Contributions of the seroepidemiological and clinical surveillance of dengue. 1997-2019
Keywords:
dengue, seroepidemiological clinical surveillance, febrile syndromeAbstract
Introduction: Dengue is the most important arbovirus worldwide, it has a wide clinical spectrum, from asymptomatic infections to serious forms. It is caused by dengue virus and transmitted mainly by Ae. aegypti. In Cuba, despite the efforts made, it has not been possible to reverse the constant risk of activation of transmission, hence the need to carry out operational investigations that characterize the epidemiological situation of dengue, identify contributions in the study and control of outbreaks and evaluate selected attributes of the dengue surveillance system.
Methods: It is an investigation in health services and systems of an operational nature, inserted in the process of surveillance actions, structured in five investigations: descriptive study of the circulation of the dengue virus; description of the dengue outbreaks of 2000 and 2001; a population seroprevalence to dengue; a prevalence of febrile syndromes; and a retrospective cohort study in patients admitted for suspected dengue. The combination of the designs made it possible to evaluate the performance of surveillance in Havana between 1997 and 2019.
Results: The monitoring of the dengue virus made it possible to identify its reintroduction and the current situation of hyperendemicity. In addition, it was proven that it is possible to control dengue transmission by combining political will, implementation of intersectoral actions, and community participation. The overall sensitivity of the system turned out to be low, while the World Health Organization case definition showed high sensitivity. Conclusions. The actions of the surveillance system made it possible to identify the transition from the endemic transmission phase to the current hyperendemicity; It was provided evidence on the possibility of controlling an outbreak when political will, intersectorality and community participation are combined. Finally, the system showed gaps in the location of cases.
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