Evaluation of the National Case Report Form for dengue and timely case notification before the co-circulation of multiple arboviruses in Barranquilla, Colombia / Evaluación del formulario nacional de informe de caso para dengue y de la puntualidad en la notificación del caso antes de la co-circulación de múltiples arbovirus en Barranquilla-Colombia

ABSTRACT Objective To evaluate the case report forms and times elapsed between the surveillance steps for dengue virus (DENV) infection in a large Colombian city before the emergence of other arbovirus epidemics. Materials and Methods The descriptive epidemiology of DENV infection cases was analyzed from 2009 to 2013. The completeness of the case report forms filed at the Primary Units of Data Generation (PUDG) were evaluated, as well as the accuracy and suitability of the tests (PPV: positive predictive value). The average time-lags between each step were then calculated. Results There were 7.3, 12.38, 4.66, 6.25 and 29.9 annual cases of dengue infection per 10 000 inhabitants in 2009 to 2013, respectively. In this study, only 57.76% of the cases were classified correctly by the physicians and 26.32% of them were questioned about their home conditions and whether their family/friends had similar symptoms. Patients visited a clinic/hospital on average 4.76 days after developing symptoms and the health system was notified on average 1.75 days later, while 70.6% of them were reported within the one-day target period. There were only minor changes in case reporting times even during a DENV epidemic. Some (12.85%) of the case forms were later modified (average 16.7 days). In the period 2009-2013, the IgM confirmed PPV was 58.60%, while 20 mandatory criteria were absent on more than 25% of the forms. Conclusions The system was accurate, simple, flexible, stable and acceptable, but a number of ways are suggested to improve this case detection and reporting system.(AU)

RESUMEN Objetivo Evaluar los formularios de informe de casos y los tiempos entre los pasos de vigilancia para el dengue en una ciudad colombiana antes de la aparición de otras epidemias de arbovirus. Materiales y Métodos Se analizó la epidemiología descriptiva entre 2009 y 2013. Se evaluó la integridad de los formularios de informes de casos, registrados en las Unidades Primarias de Generación de Datos, así como el valor predictivo (VPP) de las pruebas diagnósticas. Se calcularon los intervalos de tiempo promedio entre cada paso de la vigilancia. Resultados Hubo 7.3, 12.38, 4.66, 6.25 y 29.9 casos anuales por cada 10 000 habitantes en 2009-2013, respectivamente. Solo el 57.76% de los casos fueron clasificados correctamente por los médicos, el 26.32% de ellos fueron interrogados sobre las condiciones de su hogar y si sus familiares/amigos tenían síntomas similares. Los pacientes se presentaron a una clínica/hospital en promedio 4.76 días después de desarrollar síntomas y el sistema de salud fue notificado en promedio 1.75 días más tarde, mientras que el 70.6% de ellos se informaron dentro del período objetivo de un día. Algunos (12.85%) de los formularios de casos se modificaron posteriormente (promedio de 16.7 días). Desde 2009-2013, el VPP confirmado por IgM fue de 58.60%, mientras que veinte criterios obligatorios estuvieron ausentes en más del 25% de los formularios. Conclusiones El sistema fue preciso, simple, flexible, estable y aceptable, pero sugerimos varias formas de mejorar este sistema de detección e informe de casos.(AU)

Evaluation of a rapid water-surface sweeping method to accurately estimate numbers of Aedes aegypti (Diptera: Culicidae) late larval stages in large water-storage containers: comparison with pupal estimates / Evaluación de un método de barrido rápido sobre la superficie para estimar el número total de estados larvarios tardíos de Aedes aegypti (Diptera: Culicidae) en depósitos de agua de grandes capacidades: comparación con estimativos de pupas

Introduction. Since the methodologies used to calculate Stegomyia indices have been shown to be inadequate for assessing the risk of dengue virus transmission and targeting Aedes aegypti control strategies, new surveillance methods are needed. Objective. To evaluate the water-surface sweeping method in combination with calibration factors to estimate the total number of Ae. aegypti late larval stages (L3/L4) in large water-storage containers at different temperatures at which transmission of dengue virus occurs. Materials and methods. Calibration factors were derived based on the proportion of L3/L4 recovered from a predetermined number of larvae using a net of specific dimensions and water-storage containers of different capacities and water levels in semi-field conditions and at four different altitudes (14, 358, 998 and 1,630 meters above sea level). The calibration factors obtained at 14 masl were then fully validated in a field study site at this altitude. Results. Four calibration factors were derived at 14 masl (28-30°C) that were used to estimate the total L3/L4 numbers in large water storage containers greater than 20 L (n=478) at 1/3, 2/3 and full water-levels. This methodology was accurate and robust within and between the 10 pairs of field workers who applied it. Different calibration factors were, however, derived to accurately estimate the total L3/L4 numbers at each of the study sites located at 358, 998 and 1,630 masl, where average temperatures were 19°C, 24°C, and 26°C respectively. Conclusions. The accurate estimates of L3/L4 numbers calculated using the water surface sweeping method can be useful for evaluating intervention strategies directed against the larval stages.

