Seroprevalence and risk factors for dengue infection in socio-economically distinct areas of Recife, Brazil.
Seroprevalence and risk factors for dengue infection in socio-economically distinct areas of Recife, Brazil.
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DOI：
10.1016/j.actatropica.2009.10.021
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发表时间：
2010-03
期刊：
影响因子：
2.7
通讯作者：
Marques ET
中科院分区：
文献类型：
--
作者：
Braga C;Luna CF;Martelli CM;de Souza WV;Cordeiro MT;Alexander N;de Albuquerque Mde F;Júnior JC;Marques ET
巴西目前占美洲报告的登革热病例的大多数，与DENV 1，2和3共同传播。在城市内，感染的流行病学模式有着惊人的差异。因此，在小范围内调查登革热传播情况对制定控制策略具有重要意义。2005年至2006年期间，在巴西的一个大城市中心累西腓的三个不同的社会经济和环境领域进行了一项以人口为基础的家庭调查。收集了5至64岁居民的登革热血清状态以及个人和家庭感染风险因素。共对2 833人进行了检查，并对他们的住所进行了地理参照。使用商业ELISA测量抗登革热IgG抗体。估计各地区登革热血清阳性率和感染力。与血清阳性的个人和家庭变量进行了评估，每个地区的多层次模型。利用广义加性模型（GAM）进行空间分析，以确定登革热血清阳性的风险梯度。登革热血清阳性率分别为91.1%，87.4%和74.3%，在贫困，中等和高社会经济地位，他们的社会经济地位呈负相关。在贫困地区，59%的儿童在5岁之前已经接触过登革热病毒，估计感染力比特权地区高出三倍。在这三个地区，感染的风险随着年龄的增长而增加。外出工作或学习是贫困地区血清阳性的危险因素（OR=2.26; 95%CI：1.18-4.30）。每间客房的人数是中等（OR=3.00; 95%CI：3.21-7.37）和特权地区（OR=1.81; 95%CI：1.07-3.04）血清阳性的危险因素。居住在房子里，而不是公寓，是特权地区血清阳性的危险因素（OR=3.62; 95%CI：2.43-5.41）。特权地区和其他地区之间的主要差异可能归因于公寓居民的比例要大得多。应考虑在儿童幼年感染比例高的贫困城市地区加强病媒控制、监测和社区教育。
Brazil currently accounts for the majority of dengue cases reported in the Americas, with co-circulation of DENV 1, 2 and 3. Striking variation in the epidemiological pattern of infection within cities has been observed. Therefore, investigation of dengue transmission in small areas is important to formulate control strategies. A population-based household survey was performed in three diverse socio-economic and environmental areas of Recife, a large urban center of Brazil, between 2005 and 2006. Dengue serostatus and individual- and household-level risk factors for infection were collected in residents aged between 5 and 64 years. A total of 2,833 individuals were examined, and their residences were geo-referenced. Anti-dengue IgG antibodies were measured using commercial ELISA. The dengue seroprevalence and the force of infection were estimated in each area. Individual and household variables associated with seropositivity were assessed by multilevel models for each area. A spatial analysis was conducted to identify risk gradients of dengue seropositivity using generalized additive models (GAM). The dengue seroprevalence was 91.1%, 87.4% 74.3%, respectively, in the deprived, intermediate and high socioeconomic areas, inversely related to their socio-economic status. In the deprived area, 59% of children had already been exposed to dengue virus by the age of 5 years and the estimated force of infection was three times higher than that in the privileged area. The risk of infection increased with age in the three areas. Working or studying outside the home area was a risk factor for seropositivity in the deprived area (OR=2.26; 95% CI: 1.18-4.30). Number of persons per room was a risk factor for seropositivity in the intermediate (OR=3.00; 95% CI: 3.21-7.37) and privileged areas (OR=1.81; 95% CI: 1.07-3.04). Living in a house, as opposed to an apartment, was a risk factor for seropositivity in the privileged area (OR=3.62; 95% CI: 2.43-5.41). The main difference between the privileged and other areas could be attributed to the much larger proportion of apartment dwellers. Intensive vector control, surveillance and community education should be considered in deprived urban areas where a high proportion of children are infected by an early age.
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影响因子：
4.5
作者：
Siqueira-Junior, Joao B.;Maciel, Ivan J.;Martelli, Celina M. T.
通讯作者：
Martelli, Celina M. T.
影响因子：
3.3
作者：
Teixeira, MD;Barreto, ML;Cairncross, S
通讯作者：
Cairncross, S
影响因子：
5
作者：
KO, YC;CHEN, MJ;YEH, SM
通讯作者：
YEH, SM
DOI：
10.4269/ajtmh.2008.79.485
发表时间：
2008-10-01
影响因子：
3.3
作者：
da Silva-Nunes, Monica;de Souza, Vanda A. F.;Ferreira, Marcelo U.
通讯作者：
Ferreira, Marcelo U.
影响因子：
5
作者：
Endy, TP;Nisalak, A;Ennis, FA
通讯作者：
Ennis, FA