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哥伦比亚麦德林市 2009 年至 2017 年登革热的监测和流行病学研究。

Surveillance and Epidemiology of Dengue in Medellín, Colombia from 2009 to 2017.

机构信息

1Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellín, Colombia.

2Sustainable Sciences Institute (SSI), San Francisco, California.

出版信息

Am J Trop Med Hyg. 2021 Mar 22;104(5):1719-1728. doi: 10.4269/ajtmh.19-0728.

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.

摘要

登革热是人类最常见的虫媒病毒病,主要由埃及伊蚊传播。我们使用来自哥伦比亚麦德林卫生局的数据,对 2009 年至 2017 年期间的登革热病例进行了描述性分析。我们分析了疫情年份对医疗保健系统的负担、出现重症病例的风险、潜在疾病监测问题、性别和年龄作为风险因素,以及疾病发生的时空模式。我们的数据包括 50083 例病例,根据是否为诊断性检测阴性、诊断性检测阳性(主要为 IgM ELISA)、临床确诊、流行病学关联或可能进行了分类。我们使用登革热发病率分析了研究年份之间与人类活动模式、性别和年龄组之间以及时空相关的流行病学趋势。我们使用风险分析了研究年份之间登革热病例的严重程度。我们发现人类活动可能导致登革热传播,男性(发病率:0.86;95%置信区间:0.76-0.96)和 15 岁以下的个体(发病率:1.24;95%置信区间:1.13-1.34)登革热发病率更高,且位于城市的关键区域,该区域的登革热发病率较高。分析受到参与者诊断信息、循环株相关数据以及缺乏系统发育信息的限制。了解登革热的特征是改善高危人群健康结果的基础。该分析将有助于支持对抗登革热的研究和举措,并为麦德林卫生局收集的监测数据提供背景。

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