A carga de dengue nos países da América do Sul e no Brasil entre os anos de 1990 e 2019: estimativas do Global Burden of Disease

Abstract

Dengue is the most relevant urban arbovirus in the Americas, in addition to being one of the main public health problems in the world, as it is an infectious disease, but not contagious. Its endemic-epidemic pattern is verified every three to five years in the Americas. Some of the factors related to the establishment and transmission of the disease in the American continent are the tropical climate; availability of breeding sites in urban areas for Aedes aegypti; population growth; migration; insufficient coverage of basic sanitation; in addition to socioeconomic inequality. As a result of this scenario, studies in epidemiology using databases to generate estimates on the loss of health of the population at a global, national or local level in relation to diseases and their risk factors, become relevant, especially for the dengue. Therefore, the present study aimed to analyze the dengue burden in Brazil and other countries in South America through the metrics estimated by the Global Burden of Disease (GBD) Study, between the years 1990 and 2019, in order to describe, compare and map estimates of disability adjusted life years (DALY), years of life lost to premature death (YLL), years of life lost to disability (YLD), and incidence rates. In South America, Brazil, Colombia, Paraguay and Suriname had the highest incidence rates, DALY, YLL and YLD for arboviruses in the years studied. Overall, the highest and lowest value of the percentage change in the DALY rate between the years of the study was seen in Colombia (176.36%) between 1996 and 2000 and Argentina (2.48%) between 2006 and 2010, respectively. For Brazil, the states of Goiás, Maranhão and Mato Grosso do Sul had higher incidence rates, DALY, YLL and YLD. Rio Grande do Sul and Santa Catarina were the states with the lowest incidence rates, DALY, YLL and YLD. The highest and lowest value of the percentage change in DALYs rates, in the years of study, was verified in Goiás (403.64%) between the years 2006 and 2010 and in Paraíba (0.54%) between the years 2001 and 2005. The male sex and the age groups of less than one year and 80 or more, were the ones with the highest value for the DALY rate, in the countries of South America, while in Brazil and federative units, the female gender and the same age groups had the highest value. The present study showed high DALY rates for individuals of both genders, of different age groups, in South American countries and in Brazil. Studies that describe the epidemiological dynamics of dengue, compared to disease burden indicators, can help in the development of public policies that help in areas that need improvement, such as vector control, infrastructure and health systems.