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南美洲儿童登革热流行病学的变化。

Changing epidemiology of dengue fever in children in South America.

机构信息

Hospital Epidemiology and Infection Control, Hospital São Lucas.

Escola de Medicina Estácio-Idomed, Ribeirão Preto, São Paulo State, Brazil.

出版信息

Curr Opin Pediatr. 2023 Apr 1;35(2):147-154. doi: 10.1097/MOP.0000000000001220. Epub 2023 Jan 30.

Abstract

PURPOSE OF REVIEW

Dengue is the most important arthropod-borne viral disease of public health significance. Its geographic distribution includes 128 countries worldwide, affecting 390 million people every year causing significant morbidity and mortality in children and adults everywhere.

RECENT FINDINGS

In the past, severe dengue affected mostly adults in the Americas; this scenario has changed and now cases of dengue, severe dengue, and dengue deaths have increased in children under 15 years in Brazil and in Colombia. Dengue and COVID-19 co-infections have been reported in South America, with increased hospitalization. A dengue vaccine for 9-year-old children and older children and adults who have serological evidence of previous dengue has been licensed in many countries; a different dengue vaccine trial for 4-16-year-old children has demonstrated decrease in clinical dengue and decrease in dengue hospitalizations.

SUMMARY

There is no specific treatment of dengue, and a changing climate, insecticide resistance and urban expansion have permitted the vector's spread, making the vector control almost impossible. The hope for dengue control relies on vaccine development; there is important research on this area with one vaccine already licensed and another one showing promising results.

摘要

目的综述

登革热是最重要的虫媒病毒性疾病,具有重要的公共卫生意义。其地理分布包括全球 128 个国家,每年影响 3.9 亿人,在儿童和成人中导致发病率和死亡率居高不下。

最新发现

过去,重症登革热主要影响美洲的成年人;这种情况已经发生变化,现在巴西和哥伦比亚 15 岁以下儿童的登革热、重症登革热和登革热死亡病例有所增加。在南美洲,已报告登革热和 COVID-19 合并感染病例,住院人数增加。一种针对 9 岁及以上儿童和有既往登革热血清学证据的儿童和成人的登革热疫苗已在许多国家获得许可;一项针对 4-16 岁儿童的不同登革热疫苗试验表明,可降低临床登革热的发生率和住院率。

总结

目前尚无登革热的特效治疗方法,气候变化、杀虫剂耐药性和城市扩张使登革热的传播变得更加容易,几乎不可能进行病媒控制。控制登革热的希望依赖于疫苗的开发;该领域的研究非常重要,一种疫苗已经获得许可,另一种疫苗显示出有前景的结果。

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