Cargando…

Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study

BACKGROUND: In addition to their direct pathogenic effects, arthropod-borne (arboviruses) have been hypothesized to indirectly contribute to hospitalizations and death through decompensation of pre-existing comorbidities. Using nationwide data routinely collected from 1 January 2014 to 31 December 2...

Descripción completa

Detalles Bibliográficos
Autores principales: Pescarini, Julia M., Rodrigues, Moreno, Paixão, Enny S., Cardim, Luciana, de Brito, Carlos A. A., Costa, Maria da Conceição N., Santos, Andreia C., Smeeth, Liam, Teixeira, Maria da Glória, de Souza, André P. F., Barreto, Mauricio L., Brickley, Elizabeth B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9359537/
https://www.ncbi.nlm.nih.gov/pubmed/35895718
http://dx.doi.org/10.1371/journal.pntd.0010602
_version_ 1784764160970588160
author Pescarini, Julia M.
Rodrigues, Moreno
Paixão, Enny S.
Cardim, Luciana
de Brito, Carlos A. A.
Costa, Maria da Conceição N.
Santos, Andreia C.
Smeeth, Liam
Teixeira, Maria da Glória
de Souza, André P. F.
Barreto, Mauricio L.
Brickley, Elizabeth B.
author_facet Pescarini, Julia M.
Rodrigues, Moreno
Paixão, Enny S.
Cardim, Luciana
de Brito, Carlos A. A.
Costa, Maria da Conceição N.
Santos, Andreia C.
Smeeth, Liam
Teixeira, Maria da Glória
de Souza, André P. F.
Barreto, Mauricio L.
Brickley, Elizabeth B.
author_sort Pescarini, Julia M.
collection PubMed
description BACKGROUND: In addition to their direct pathogenic effects, arthropod-borne (arboviruses) have been hypothesized to indirectly contribute to hospitalizations and death through decompensation of pre-existing comorbidities. Using nationwide data routinely collected from 1 January 2014 to 31 December 2019 in Brazil, we investigated whether local increases in arbovirus notifications were associated with excess hospitalization. METHODS: We estimated the relative risks for the association between municipality- and state-level increases in arboviral case notifications and age-standardized hospitalization rates (i.e., classified as direct or indirect based on ICD-10 codes) using Bayesian multilevel models with random effects accounting for temporal and geographic correlations. For municipality-level analyses, we excluded municipalities with <200 notifications of a given arbovirus and further adjusted the models for the local Gini Index, Human Development Index, and Family Healthcare Strategy (Estratégia de Saúde da Família) coverage. Models for dengue, Zika, and chikungunya were performed separately. RESULTS: From 2014 to 2019, Brazil registered 7,566,330 confirmed dengue cases, 159,029 confirmed ZIKV cases, and 433,887 confirmed CHIKV cases. Dengue notifications have an endemic and seasonal pattern, with cases present in 5334 of the 5570 (95.8%) Brazilian municipalities and most (69.5%) registered between February and May. Chikungunya notifications followed a similar seasonal pattern to DENV but with a smaller incidence and were restricted to 4390 (78.8%) municipalities. ZIKV was only notified in 2581 (46.3%) municipalities. Increases in dengue and chikungunya notifications were associated with small increases in age-standardized arbovirus-related hospitalizations, but no consistent association was found with all-cause or other specific indirect causes of hospitalization. Zika was associated to increases in hospitalizations by neurological diseases. CONCLUSIONS: Although we found no clear association between increased incidence of the three arboviruses and excess risks of all-cause or indirect hospitalizations at the municipality- and state-levels, follow-up investigations at the individual-level are warranted to define any potential role of acute arbovirus infection in exacerbating risks of hospitalization from underlying conditions.
format Online
Article
Text
id pubmed-9359537
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-93595372022-08-10 Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study Pescarini, Julia M. Rodrigues, Moreno Paixão, Enny S. Cardim, Luciana de Brito, Carlos A. A. Costa, Maria da Conceição N. Santos, Andreia C. Smeeth, Liam Teixeira, Maria da Glória de Souza, André P. F. Barreto, Mauricio L. Brickley, Elizabeth B. PLoS Negl Trop Dis Research Article BACKGROUND: In addition to their direct pathogenic effects, arthropod-borne (arboviruses) have been hypothesized to indirectly contribute to hospitalizations and death through decompensation of pre-existing comorbidities. Using nationwide data routinely collected from 1 January 2014 to 31 December 2019 in Brazil, we investigated whether local increases in arbovirus notifications were associated with excess hospitalization. METHODS: We estimated the relative risks for the association between municipality- and state-level increases in arboviral case notifications and age-standardized hospitalization rates (i.e., classified as direct or indirect based on ICD-10 codes) using Bayesian multilevel models with random effects accounting for temporal and geographic correlations. For municipality-level analyses, we excluded municipalities with <200 notifications of a given arbovirus and further adjusted the models for the local Gini Index, Human Development Index, and Family Healthcare Strategy (Estratégia de Saúde da Família) coverage. Models for dengue, Zika, and chikungunya were performed separately. RESULTS: From 2014 to 2019, Brazil registered 7,566,330 confirmed dengue cases, 159,029 confirmed ZIKV cases, and 433,887 confirmed CHIKV cases. Dengue notifications have an endemic and seasonal pattern, with cases present in 5334 of the 5570 (95.8%) Brazilian municipalities and most (69.5%) registered between February and May. Chikungunya notifications followed a similar seasonal pattern to DENV but with a smaller incidence and were restricted to 4390 (78.8%) municipalities. ZIKV was only notified in 2581 (46.3%) municipalities. Increases in dengue and chikungunya notifications were associated with small increases in age-standardized arbovirus-related hospitalizations, but no consistent association was found with all-cause or other specific indirect causes of hospitalization. Zika was associated to increases in hospitalizations by neurological diseases. CONCLUSIONS: Although we found no clear association between increased incidence of the three arboviruses and excess risks of all-cause or indirect hospitalizations at the municipality- and state-levels, follow-up investigations at the individual-level are warranted to define any potential role of acute arbovirus infection in exacerbating risks of hospitalization from underlying conditions. Public Library of Science 2022-07-27 /pmc/articles/PMC9359537/ /pubmed/35895718 http://dx.doi.org/10.1371/journal.pntd.0010602 Text en © 2022 Pescarini et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Pescarini, Julia M.
Rodrigues, Moreno
Paixão, Enny S.
Cardim, Luciana
de Brito, Carlos A. A.
Costa, Maria da Conceição N.
Santos, Andreia C.
Smeeth, Liam
Teixeira, Maria da Glória
de Souza, André P. F.
Barreto, Mauricio L.
Brickley, Elizabeth B.
Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study
title Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study
title_full Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study
title_fullStr Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study
title_full_unstemmed Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study
title_short Dengue, Zika, and Chikungunya viral circulation and hospitalization rates in Brazil from 2014 to 2019: An ecological study
title_sort dengue, zika, and chikungunya viral circulation and hospitalization rates in brazil from 2014 to 2019: an ecological study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9359537/
https://www.ncbi.nlm.nih.gov/pubmed/35895718
http://dx.doi.org/10.1371/journal.pntd.0010602
work_keys_str_mv AT pescarinijuliam denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT rodriguesmoreno denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT paixaoennys denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT cardimluciana denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT debritocarlosaa denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT costamariadaconceicaon denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT santosandreiac denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT smeethliam denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT teixeiramariadagloria denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT desouzaandrepf denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT barretomauriciol denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy
AT brickleyelizabethb denguezikaandchikungunyaviralcirculationandhospitalizationratesinbrazilfrom2014to2019anecologicalstudy