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Recker M, Fleischmann WA, Nghia TH, Truong NV, Nam LV, Duc Anh D, Song LH, The NT, Anh CX, Hoang NV, My Truong N, Toan NL, Kremsner PG, Velavan TP. Markers of prolonged hospitalisation in severe dengue. PLoS Negl Trop Dis 2024; 18:e0011922. [PMID: 38289968 PMCID: PMC10857710 DOI: 10.1371/journal.pntd.0011922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 02/09/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Dengue is one of the most common diseases in the tropics and subtropics. Whilst mortality is a rare event when adequate supportive care can be provided, a large number of patients get hospitalised with dengue every year that places a heavy burden on local health systems. A better understanding of the support required at the time of hospitalisation is therefore of critical importance for healthcare planning, especially when resources are limited during major outbreaks. METHODS Here we performed a retrospective analysis of clinical data from over 1500 individuals hospitalised with dengue in Vietnam between 2017 and 2019. Using a broad panel of potential biomarkers, we sought to evaluate robust predictors of prolonged hospitalisation periods. RESULTS Our analyses revealed a lead-time bias, whereby early admission to hospital correlates with longer hospital stays - irrespective of disease severity. Importantly, taking into account the symptom duration prior to hospitalisation significantly affects observed associations between hospitalisation length and previously reported risk markers of prolonged stays, which themselves showed marked inter-annual variations. Once corrected for symptom duration, age, temperature at admission and elevated neutrophil-to-lymphocyte ratio were found predictive of longer hospitalisation periods. CONCLUSION This study demonstrates that the time since dengue symptom onset is one of the most significant predictors for the length of hospital stays, independent of the assigned severity score. Pre-hospital symptom durations need to be accounted for to evaluate clinically relevant biomarkers of dengue hospitalisation trajectories.
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Affiliation(s)
- Mario Recker
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Centre for Ecology and Conservation, University of Exeter, Penryn Campus, Penryn, United Kingdom
| | - Wim A. Fleischmann
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Trinh Huu Nghia
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Truong
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Le Van Nam
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Do Duc Anh
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
| | - Le Huu Song
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Trong The
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | | | | | - Nhat My Truong
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- 108 Military Central Hospital, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Peter G. Kremsner
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon
| | - Thirumalaisamy P. Velavan
- Institute for Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, VG-CARE, Hanoi, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
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Abud DA, Santos CY, Neto AAL, Senra JT, Tuboi S. Real world data study of prevalence and direct costs related to dengue management in Brazil's private healthcare from 2015 to 2020. Braz J Infect Dis 2022; 26:102718. [PMID: 36423695 PMCID: PMC9700264 DOI: 10.1016/j.bjid.2022.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/24/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The burden of dengue in Brazil is poorly documented and is based on data from the public health care setting. This study estimated the prevalence and costs of dengue management in the private health care system in Brazil from 2015 to 2020 using a large claims database from Orizon. METHODS We selected claims with dengue ICD codes (ICD-10 A90 or A91) from January 2015 to December 2020. Prevalence was estimated based on the population enrolled in health insurance plans in the given year. Costs were adjusted for the inflation up to December 2021 and evaluated by measures of central tendency and dispersion. RESULTS A total of 63,882 unique beneficiaries were included, with a total of 64,186 dengue cases. The year with the highest prevalence was 2015 (1.6% of patients who used health plans), and there was also an increase in cases in 2016 and 2019. The median cost per hospitalization in 2015 was US$486.17, and in 2020, it reached US$696.72. The median cost of a case seen at an emergency room ranged from US$ 97.78 in 2015 to US$ 118.16 in 2017. CONCLUSIONS The estimated prevalence of dengue in this population of private health-insured patients followed the epidemiological trends of the general population in Brazil, with the highest rates in 2015, 2016, and 2019. The cost of dengue management has increased in the private health care setting over the years.
