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Bohm BC, Morais MHF, Cunha MDCM, Bruhn NCP, Caiaffa WT, Bruhn FRP. Determining the relationship between dengue and vulnerability in a Brazilian city: a spatial modeling analysis. Pathog Glob Health 2024; 118:120-130. [PMID: 37602571 PMCID: PMC11141313 DOI: 10.1080/20477724.2023.2247273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Dengue is a viral infection transmitted by the Aedes aegypti mosquito. This study aimed to assess the distribution of cases and deaths from dengue and severe dengue, and its relationship with social vulnerability in Belo Horizonte, State of Minas Gerais, Brazil, from 2010 to 2018. The incidence and lethality rates of dengue and their relationship with sex, age, education, skin color, and social vulnerability were studied using chi-square tests, Ordinary Least Squares (OLS), and Geographically Weighted Regression (GWR) analyses. The number of cases of dengue in Belo Horizonte during the study period was 324,044 dengue cases, with 1,334 cases of severe dengue and 88 deaths. During the past few decades, the incidence rate of both dengue and severe cases varied, with an average incidence rate of respectively 1515.5 and 6.2/100,000 inhabitants. The increase in dengue cases was directly related to areas with higher social vulnerability areas and more working-age people. Also, the disease is more severe in people self-declared as black, elderly, and male. The findings of this study might provide relevant information for health services in the organization of control and prevention policies for this problem, emphasizing the most vulnerable urban areas and categories.
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Affiliation(s)
- Bianca Conrad Bohm
- Veterinary Epidemiology Laboratory, Preventive Veterinary Department, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | | | | | - Waleska Teixeira Caiaffa
- Urban Health Observatory - Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fábio Raphael Pascoti Bruhn
- Preventive Veterinary Department, Zoonoses Control Center (UFPel), Federal University of Pelotas, Pelotas, Brazil
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Rojas A, Shen J, Cardozo F, Bernal C, Caballero O, Ping S, Key A, Haider A, de Guillén Y, Langjahr P, Acosta ME, Aria L, Mendoza L, Páez M, Von-Horoch M, Luraschi P, Cabral S, Sánchez MC, Torres A, Pinsky BA, Piantadosi A, Waggoner JJ. Characterization of Dengue Virus 4 Cases in Paraguay, 2019-2020. Viruses 2024; 16:181. [PMID: 38399957 PMCID: PMC10892180 DOI: 10.3390/v16020181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/25/2024] Open
Abstract
In 2019-2020, dengue virus (DENV) type 4 emerged to cause the largest DENV outbreak in Paraguay's history. This study sought to characterize dengue relative to other acute illness cases and use phylogenetic analysis to understand the outbreak's origin. Individuals with an acute illness (≤7 days) were enrolled and tested for DENV nonstructural protein 1 (NS1) and viral RNA by real-time RT-PCR. Near-complete genome sequences were obtained from 62 DENV-4 positive samples. From January 2019 to March 2020, 799 participants were enrolled: 253 dengue (14 severe dengue, 5.5%) and 546 other acute illness cases. DENV-4 was detected in 238 dengue cases (94.1%). NS1 detection by rapid test was 52.5% sensitive (53/101) and 96.5% specific (387/401) for dengue compared to rRT-PCR. DENV-4 sequences were grouped into two clades within genotype II. No clustering was observed based on dengue severity, location, or date. Sequences obtained here were most closely related to 2018 DENV-4 sequences from Paraguay, followed by a 2013 sequence from southern Brazil. DENV-4 can result in large outbreaks, including severe cases, and is poorly detected with available rapid diagnostics. Outbreak strains seem to have been circulating in Paraguay and Brazil prior to 2018, highlighting the importance of sustained DENV genomic surveillance.
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Affiliation(s)
- Alejandra Rojas
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - John Shen
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Fátima Cardozo
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
- Departamento de Laboratorio de Análisis Clínicos, Hospital Central—Instituto de Previsión Social, Asunción 001531, Paraguay; (M.C.S.); (A.T.)
| | - Cynthia Bernal
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Oliver Caballero
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Sara Ping
- Department of Medicine, Division of Infectious Diseases, Emory University, 1760 Haygood Drive NE, Room E-169, Bay E-1, Atlanta, GA 30322, USA; (S.P.); (A.H.); (A.P.)
