A dengue em Belo Horizonte: inquérito soroepidemiológico de base populacional (2006-2007), estudo de vírus em vetores (2007). Avaliação do plano nacional de controle da dengue (2008)

Abstract

Introduction: In the summer-autumn of 1996, was the first dengue epidemic in the municipality located in the DS Venda Nova, north of the city. In the first half of 1997, there was a new epidemic, concentrated in two regions of the city, again including Venda Nova, but with a higherincidence of reported cases in the DS West (56% of cases). In both epidemics, the only serotype of the Dengue virus (DENV) was identified as DENV-1. In the second half of 1997, a new epidemic occurred lasting until the end of the first half of 1998, when it was detected simultaneous circulation of DENV-1 and DENV-2. This epidemic, with over 86,000 cases reported was the highest magnitude in the history of the city. Since then, the serotypes DENV-1 and DENV-2 were associated with annual epidemics occurring handles mainly in hot and humid months. In February 2002 the DENV-3 was first identified in the county, without change in the seasonally previously observed. Objective. This thesis, presented in the form of three articles, aimed at studying dengue in the city of Belo Horizonte-MG, by means of random population survey in three health districts (Central South, East and Venda Nova), between 2006-2007, and detection of antibodies to serotypes circulating virus. This study, described in one of the articles, was related to previous surveyresults and data from the Surveillance of the city. Other article evaluates the National Program of Dengue Control-PNCD and another study in a complementary manner the presence of virus in vectors collected in the wild. Method. In one of the articles was rated the achievement of goals by PNDC, using comparative analysis between the periods before and after their deployment as a parameter considering the goals achieved in the municipalities identified as priorities by the PNDC. Were descriptiveepidemiological indicators after the implementation of national program and statistical analysis considering the incidence rates of dengue in the previous period, climate data, demographic and socioeconomic factors, using multiple linear regression. In the article which analyzes the seroepidemiological survey, a questionnaire was applied general and socioeconomic information about previous history of dengue. The serum samples collected were examined by testing serum neutralization. In the article number 3 were analyzed using the technique RT-PCR, presence ofvirus in samples of vectors collected in the same regions in which we performed the seroepidemiological survey. Results. The assessment pointed PNCD difficulties related to the Program, with goals notachieved and evidence of worsening the problem. In sero-epidemiological survey of seroprevalence was 11.85% (84/709), signifying the persistence of important susceptible population for all serotypes (88.15%). Seropositive compared to seronegative, were morecommon in residents of buildings that were residing in the horizontal and Sanitary District of Venda Nova. In search of virus vectors, individual and pooled samples of Ae. aegypti and Ae. Albopictus, were positive for one or two DENV serotypes, in a period where only DENV-3 wasisolated in serum samples of Epidemiological Surveillance.Conclusions. This study attests to the quality of surveillance in Belo Horizonte City, and their findings may help in determining priorities for interventions. Surveillance active, sensitive and specific, vector control, and the mobilization of the population, public and private institutions arecrucial to a successful outcome in dengue control. Serological surveys should be encouraged, assessing quality and timeliness of the Epidemiological Surveillance System and the susceptibility to serotype.