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Carreto C, Gutiérrez-Romero R, Rodríguez T. Climate-driven mosquito-borne viral suitability index: measuring risk transmission of dengue, chikungunya and Zika in Mexico. Int J Health Geogr 2022; 21:15. [PMID: 36303147 PMCID: PMC9610358 DOI: 10.1186/s12942-022-00317-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background Climate variability influences the population dynamics of the Aedes aegypti mosquito that transmits the viruses that cause dengue, chikungunya and Zika. In recent years these diseases have grown considerably. Dengue is now the fastest-growing mosquito-transmitted disease worldwide, putting 40 per cent of the global population at risk. With no effective antiviral treatments or vaccines widely available, controlling mosquito population remains one of the most effective ways to prevent epidemics. This paper analyses the temporal and spatial dynamics of dengue in Mexico during 2000–2020 and that of chikungunya and Zika since they first appeared in the country in 2014 and 2015, respectively. This study aims to evaluate how seasonal climatological variability affects the potential risk of transmission of these mosquito-borne diseases. Mexico is among the world’s most endemic countries in terms of dengue. Given its high incidence of other mosquito-borne diseases and its size and wide range of climates, it is a good case study. Methods We estimate the recently proposed mosquito-borne viral suitability index P, which measures the transmission potential of mosquito-borne pathogens. This index mathematically models how humidity, temperature and precipitation affect the number of new infections generated by a single infected adult female mosquito in a host population. We estimate this suitability index across all Mexico, at small-area level, on a daily basis during 2000–2020. Results We find that the index P predicted risk transmission is strongly correlated with the areas and seasons with a high incidence of dengue within the country. This correlation is also high enough for chikungunya and Zika in Mexico. We also show the index P is sensitive to seasonal climatological variability, including extreme weather shocks. Conclusions The paper shows the dynamics of dengue, chikungunya and Zika in Mexico are strongly associated with seasonal climatological variability and the index P. This potential risk of transmission index, therefore, is a valuable tool for surveillance for mosquito-borne diseases, particularly in settings with varied climates and limited entomological capacity. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00317-0.
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Affiliation(s)
- Constantino Carreto
- El Colegio de México (COLMEX), Carretera Picacho-Ajusco 20, Tlalpan, 14110, Mexico City, Mexico.
| | - Roxana Gutiérrez-Romero
- Queen Mary University of London (QMUL), Mile End Campus, Bancroft Building, 4th Floor, London, E1 4NS, UK.
| | - Tania Rodríguez
- Institute of Geography, Universidad Nacional Autónoma de México (UNAM), Investigación Científica, Ciudad Universitaria, C.U., Coyoacán, 04510, Mexico City, Mexico.
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Determining Perceived Self-Efficacy for Preventing Dengue Fever in Two Climatically Diverse Mexican States: A Cross-Sectional Study. Behav Sci (Basel) 2022; 12:bs12040094. [PMID: 35447666 PMCID: PMC9031455 DOI: 10.3390/bs12040094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/03/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Knowledge of dengue fever and perceived self-efficacy toward dengue prevention does not necessarily translate to the uptake of mosquito control measures. Understanding how these factors (knowledge and self-efficacy) influence mosquito control measures in Mexico is limited. Our study sought to bridge this knowledge gap by assessing individual-level variables that affect the use of mosquito control measures. A cross-sectional survey with 623 participants was administered online in Mexico from April to July 2021. Multiple linear regression and multiple logistic regression models were used to explore factors that predicted mosquito control scale and odds of taking measures to control mosquitoes in the previous year, respectively. Self-efficacy (β = 0.323, p-value = < 0.0001) and knowledge about dengue reduction scale (β = 0.316, p-value =< 0.0001) were the most important predictors of mosquito control scale. The linear regression model explained 24.9% of the mosquito control scale variance. Increasing age (OR = 1.064, p-value =< 0.0001) and self-efficacy (OR = 1.020, p-value = 0.0024) were both associated with an increase in the odds of taking measures against mosquitoes in the previous year. There is a potential to increase mosquito control awareness and practices through the increase in knowledge about mosquito reduction and self-efficacy in Mexico.