| | - Autum Key
- Department of Pathology, Emory University, Atlanta, GA 30322, USA;
| | - Ali Haider
- Department of Medicine, Division of Infectious Diseases, Emory University, 1760 Haygood Drive NE, Room E-169, Bay E-1, Atlanta, GA 30322, USA; (S.P.); (A.H.); (A.P.)
| | - Yvalena de Guillén
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Patricia Langjahr
- Facultad de Ciencias Químicas, Universidad Nacional de Asunción, Campus Universitario, San Lorenzo 111421, Paraguay;
| | - Maria Eugenia Acosta
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Laura Aria
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Laura Mendoza
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Malvina Páez
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo 111241, Paraguay; (F.C.); (C.B.); (O.C.); (Y.d.G.); (M.E.A.); (L.A.); (L.M.); (M.P.)
| | - Marta Von-Horoch
- Departamento de Epidemiología, Hospital Central—Instituto de Previsión Social, Asunción 001531, Paraguay; (M.V.-H.); (P.L.); (S.C.)
| | - Patricia Luraschi
- Departamento de Epidemiología, Hospital Central—Instituto de Previsión Social, Asunción 001531, Paraguay; (M.V.-H.); (P.L.); (S.C.)
| | - Sandra Cabral
- Departamento de Epidemiología, Hospital Central—Instituto de Previsión Social, Asunción 001531, Paraguay; (M.V.-H.); (P.L.); (S.C.)
| | - María Cecilia Sánchez
- Departamento de Laboratorio de Análisis Clínicos, Hospital Central—Instituto de Previsión Social, Asunción 001531, Paraguay; (M.C.S.); (A.T.)
| | - Aurelia Torres
- Departamento de Laboratorio de Análisis Clínicos, Hospital Central—Instituto de Previsión Social, Asunción 001531, Paraguay; (M.C.S.); (A.T.)
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA;
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Anne Piantadosi
- Department of Medicine, Division of Infectious Diseases, Emory University, 1760 Haygood Drive NE, Room E-169, Bay E-1, Atlanta, GA 30322, USA; (S.P.); (A.H.); (A.P.)
- Department of Pathology, Emory University, Atlanta, GA 30322, USA;
| | - Jesse J. Waggoner
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
- Department of Medicine, Division of Infectious Diseases, Emory University, 1760 Haygood Drive NE, Room E-169, Bay E-1, Atlanta, GA 30322, USA; (S.P.); (A.H.); (A.P.)
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Development of a Dengue Virus Serotype-Specific Non-Structural Protein 1 Capture Immunochromatography Method. SENSORS 2021; 21:s21237809. [PMID: 34883813 PMCID: PMC8659457 DOI: 10.3390/s21237809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
Four serotypes of dengue virus (DENV), type 1 to 4 (DENV-1 to DENV-4), exhibit approximately 25–40% of the difference in the encoded amino acid residues of viral proteins. Reverse transcription of RNA extracted from specimens followed by PCR amplification is the current standard method of DENV serotype determination. However, since this method is time-consuming, rapid detection systems are desirable. We established several mouse monoclonal antibodies directed against DENV non-structural protein 1 and integrated them into rapid DENV detection systems. We successfully developed serotype-specific immunochromatography systems for all four DENV serotypes. Each system can detect 104 copies/mL in 15 min using laboratory and clinical isolates of DENV. No cross-reaction between DENV serotypes was observed in these DENV isolates. We also confirmed that there was no cross-reaction with chikungunya, Japanese encephalitis, Sindbis, and Zika viruses. Evaluation of these systems using serum from DENV-infected individuals indicated a serotype specificity of almost 100%. These assay systems could accelerate both DENV infection diagnosis and epidemiologic studies in DENV-endemic areas.
