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      Analysis of dengue cases according to clinical severity, São Luís, Maranhão, Brazil

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          ABSTRACT

          Severe dengue cases have increased in Brazil since 2001, with the first records in Maranhão dating back to 2002. The aim of this study was to determine the prevalence of severe dengue cases by age group and the possible risk factors. This was a study of secondary data on dengue in residents of São Luís, Maranhão , Brazil, using probable cases notified to the National Mandatory Reporting System (SINAN) from 2002 to 2011. The diagnosis and classification of dengue were based on the Brazilian Ministry of Health criteria: dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue fever with complications (DWC). DHF and DWC were considered severe dengue, and DF was classified as non-severe dengue. A logistic regression analysis was performed with severe dengue as the outcome. During the study period, 1,229 cases of severe dengue were reported; of these, 812 in patients under the age of 15 (66%). Among the risk factors evaluated, age under 15 years old (OR = 3.10, 95% CI = 2.69-3.57, p-value = 0.001) was associated with severe dengue. The prevalence of severe dengue in children under the age of 15 was higher, and only this age group was associated with the occurrence of severe dengue.

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          The global distribution and burden of dengue

          Samir Bhatt, Peter W. Gething, Oliver J Brady … (2013)
          Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes 1 . For some patients dengue is a life-threatening illness 2 . There are currently no licensed vaccines or specific therapeutics, and substantial vector control efforts have not stopped its rapid emergence and global spread 3 . The contemporary worldwide distribution of the risk of dengue virus infection 4 and its public health burden are poorly known 2,5 . Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modelling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010. We predict dengue to be ubiquitous throughout the tropics, with local spatial variations in risk influenced strongly by rainfall, temperature and the degree of urbanisation. Using cartographic approaches, we estimate there to be 390 million (95 percent credible interval 284-528) dengue infections per year, of which 96 million (67-136) manifest apparently (any level of clinical or sub-clinical severity). This infection total is more than three times the dengue burden estimate of the World Health Organization 2 . Stratification of our estimates by country allows comparison with national dengue reporting, after taking into account the probability of an apparent infection being formally reported. The most notable differences are discussed. These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue. We anticipate that they will provide a starting point for a wider discussion about the global impact of this disease and will help guide improvements in disease control strategies using vaccine, drug and vector control methods and in their economic evaluation. [285]
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            Dengue and dengue hemorrhagic fever.

            Duane J. Gubler (1998)
            Dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity (the cocirculation of multiple serotypes), and the emergence of dengue hemorrhagic fever in new geographic regions. In 1998 this mosquito-borne disease is the most important tropical infectious disease after malaria, with an estimated 100 million cases of dengue fever, 500,000 cases of dengue hemorrhagic fever, and 25,000 deaths annually. The reasons for this resurgence and emergence of dengue hemorrhagic fever in the waning years of the 20th century are complex and not fully understood, but demographic, societal, and public health infrastructure changes in the past 30 years have contributed greatly. This paper reviews the changing epidemiology of dengue and dengue hemorrhagic fever by geographic region, the natural history and transmission cycles, clinical diagnosis of both dengue fever and dengue hemorrhagic fever, serologic and virologic laboratory diagnoses, pathogenesis, surveillance, prevention, and control. A major challenge for public health officials in all tropical areas of the world is to develop and implement sustainable prevention and control programs that will reverse the trend of emergent dengue hemorrhagic fever.
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              Observations related to pathogenesis of dengue hemorrhagic fever. IV. Relation of disease severity to antibody response and virus recovered.

              S B Halstead, S. Nimmannitya, S N Cohen (1970)
              Article 0 comments Cited 133 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Rev Inst Med Trop Sao Paulo
                Journal ID (iso-abbrev): Rev. Inst. Med. Trop. Sao Paulo
                Journal ID (publisher-id): rimtsp
                Title: Revista do Instituto de Medicina Tropical de São Paulo
                Publisher: Instituto de Medicina Tropical
                ISSN (Print): 0036-4665
                ISSN (Electronic): 1678-9946
                Publication date (Electronic): 06 November 2017
                Publication date Collection: 2017
                Volume: 59
                Electronic Location Identifier: e71
                Affiliations
                [(1) ]Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, Maranhão, Brazil
                [(2) ]Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde e Ambiente, São Luís, Maranhão, Brazil
                [(3) ]Secretaria Municipal de Saúde, São Luís, Maranhão, Brazil
                Author notes
                Correspondence to: Maria dos Remédios Freitas Carvalho Branco Universidade Federal do Maranhão, Praça Madre Deus, 2, CEP 65025-560, São Luís, MA, Brazil Tel: +55 98 988803-2488. E-mail: mrfcbranco@ 123456gmail.com

                AUTHORS CONTRIBUTIONS

                JJDJ: data analysis, article design and writing. MRCB: study conception, data analysis, article design and writing, and coordination of all research stages up to the final writing of the article. RCSQ: study design, data analysis and article writing. AMS and EPBM: data analysis and article writing. MSS: study design, data analysis and article writing. All authors approved the final version of the manuscript.

                Article
                Other ID: 00243
                DOI: 10.1590/S1678-9946201759071
                PMC ID: 5679683
                PubMed ID: 29116291
                SO-VID: 25da1a7a-f020-42fa-ae84-9e4071ab01fd
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 April 2017
                Date accepted : 29 August 2017
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 42, Pages: 1
                Categories
                Subject: Original Article

                Keywords: severe dengue,children,public health surveillance,risk factors,dengue complications,dengue clinical severity
                Data availability:
                Keywords: severe dengue, children, public health surveillance, risk factors, dengue complications, dengue clinical severity

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