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Dzul-Manzanilla F, Correa-Morales F, Che-Mendoza A, Palacio-Vargas J, Sánchez-Tejeda G, González-Roldan JF, López-Gatell H, Flores-Suárez AE, Gómez-Dantes H, Coelho GE, da Silva Bezerra HS, Pavia-Ruz N, Lenhart A, Manrique-Saide P, Vazquez-Prokopec GM. Identifying urban hotspots of dengue, chikungunya, and Zika transmission in Mexico to support risk stratification efforts: a spatial analysis. Lancet Planet Health 2021; 5:e277-e285. [PMID: 33964237 PMCID: PMC8114339 DOI: 10.1016/s2542-5196(21)00030-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Effective Aedes aegypti control is limited, in part, by the difficulty in achieving sufficient intervention coverage. To maximise the effect of vector control, areas with persistently high numbers of Aedes-borne disease cases could be identified and prioritised for preventive interventions. We aimed to identify persistent Aedes-borne disease hotspots in cities across southern Mexico. METHODS In this spatial analysis, geocoded cases of dengue, chikungunya, and Zika from nine endemic Mexican cities were aggregated at the census-tract level. We included cities that were located in southern Mexico (the arbovirus endemic region of Mexico), with a high burden of dengue cases (ie, more than 5000 cases reported during a 10-year period), and listed as high priority for the Mexican dengue control and prevention programme. The Getis-Ord Gi*(d) statistic was applied to yearly slices of the dataset to identify spatial hotspots of each disease in each city. We used Kendall's W coefficient to quantify the agreement in the distribution of each virus. FINDINGS 128 507 dengue, 4752 chikungunya and 25 755 Zika clinical cases were reported between Jan 1, 2008, and Dec 31, 2016. All cities showed evidence of transmission heterogeneity, with a mean of 17·6% (SD 4·7) of their total area identified as persistent disease hotspots. Hotspots accounted for 25·6% (SD 9·7; range 12·8-43·0) of the population and 32·1% (10·5; 19·6-50·5) of all Aedes-borne disease cases reported. We found an overlap between hotspots of 61·7% for dengue and Zika and 53·3% for dengue and chikungunya. Dengue hotspots in 2008-16 were significantly associated with dengue hotspots detected during 2017-20 in five of the nine cities. Heads of vector control confirmed hotspot areas as problem zones for arbovirus transmission. INTERPRETATION This study provides evidence of the overlap of Aedes-borne diseases within geographical hotspots and a methodological framework for the stratification of arbovirus transmission risk within urban areas, which can guide the implementation of surveillance and vector control. FUNDING USAID, the US Centers for Disease Control and Prevention, the Canadian Institutes of Health Research, International Development Research Centre, Fondo Mixto CONACyT (Mexico)-Gobierno del Estado de Yucatan, and the US National Institutes of Health. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Felipe Dzul-Manzanilla
- Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE), Ministry of Health, Mexico
| | - Fabián Correa-Morales
- Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE), Ministry of Health, Mexico
| | - Azael Che-Mendoza
- Collaborative Unit for Entomological Bioassays (UCBE), Campus de Ciencias Biologicas y Agropecuarias, Universidad Autonoma de Yucatan, Merida, Yucatan, Mexico
| | | | - Gustavo Sánchez-Tejeda
- Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE), Ministry of Health, Mexico
| | | | - Hugo López-Gatell
- Subsecretaria de Prevencion y Promocion de la Salud, Mexico City, Mexico
| | - Adriana E Flores-Suárez
- Facultad de Ciencias Biologicas Universidad Autónoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Hector Gómez-Dantes
- Health Systems Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Giovanini E Coelho
- Pan American Health Organization (PAHO), Department of Communicable Diseases and Environmental Determinants of Health, Washington DC, USA
| | - Haroldo S da Silva Bezerra
- Pan American Health Organization (PAHO), Department of Communicable Diseases and Environmental Determinants of Health, Washington DC, USA
| | - Norma Pavia-Ruz
