ABSTRACT
BACKGROUND: Dengue Viral Infection (DVI) has become endemic in Pakistan since the first major outbreak in Karachi in 1996. Despite aggressive measures taken by relevant authorities, Pakistan has been dealing with a worsening dengue crisis for the past two decades. DHF is severe form of dengue infection which is linked with significant morbidity and mortality. Early identification of severe dengue infections can reduce the morbidity and mortality. In this context we planned current study in which we find out the different factors related with DHF as well as clinical laboratory features of DHF and compare them to DF so that patients can be best evaluated for DHF and managed accordingly at admission. METHODS: Retrospective study conducted over a period of 6 years (2013-2018) in two tertiary care hospitals in Pakistan. Data were collected by using a pre-structured data collection form. Data were statistically analyzed to determine the clinical and laboratory characteristics of DVI and risk factors of dengue hemorrhagic fever (DHF). RESULTS: A total 512 dengue cases (34.05 ± 15.08 years; Male 69.53%) were reviewed. Most common clinical manifestations of DVI were fever (99.60%), headache (89.1%), chills (86.5%), rigors (86.5%), myalgia (72.3%). Less common clinical manifestations were vomiting (52.5%), arthralgia (50.2%) and skin rashes (47.5%). Furthermore, nasal bleeding (44.1%), gum bleeding (32.6%), pleural effusion (13.9%) and hematuria (13.1%) were more profound clinical presentations among DHF patients. Mortality rate was 1.5% in this study. Logistic regression analysis indicated that delayed hospitalization (OR: 2.30) and diabetes mellitus (OR:2.71), shortness of breath (OR:2.21), association with risk groups i.e., living near stagnant water, travelling to endemic areas, living in endemic regions (OR:1.95), and presence of warning signs (OR:2.18) were identified as risk factors of DHF. Statistically we found that there is strong association of diabetes mellitus (DM) with DHF while the patient suffering from DM individually had higher odds (2.71) of developing DHF than patients without disease. CONCLUSIONS: The current study demonstrated that the clinical and laboratory profiles of DF and DHF are significantly distinct. Significant predictors of DHF were advanced age, diabetes mellitus, ascites, pleural effusion, thick gallbladder and delayed hospitalization. The identification of these factors at early stage provides opportunities for the clinicians to identify high risk patients and to reduce dengue-related morbidity and mortality.
Subject(s)
Severe Dengue , Humans , Retrospective Studies , Severe Dengue/epidemiology , Male , Female , Risk Factors , Adult , Middle Aged , Pakistan/epidemiology , Young Adult , Dengue Virus/pathogenicity , Adolescent , Dengue/epidemiology , Dengue/mortality , AgedABSTRACT
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
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/drug therapy , Dengue/complications , Dengue/mortalityABSTRACT
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
Subject(s)
Humans , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/drug therapy , Dengue/complications , Dengue/mortalityABSTRACT
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
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/drug therapy , Dengue/complications , Dengue/mortality , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/drug therapy , Dengue/complications , Dengue/mortality , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/drug therapy , Dengue/complications , Dengue/mortality , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/drug therapy , Dengue/classification , Dengue/mortality , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiologyABSTRACT
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
Subject(s)
Humans , Adult , Middle Aged , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/prevention & control , Arbovirus Infections/drug therapy , Dengue/classification , Dengue/mortality , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Arbovirus Infections/epidemiology , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Dengue/mortality , Chikungunya Fever/mortality , Zika Virus Infection/mortality , Microcephaly/epidemiologyABSTRACT
El dengue es una enfermedad viral transmitida por vector, mosquitos del género Aedes, endémica en gran parte de los países tropicales. El objetivo de este estudio es describir el brote epidemiológico de dengue ocurrido en el Hospital Pediátrico Dr. Hugo Mendoza de Santo Domingo a través de los registros clínicos-epidemiológicos del hospital. Se han calculado tasas de mortalidad, letalidad, incidencias, tasas de hospitalización y se compararon entre grupos de edad, lugar y sexo. El brote de dengue del 2023 en República Dominicana ha sido el más grande de la historia del país. En el hospital se han tenido que ingresar al 92,51% de los pacientes diagnosticados con el fin de monitorizar la enfermedad. Se reportaron un total de 1149 casos de dengue. Se produjeron un total de 16 muertes probables. La importancia del uso de medidas de prevención es primordial para evitar futuros brotes como el sufrido este año. (AU)
Dengue is a viral disease transmitted by vector, mosquitoes of the genus Aedes, endemic in much of tropical countries. The objective of this study is to describe the epidemiological outbreak of dengue that occurred at the Dr. Hugo Mendoza Pediatric Hospital in Santo Domingo through the clinical-epidemiological records of the hospital. Mortality, fatality, incidence, and hospitalization rates have been calculated and compared between age groups, location, and sex. The 2023 dengue outbreak in the Dominican Republic has been the largest in the countrys history. 92.51% of the diagnosed patients have had to be admitted to the hospital in order to monitor the disease. A total of 1,149 cases of dengue were reported. A total of 16 probable deaths occurred. The importance of using preventive measures is essential to avoid future outbreaks like the one suffered this year. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Dengue/epidemiology , Dengue/mortality , Dengue/prevention & control , Hospitals, Pediatric , Dominican Republic/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Arbovirus Infections/epidemiology , Dengue/mortality , Chikungunya Fever/mortality , Zika Virus Infection/mortality , Microcephaly/epidemiologyABSTRACT
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
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Dengue/epidemiology , Arbovirus Infections/epidemiology , Dengue/mortality , Chikungunya Fever/mortality , Chikungunya Fever/epidemiology , Zika Virus Infection/mortality , Zika Virus Infection/epidemiology , Microcephaly/epidemiologyABSTRACT
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
Subject(s)
Humans , Arbovirus Infections/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/prevention & control , Arbovirus Infections/drug therapy , Dengue/classification , Dengue/mortality , Epidemiological Monitoring , Chikungunya Fever/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Microcephaly/epidemiology , Dengue/mortality , Chikungunya Fever/mortality , Zika Virus Infection/mortalityABSTRACT
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
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Dengue/mortality , Chikungunya Fever/mortality , Zika Virus Infection/mortality , Microcephaly/epidemiologyABSTRACT
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.
