Prevalence of self-reported dengue infections in Manaus Metropolitan Region: a cross-sectional study.

Gustavo Magno Baldin Tiguman,Tais Freire Galvao,Marcus Tolentino Silva,Kathiaja Miranda Souza

doi:10.1590/0037-8682-0232-2019

Abstract

Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease. Amazonas State has a high risk of transmission. This study aimed to assess the self-reported prevalence of dengue in adults living in Manaus Metropolitan Region. A cross-sectional study was conducted with adults living in Manaus Metropolitan Region in 2015. We performed a three-phase probabilistic sampling to collect participants' clinical and sociodemographic data. Self-reported dengue infection in the previous year was the primary outcome. Descriptive statistics and Poisson regression analysis with robust variance were used to calculate the prevalence ratio (PR) of dengue infections with 95% confidence intervals (95% CIs). Multilevel analysis including city and neighborhood variables was calculated. All analyses considered the complex sampling. Among the 4,001 participants, dengue in the previous year was self-reported by 7.0% (95% CI 6.3%-7.8%). Dengue was more frequent in women(PR 1.51; 95% CI 1.06-2.13), elderly participants (≥60 years old, PR 2.54; 95% CI 1.19-5.45), White and Asian participants (PR, 1.57; 95% CI, 1.11-2.23), and individuals who had not received endemic agent visits (PR, 2.28; 95% CI, 1.31-3.99). After multilevel analysis, sex was no longer a significant variable, with the remaining associations still significant. Seven out of 100 inhabitants of Manaus Metropolitan Region reported dengue in the previous year. Dengue was predominantly observed in women, elderly individuals, White and Asian individuals, and individuals who did not receive endemic agent visits. The setting plays an important role in dengue infections.

Highlights

Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease
We included 4,001 participants, of whom 281 self-reported dengue infections in the previous year
The frequency of dengue infections was higher in women (8.3%) and adults aged 45 to 59 years (10.6%) and ≥60 years (9.4%), individuals who completed elementary school or less (9.0%), White and Asian individuals (9.0%), individuals belonging to the lower socioeconomic status (9.2%), individuals with bad or very bad health statuses (8.9%), individuals with chronic diseases (8.1%), women who were pregnant in the last 12 months (11.2%), and individuals without any visit from a family health agent in the last year (10.7%)

Summary

Introduction

Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease. This study aimed to assess the self-reported prevalence of dengue in adults living in Manaus Metropolitan Region. Self-reported dengue infection in the previous year was the primary outcome. Results: Among the 4,001 participants, dengue in the previous year was self-reported by 7.0% (95% CI 6.3%–7.8%). Conclusions: Seven out of 100 inhabitants of Manaus Metropolitan Region reported dengue in the previous year. Dengue is a viral infection with both endemic and epidemic transmission cycles and has an estimated global incidence of 390 million cases per year, of which 96 million manifest symptoms of any severity[1]. The management, planning, and execution of dengue control policies is one of the competencies of the national, state, and municipal spheres of the Brazilian National Health System (Sistema Único de Saúde)[8]

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