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BackgroundBrazil has the third-highest number of Coronavirus disease 2019 (COVID-19) cases worldwide. Understanding the epidemiology of COVID-19 from reported cases is challenging due to heterogeneous testing rates. We estimated the number of COVID-19 cases in Brazil on a national and regional level using digital technology. MethodsWe used a web-based application to perform a population-based survey from March 21st to August 29th, 2020 in Brazil. We obtained responses from 243 461 individuals across all federative units, who answered questions on COVID-19-related symptoms, chronic diseases and address of residence. COVID-19 was defined as at least one of the following: fever, cough, dyspnea and nasal flaring, associated with a history of close contact with a suspect or confirmed COVID-19 case in the previous 14 days. A stratified two-stage weighted survey analysis was performed to estimate the population level prevalence of COVID-19 cases. ResultsAfter calibration weighing, we estimated that 10 339 461 cases of COVID-19 occurred, yielding a 2.75 estimated infection per officially reported case. Estimated/reported ratios varied across Brazilian states and were higher in states with lower human development indexes. Areas with lower income levels displayed higher rates of COVID-19 cases (66 vs 38 cases/1000 people in the lowest and highest income strata respectively, p<0.001), but presented lower rates of COVID-19 testing. ConclusionIn this population-based survey using digital technology in Brazil, we estimated that the COVID-19 case rates were 2.75 times higher than officially reported. The estimated per reported case ratios were higher in areas with worse socioeconomic status.
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INTRODUCTIONPrevention measures are highly important to poor communities because surveillance and access to health care may be limited. OBJECTIVESWe aimed establish measures to contain and suppress the spread of COVID-19, associating education, active case tracking, and humanitarian aid in two needy communities in Brazil. The adherence to the measures and evolution of the number of cases were verified during the project. MATERIALS AND METHODSThe target population consisted of approximately 1300 participants(350 families). A collection of epidemiological data was performed in family members registered for the project. Rapid tests were performed on people who had symptoms and their contacts. Scientific information through audio-visual materials,educational pamphlets written in colloquial language, food parcels,masks,hygiene and cleaning materials were provided directly to family nuclei. RESULTSThe common needs faced by families were food inputs and/or ready-to-eat food, mentioned by 91.4% (233) of the people, and hygienic and cleaning materials, mentioned by 30.6% (78) of the people. Only 34.9% (84) of families had 70% rubbing alcohol or hand sanitizer gel at home.The most frequently cited sources of information on COVID-19 were television [cited by 82.4% (210) of the people]; social media [25.5% (65)]; friends, neighbours, or family members [13.7% (35)]; and radio [11.4% (29)] .A total of 83.7% (175) stated that the actions helped them to avoid leaving the community. CONCLUSIONSCommunity isolation may be the best way to contain the spread of pandemics in fragile populations with low socio-economic status.Educational actions combined with rapid testing and humanitarian aid were objective forms to promote community isolation.
