively. Comparing the records of the respective years, a significant increase of notifications is observed, representing a 16 times growth from one year to the other. Conclusion: Several aspects show the severity of dengue, where the inadequacy of various factors contributes to greater population involvement. Inadequate management and ineffective case management result in progression of the disease, leading to its rapid evolution, often leading to death.(AU)

Justificación y objetivos: La descripción del perfil epidemiológico es una herramienta importante en la búsqueda de soluciones eficaces en lo que se refiere, en particular, a las enfermedades infecciosas y alternativas de mejora de la salud pública, siendo instrumento para el desarrollo de políticas adecuadas a las realidades locales. Este artículo objetiva describir el perfil epidemiológico de los casos de dengue notificados a la Secretaría Municipal de Salud (SMS) de Ceres-GO, en los años 2014 a 2015. Métodos: Se trata de un estudio observacional descriptivo de corte transversal, desarrollado a través de investigación e interpretación de datos del Sistema de Notificación Compulsiva de dengue. La información recolectada fue introducida en una base de datos donde los tipos de distribución de cada variable (cuantitativa y cualitativa) fueron evaluados y distribuidos en forma de tablas, siendo realizado cálculo de las tasas de incidencia por 100 mil habitantes. Las variables estudiadas incluyeron datos socio demográficos y datos de laboratorio, recolectados en el período de marzo a mayo de 2017. Resultados: Durante los años 2014 y 2015, se han notificado un total de 3.374 posibles casos de dengue en el municipio de Ceres-GO, siendo, de estos, 189 para 2014 y 3.185 a 2015, donde la tasa de incidencia por 100 mil habitantes fue de 868 y 14.537 respectivamente. Comparando los registros de los respectivos años, se observa que hubo un aumento significativo de notificaciones, representando un crecimiento 16 veces mayor de un año para el otro. Conclusiones: Diversos aspectos evidencian la gravedad del dengue, donde la inadecuación de diversos factores contribuye para el mayor acometimiento poblacional. El manejo inadecuado y la gestión ineficaz de casos resultan en el progreso de la enfermedad, llevando a su rápida evolución, cursando muchas veces en muerte.(AU)

Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil.

Please see Additional file 1 for translations of the abstract into the five official working languages of the United Nations. BACKGROUND: Currently, in Brazil, there is a co-circulation of the four dengue (DENV-1 to DENV-4) serotypes. This study aimed to assess whether different serotypes and antibody response patterns were associated with the severity of the disease during a dengue outbreak, which occurred in 2012/2013 in centre of Brazil. METHODS: We conducted a prospective study with 452 patients with laboratory confirmed dengue in central Brazil, from January 2012 to July 2013. The clinical outcome was the severity of cases: dengue, dengue with warning signs, and severe dengue. The patients were evaluated at three different moments. Blood sampling for laboratory testing and confirmatory tests for dengue infection were performed. We performed a multinomial analysis considering the three categories of the dependent variable, as outlined above. The odds ratios (ORs) were calculated. A multinomial logistic regression model was applied for variables with a P-value <0.20. Statistical analysis was performed with STATA 12.0 software. RESULTS: Four hundred fifty-two patients (452/632, 71.5%) were diagnosed with dengue. The dengue virus (DENV) serotypes were identified in 243 cases. DENV-4 was detected in 135 patients (55.6%), DENV-1 in 91 (37.4%), DENV-3 in 13 (5.3%), and DENV-2 in 4 (1.6%). Patients with the DENV-1 serotype were more prone to present with several clinical and laboratory features as compared with DENV-4 patients, including spontaneous bleeding (P = 0.03), intense abdominal pain (P = 0.004), neurological symptoms (P = 0.09), and thrombocytopenia (P = 0.01). Secondary infection was more predominant among DENV-4 cases (80.0%) compared with DENV-1 cases (62.3%) (P = 0.03). The univariate analysis showed that females (OR = 2.12; 95% CI: 1.44-3.13; P < 0.01) had a higher risk of having dengue with warning signs. The multinomial analysis showed that severe dengue cases with secondary infection had an adjusted OR of 2.80 (95% CI: 0.78-10.00; P = 0.113) as compared with dengue fever with primary infection when adjusted for age and sex. CONCLUSION: The current data show that 5.8% of patients recruited for treatment in healthcare centres and hospitals during the study period had severe dengue. DENV-4 was the predominant serotype, followed by DENV-1, in a large outbreak of dengue in central Brazil. Our findings contribute to the understanding of clinical differences and immune status related to the serotypes DENV-1 and DENV-4 in central of Brazil.

Neurological manifestations of dengue in Central Brazil.