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Warnes CM, Santacruz-Sanmartín E, Bustos Carrillo F, Vélez ID. Surveillance and Epidemiology of Dengue in Medellín, Colombia from 2009 to 2017. Am J Trop Med Hyg 2021; 104:1719-1728. [PMID: 33755586 PMCID: PMC8103481 DOI: 10.4269/ajtmh.19-0728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/22/2021] [Indexed: 11/07/2022] Open
Abstract
Dengue is the most prevalent arthropod-borne viral disease in humans, primarily transmitted by the Aedes aegypti mosquito. We conducted a descriptive analysis of dengue cases from 2009 to 2017 in Medellín, Colombia, using data available from the Secretariat of Health. We analyzed the burden of outbreak years on the healthcare system, risk of cases exhibiting severe illness, potential disease surveillance problems, gender and age as risk factors, and spatiotemporal patterns of disease occurrence. Our data consisted of 50,083 cases, separated based on whether they were diagnostic test negative, diagnostic test positive (primarily IgM ELISA), clinically confirmed, epidemiologically linked, or probable. We used dengue incidence to analyze epidemiological trends between our study years, related to human movement patterns, between gender and age-groups, and spatiotemporally. We used risk to analyze the severity of dengue cases between the study years. We identified human movement could contributed to dengue spread, and male individuals (incidence rate: 0.86; 95% CI: 0.76-0.96) and individuals younger than 15 years (incidence rate: 1.24; 95% CI: 1.13-1.34) have higher incidence of dengue and located critical parts of the city where dengue incidence was high. Analysis was limited by participant diagnostic information, data concerning circulating strains, and a lack of phylogenetic information. Understanding the characteristics of dengue is a fundamental part of improving the health outcomes of at-risk populations. This analysis will be useful to support studies and initiatives to counteract dengue and provide context to the surveillance data collected by the health authorities in Medellín.
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Affiliation(s)
- Colin M. Warnes
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellín, Colombia
| | - Eduardo Santacruz-Sanmartín
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellín, Colombia
| | | | - Iván Darío Vélez
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellín, Colombia
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Tsheten T, Clements ACA, Gray DJ, Wangchuk S, Wangdi K. Spatial and temporal patterns of dengue incidence in Bhutan: a Bayesian analysis. Emerg Microbes Infect 2021; 9:1360-1371. [PMID: 32538299 PMCID: PMC7473275 DOI: 10.1080/22221751.2020.1775497] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Dengue is an important emerging vector-borne disease in Bhutan. This study aimed to quantify the spatial and temporal patterns of dengue and their relationship to environmental factors in dengue-affected areas at the sub-district level. A multivariate zero-inflated Poisson regression model was developed using a Bayesian framework with spatial and spatiotemporal random effects modelled using a conditional autoregressive prior structure. The posterior parameters were estimated using Bayesian Markov Chain Monte Carlo simulation with Gibbs sampling. A total of 708 dengue cases were notified through national surveillance between January 2016 and June 2019. Individuals aged ≤14 years were found to be 53% (95% CrI: 42%, 62%) less likely to have dengue infection than those aged >14 years. Dengue cases increased by 63% (95% CrI: 49%, 77%) for a 1°C increase in maximum temperature, and decreased by 48% (95% CrI: 25%, 64%) for a one-unit increase in normalized difference vegetation index (NDVI). There was significant residual spatial clustering after accounting for climate and environmental variables. The temporal trend was significantly higher than the national average in eastern sub-districts. The findings highlight the impact of climate and environmental variables on dengue transmission and suggests prioritizing high-risk areas for control strategies.
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Affiliation(s)
- Tsheten Tsheten
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia.,Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Australia.,Telethon Kids Institute, Nedlands, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Kinley Wangdi
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
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Molecular Epidemiology of Dengue in Panama: 25 Years of Circulation. Viruses 2019; 11:v11080764. [PMID: 31434193 PMCID: PMC6724401 DOI: 10.3390/v11080764] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/16/2019] [Accepted: 07/24/2019] [Indexed: 11/16/2022] Open
Abstract
Dengue virus (DENV) is the most prevalent arbovirus in terms of human public health importance globally. In addition to DENV epidemiological surveillance, genomic surveillance may help investigators understand the epidemiological dynamics, geographic distribution, and temporal patterns of DENV circulation. Herein, we aimed to reconstruct the molecular epidemiology and phylogeny of DENV in Panama to connect the epidemiological history of DENV dispersal and circulation in Latin America. We retrospectively analyzed the epidemiological data obtained during 25 years of DENV surveillance in Panama. DENV was reintroduced in Panama in 1993 after a 35 year absence of autochthonous transmission. The increase in the number of total dengue cases has been accompanied by an increase in severe and fatal cases, with the highest case fatality rate recorded in 2011. All four serotypes were detected in Panama, which is characterized by serotype replacement and/or co-circulation of multiple serotypes. Phylogenetic analysis of datasets collected from envelope (E) gene sequences obtained from viruses isolated from human sera demonstrated that circulating viruses were highly diverse and clustered in distinct clades, with co-circulation of clades from the same genotype. Our analyses also suggest that Panamanian strains were related to viruses from different regions of the Americas, suggesting a continuous exchange of viruses within the Americas.
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