Introducción. Las metodologías usadas para calcular los índices de Stegomyia son inadecuadas para evaluar el riesgo de transmisión del virus del dengue y, tampoco, permiten enfocar estrategias de control de Aedes aegypti, por lo cual se requiere desarrollar nuevos métodos para la vigilancia. Objetivo. Evaluar el método de barrido del agua superficial combinado con factores de calibración para estimar el número total estadios larvarios tardíos (L3/L4) de Ae. aegypti en depósitos de grandes capacidades a diferentes temperaturas de transmisión del virus del dengue. Materiales y métodos. Los factores de calibración se derivaron de la proporción de L3/L4 recolectadas con una malla de dimensiones específicas y a partir de un número conocido de larvas, en depósitos de diferentes capacidades y niveles de agua, en condiciones de campo simuladas y a cuatro altitudes diferentes (14, 358, 998 y 1.630 metros sobre el nivel del mar). Los factores de calibración obtenidos a 14 msnm fueron plenamente validados en el campo a esa altitud. Resultados. Se derivaron cuatro factores de calibración a 14 msnm (28°C-30°C) los cuales se emplearon para estimar el número total de L3/L4 en depósitos con capacidades mayores a 20 L (n=478) y a niveles de agua de un tercio, dos tercios y lleno. Esta metodología fue precisa y sólida en los 10 pares de trabajadores que aplicaron el método y entre ellos. Sin embargo, diferentes factores de calibración fueron derivados para estimar con precisión los números totales de L3/L4 en cada uno de los sitios de estudio localizados a 358, 998 y 1.630 msnm, donde las temperaturas promedio fueron de 19°C, 24°C y 26°C, respectivamente. Conclusión. La estimación precisa del número total de L3/L4 usando el barrido descrito permite proponer el uso de este método para evaluar estrategias de control dirigido a contra estados larvarios.

Comportamiento de la leptospirosis en el departamento del Atlántico (Colombia) Enero de 1999 a marzo del 2004 / Behavior of leptospirosis in Atlantic Department (Colombia)January 1999 –March 2004

Objetivos: Describir el comportamiento epidemiológico de la leptospirosis en el departamento delAtlántico (Colombia), de enero de 1999 a marzo del 2004.Metodología: Estudio descriptivo. Se analizaron 970 muestras únicas de pacientes sospechosos deinfecciones con Leptospira en el Laboratorio Departamental del Atlántico mediante AglutinaciónMicroscópica (MAT), usando como antígenos los serovares Icterohemorragiae, Pomona, Canícola,Hardjo, Grippotyphosa y Hardjo-bovis de Leptospira interrogans.

Objective: This study was performed to describe the epidemiological situation of Leptospira in theDepartament of Atlantico (Colombia), from January 1999 to March 2004.Methods: A descriptive study was performed. A total of 970 single serum samples from patients withsuspected Leptospira infections, were analyzed using the microscopic agglutination test (MAT). Theserovars of Icterohaemorrhagiae, Pomona, Canicola, Hardjo, Grippotyphosa and Hardjo-bovis belongingto L. interrogans, were used as antigens. Information about clinical presentation based on epidemiologicalsheets, visits to patients and climatological data were obtained.Results: The 9,7percent samples were IgM positive for Leptospira and the most prevalent was the serovarIcterohaemorrhagiae (62percent), followed by Hardjo (12.8percent). Most of the patients were male (61percent) between 15 and 45 y.o. The most common presenting features in these patients were (91.7percent), myalgia (72 percent), vomit/nausea (70.8 percent), headache (68.1 percent) and icterichia (63.9 percent). 8.6percent of the cases were severe, associated to infections with the serovar Icterohemorragiae and their symptomathology was similar to the Weil ìs syndrome; no fatalities were registered. The highest incidences were recorded during the years 2003 (23),2001(21) and 2002 (18) especially during the rainy season (August-November). Barranquilla reportedthe highest number of cases (46) followed by Soledad (25), Puerto Colombia (6) and Galapa...