INTRODUCTION:: The incidence of dengue has increased throughout the 2000s with a consequent global increase in atypical clinical forms. METHODS:: This study reports a series of cases of neurological dengue out of 498 confirmed cases of laboratory dengue in Goiânia, Brazil. Cases were confirmed based on viral RNA detection via polymerase chain reaction or IgM antibody capture. RESULTS:: Neurological symptoms occurred in 5.6% of cases, including paresthesia (3.8%), encephalitis (2%), encephalopathy (1%), seizure (0.8%), meningoencephalitis (0.4%), and paresis (0.4%). DENV-3 was the predominant circulating serotype (93%). CONCLUSIONS:: We reported dengue cases with neurological manifestations in endemic area.

Neurological manifestations of dengue in Central Brazil

Abstract INTRODUCTION: The incidence of dengue has increased throughout the 2000s with a consequent global increase in atypical clinical forms. METHODS: This study reports a series of cases of neurological dengue out of 498 confirmed cases of laboratory dengue in Goiânia, Brazil. Cases were confirmed based on viral RNA detection via polymerase chain reaction or IgM antibody capture. RESULTS: Neurological symptoms occurred in 5.6% of cases, including paresthesia (3.8%), encephalitis (2%), encephalopathy (1%), seizure (0.8%), meningoencephalitis (0.4%), and paresis (0.4%). DENV-3 was the predominant circulating serotype (93%). CONCLUSIONS: We reported dengue cases with neurological manifestations in endemic area.

Dengue and dengue hemorrhagic fever among adults: clinical outcomes related to viremia, serotypes, and antibody response.

BACKGROUND: Clinical manifestations of dengue vary in different areas of endemicity and between specific age groups, whereas predictors of outcome have remained controversial. In Brazil, the disease burden predominantly affects adults, with an increasing trend toward progression to dengue hemorrhagic fever (DHF) noted. METHODS: A cohort of adults with confirmed cases of dengue was recruited in central Brazil in 2005. Patients were classified according to the severity of their disease. Associations of antibody responses, viremia levels (as determined by real-time polymerase chain reaction [PCR]), and serotypes (as determined by multiplex PCR) with disease severity were evaluated. RESULTS: Of the 185 symptomatic patients >14 years of age who had a confirmed case of dengue, 26.5% and 23.2% were classified as having intermediate dengue fever (DF)/DHF (defined as internal hemorrhage, plasma leakage, manifested signs of shock, and/or thrombocytopenia [platelet count, < or =50,000 platelets/mm3]) and DHF, respectively. The onset of intermediate DF/DHF and DHF occurred at a late stage of disease, around the period of defervescence. Patients with DHF had abnormal liver enzyme levels, with a >3-fold increase in aspartate aminotransferase level, compared with the range of values considered to be normal. Overall, 65% of patients presented with secondary infections with dengue virus, with such infection occurring in similar proportions of patients in each of the 3 disease category groups. Dengue virus serotype 3 (DV3) was the predominant serotype, and viremia was detected during and after defervescence among patients with DHF or intermediate DF/DHF. CONCLUSIONS: Viremia was detected after defervescence in adult patients classified as having DHF or intermediate DF/DHF. Secondary infection was not a predictor of severe clinical manifestation in adults with infected with the DV3 serotype.

Laboratory surveillance of dengue virus in Central Brazil, 1994-2003.

BACKGROUND: In Brazil, dengue endemic and epidemic patterns indicate an upward trend in incidence and hospitalization in the past decade. OBJECTIVE: To report dengue circulating serotypes from 1994 to 2003 and the role of distinct serotypes on dengue clinical outcomes in Central Brazil. METHODS: Virological surveillance for dengue cases was conducted in the city of Goiania ( approximately 1,200,000 population) from 1994 to 2003. Samples were tested using dengue IgM antibody (MAC-ELISA) and/or virus isolation. Circulating subtypes and genotypes were identified by reverse transcriptase PCR (RT-PCR) and by restricted site-specific PCR (RSS-PCR) patterns in selected samples. RESULTS: Adults (87.4%) were the most affected group and dengue fever accounted for the majority of the cases. Laboratory surveillance identified mainly DEN 1 serotype from 1994 to 2002 shifting to a high circulation of DEN 3 in 2003. The ratio of dengue fever to dengue with complications/DHF remained constant following the introduction of DEN 3. Diagnosis of dengue was confirmed in approximately 50% of the suspected cases enhanced by RT-PCR. RSS-PCR patterns for DEN 1 and DEN 3 corresponded to the circulating subtypes in the country. CONCLUSIONS: The result of virological surveillance did not suggest a major role of infecting DEN 3 serotype in increasing disease severity during its first-year spread in Central Brazil.