- Centro de Investigaciones Regionales Hideyo Noguchi, Universidad Autonoma de Yucatan, Merida, Yucatan, Mexico
| | - Audrey Lenhart
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pablo Manrique-Saide
- Collaborative Unit for Entomological Bioassays (UCBE), Campus de Ciencias Biologicas y Agropecuarias, Universidad Autonoma de Yucatan, Merida, Yucatan, Mexico
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Andrioli DC, Busato MA, Lutinski JA. Spatial and temporal distribution of dengue in Brazil, 1990 - 2017. PLoS One 2020; 15:e0228346. [PMID: 32053623 PMCID: PMC7018131 DOI: 10.1371/journal.pone.0228346] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 12/21/2022] Open
Abstract
Dengue is a viral disease caused by an arbovirus of the genus Flavivirus transmitted in Brazil by the mosquito Aedes aegypti (Linnaeus, 1762). Simultaneous circulation of the four viral serotypes (DENV1, 2, 3 and 4) has been occurring since 2010 and determines a scenario of hyperendemicity of the disease in the country. This study aimed to describe the epidemiological situation of dengue in Brazil in the last three decades. This is a descriptive, observational study that used data of dengue notifications of the National Surveillance System from 1990 to 2017, available in the Epidemiological Bulletins and publications of the Ministry of Health. Dengue incidence increased in all Brazilian regions and the interepidemic periods are distinct in the different regions. The greatest epidemics was recorded in 2015 (1,688,688 cases), with an incidence of 826.0 cases per 100,000 inhabitants, which illustrates the occurrence of dengue in the last decade with increasingly higher epidemic peaks and shortening of the interepidemic periods. The incidence and mortality indices point to the need to improve the organization of response to dengue epidemics. This study provides information on the epidemiology of dengue in the country and can be used in the formulation of public health policies to reduce the impacts of viral transmission.
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Affiliation(s)
- Denise Catarina Andrioli
- Postgraduate Program in Health Sciences, Community University of the Region of Chapecó (Unochapecó), Chapecó, Santa Catarina, Brazil
| | - Maria Assunta Busato
- Postgraduate Program in Health Sciences, Community University of the Region of Chapecó (Unochapecó), Chapecó, Santa Catarina, Brazil
- * E-mail:
| | - Junir Antonio Lutinski
- Postgraduate Program in Health Sciences, Community University of the Region of Chapecó (Unochapecó), Chapecó, Santa Catarina, Brazil
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Garcia-Luna SM, Chaves LF, Juarez JG, Bolling BG, Rodriguez A, Presas YE, Mutebi JP, Weaver SC, Badillo-Vargas IE, Hamer GL, Qualls WA. From Surveillance To Control: Evaluation of A Larvicide Intervention Against Aedes aegypti In Brownsville, Texas. JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION 2019; 35:233-237. [PMID: 31647710 PMCID: PMC7138466 DOI: 10.2987/19-6858.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
South Texas is recognized as a potential area for the emergence and re-emergence of mosquito-borne diseases due to recent circulation of Zika, chikungunya, and dengue viruses. During 2017, high Aedes aegypti abundance found in the city of Brownsville, TX, in combination with the previous year's local transmission of Zika virus, triggered the activation of the Texas Department of State Health Services Emergency Mosquito Control Contingency Contract. A contract with the Clarke Environmental and Mosquito Control was a response to control Ae. aegypti, using a ground-based wide-area larvicide spray (WALS™) containing Bacillus thuringiensis israelensis. The WALS application was evaluated through a field-based bioassay and by comparing surveillance data pre- and post-WALS application. The WALS application bioassay demonstrated that the larvicide was effective up to 60 m into the target properties. Additionally, the number of Ae. aegypti captured in traps decreased in the WALS intervention areas compared with the untreated control areas, with an estimated 29% control.
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