Subject(s)
Dengue/epidemiology , Epidemiologic Methods , Risk Assessment/methods , Dengue/mortality , Dengue Virus , Humans , Incidence , Philippines/epidemiologyABSTRACT
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
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Dengue/mortality , Chikungunya Fever/mortality , Zika Virus Infection/mortality , Microcephaly/epidemiologyABSTRACT
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.
Subject(s)
Chikungunya Fever/economics , Chikungunya Fever/prevention & control , Dengue/economics , Dengue/prevention & control , Adolescent , Adult , Aedes/drug effects , Aedes/physiology , Aedes/virology , Animals , Chikungunya Fever/epidemiology , Chikungunya Fever/mortality , Chikungunya virus/physiology , Child , Colombia/epidemiology , Cost-Benefit Analysis , Dengue/epidemiology , Dengue/mortality , Dengue Virus/physiology , Disability-Adjusted Life Years , Female , Humans , Insecticides/economics , Insecticides/pharmacology , Male , Mosquito Control/economics , Mosquito Vectors/drug effects , Mosquito Vectors/physiology , Mosquito Vectors/virology , Young AdultABSTRACT
Objetivo: El propósito de este trabajo ha sido describir las manifestaciones clínicas atípicas del dengue que se han reportado desde una mirada global hasta la situación actual de Colombia, principalmente en el Departamento de Arauca. Método: Se realizó una búsqueda de literatura científica en las bases de datos PubMed y Scielo Public Health, se eligieron los descriptores o palabras relacionadas con la enfermedad y se realizó búsqueda para la descripción de reportes de casos de manifestaciones inusuales producidas por la infección por dengue. Finalmente se buscaron reportes de casos en Colombia por la base de datos SciELO Public Health de manifestaciones atípicas producidas por dengue, así como los reportes del Instituto Nacional de Salud de Colombia. Resultados: De la exploración de 80 revisiones, la búsqueda identificó 26 artículos, se revisaron los resúmenes y se seleccionaron 18 por ajustarse al objetivo de la revisión. Se excluyeron 8 ya que no correspondían directamente a un episodio de complicación directa por dengue. Así mismo de las referencias de los casos reportados en la búsqueda inicial, se tomaron en cuenta para enriquecer el contexto de esta revisión. Conclusiones: Las manifestaciones atípicas resultados de la infección por el virus del dengue, cada vez son más frecuentemente en todo el mundo. Es notorio en esta revisión que la población infantil es blanco de esta infección viral y que la prevención debe estar enfocada a disminuir la transmisión vectorial con el fin de proteger la población en riesgo, además cabe resaltar que las manifestaciones clínicas más prevalentes encontradas fueron las neurológicas y gastrointestinales afectando a la población infantil en su mayoría.(AU)
Objective: The purpose of this work has been to describe the atypical clinical manifestations of dengue that have been reported from a global perspective to the current situation in Colombia, mainly in the Department of Arauca. Method: A scientific literature search was carried out in the PubMed and Scielo Public Health databases, the descriptors or words related to the disease were chosen and a search was carried out for the description of case reports of unusual manifestations produced by dengue infection. Finally, reports of cases in Colombia were searched through the Scielo Public Health database of atypical manifestations produced by dengue, as well as reports from the National Institute of Health of Colombia. Results: From the exploration of 80 reviews, the search identified 26 articles, the abstracts were reviewed, and 18 were selected to fit the purpose of the review. 8 of them were excluded because, they did not correspond directly to an episode of complication from dengue. Likewise, the references of the cases reported in the initial search were taken into account to enrich the context of this review. Conclusions: Atypical manifestations resulting from dengue virus infection are becoming more and more frequent throughout the world. It is well known in this review that the child population is the target of this viral infection and that prevention should be focused on reducing vector transmission in order to protect the population at risk, it should also be noted that the most prevalent clinical manifestations found were neurological and gastrointestinal, affecting the majority of the child population.(AU)
