Abstract
BackgroundThe spread of Dengue virus (DENV) infections, as well as their signs and symptoms, are the result of a complex interaction between several factors. In Brazil, especially in the Northeastern, dengue is an important public health problem. Here, we report an epidemiological analysis of dengue cases in Pernambuco state, Northeastern Brazil, during 2015–2017.MethodsThis work is a retrospective cross-sectional observational study on the epidemiological profile of all dengue cases confirmed and reported to the Health Secretary of Pernambuco between 2015 and 2017. These data cover all municipalities of Pernambuco, except Fernando de Noronha. DENV-positive individuals were classified according to the dengue type (without and with warning signs, or severe dengue), age, gender, ethnicity and intermediate geographic region of residence (Recife, Caruaru, Serra Talhada or Petrolina). The distribution of cases over the years was assessed by χ2 test. Temperature and rainfall data were evaluated by Unpaired t-test. p-value < 0.05 and CI 95% were considered in all analyses.ResultsMost dengue cases was without warning signs. The most observed characteristics in the less severe dengue phenotypes were: female, mulatto ethnicity and age between 20 and 39 years old; this profile was more clearly observed in 2015. In 2016 and 2017, however, the numbers of dengue without and with warning signs were more evenly distributed and the difference in cases within groups decreased significantly. Regarding severe dengue, mulattoes were the most affected, but it is possible to note a trend towards a more uniform distribution between the genders and ages. Recife was the region with the highest numbers of both total cases and incidence rates and the highest rainfall levels. Overall, over the years, there has been a decrease in dengue cases in all regions of Pernambuco.ConclusionsWe identified the epidemiological profile of dengue in Pernambuco, Brazil, reporting the gender, age, ethnicity and regions most affected by different dengue types. In addition, we observed that these cases were probably more influenced by rainfall than by temperature. Finally, we believe that this epidemiological knowledge is important to direct public health policies to the reality of each population.
Highlights
The spread of Dengue virus (DENV) infections, as well as their signs and symptoms, are the result of a complex interaction between several factors
We identified the epidemiological profile of dengue in Pernambuco, Brazil, reporting the gender, age, ethnicity and regions most affected by different dengue types
We report the epidemiological profile of dengue cases in Pernambuco state, Brazil, in the 2015–2017 triennium
Summary
The spread of Dengue virus (DENV) infections, as well as their signs and symptoms, are the result of a complex interaction between several factors. In Brazil, especially in the Northeastern, dengue is an important public health problem. We report an epidemiological analysis of dengue cases in Pernambuco state, Northeastern Brazil, during 2015–2017. The World Health Organization (WHO) estimates that 50 to 100 million new DENV infections occur worldwide each year and in more than 100 endemic countries [2]. The number of dengue cases is the result of a complex interaction between viral, environmental and host factors, which influence the signs and symptoms of the disease. The introduction of new serotypes into areas free of their circulation and/or the re-emergence of serotypes after considerable epidemiological silencing has been responsible for millions of infections [4,5,6]. The co-circulation of different DENV serotypes and the possibility of antibody-dependent enhancement (ADE) has been one of the main determinants of the severity of infections [7]
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