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孟加拉国22年登革热疫情:流行病学、临床症状、血清型及未来疾病风险

Twenty-two years of dengue outbreaks in Bangladesh: epidemiology, clinical spectrum, serotypes, and future disease risks.

作者信息

Hossain Mohammad Sorowar, Noman Abdullah Al, Mamun S M Abdullah Al, Mosabbir Abdullah Al

机构信息

Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Dhaka, Bangladesh.

Department of Environmental Science and Management, Independent University, Bangladesh, Dhaka, Bangladesh.

出版信息

Trop Med Health. 2023 Jul 11;51(1):37. doi: 10.1186/s41182-023-00528-6.

Abstract

Dengue is the most rapidly spreading mosquito-borne disease and has become a major public health threat, particularly for tropical and subtropical countries including Bangladesh. This comprehensive review aims to summarize the overall scenario of dengue, including disease burden, clinical spectrum, seroprevalence, circulating serotypes/genotypes, and spatial distribution since the first recorded outbreak in Bangladesh. Since the first recorded outbreak in 2000, dengue epidemiology has shown the typical epidemic pattern with more frequent and bigger outbreaks and gradual geographic expansion to non-endemic regions in Bangladesh. For instance, highly confined Rohingya refugee camps that provide shelters to nearly 1.2 million forcibly displaced vulnerable Myanmar nationals in Cox's Bazar district confronted a massive outbreak in 2022. Recent major outbreaks are found to be associated with the emergence of serotype DENV-3, which was undetected for a long time. Consequently, changes in serotypes might be attributed to increased severity in clinical manifestation in recent years. The existing weak surveillance and risk management systems are inadequate to deal with impending dengue risks. The healthcare system, particularly at the district level, is not prepared to manage impending large-scale dengue outbreaks in Bangladesh. Our findings would contribute to the development of strategies for dengue control and management in Bangladesh as well as other similar settings elsewhere in the world.

摘要

登革热是传播速度最快的蚊媒疾病,已成为重大公共卫生威胁,对包括孟加拉国在内的热带和亚热带国家尤为如此。本综述旨在总结自孟加拉国首次有记录的登革热疫情以来,该国登革热的总体情况,包括疾病负担、临床谱、血清流行率、流行血清型/基因型以及空间分布。自2000年首次有记录的疫情以来,登革热流行病学呈现出典型的流行模式,疫情愈发频繁且规模更大,并逐渐向孟加拉国的非流行地区地理扩张。例如,在科克斯巴扎尔区为近120万被迫流离失所的脆弱缅甸国民提供庇护的高度封闭的罗兴亚难民营,在2022年遭遇了大规模疫情。最近的主要疫情被发现与血清型DENV-3的出现有关,该血清型长期未被检测到。因此,血清型的变化可能归因于近年来临床表现严重程度的增加。现有的薄弱监测和风险管理系统不足以应对即将到来的登革热风险。医疗系统,尤其是区级医疗系统,尚未做好应对孟加拉国即将到来的大规模登革热疫情的准备。我们的研究结果将有助于制定孟加拉国以及世界其他类似地区登革热控制和管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97f9/10334535/8036696b156f/41182_2023_528_Fig1_HTML.jpg

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