Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Maria A. Diuk-Wasser

Second Advisor

Guilherme De Sousa Ribeiro

Abstract

Brazil has experienced a major increase in the incidence of dengue fever and severe dengue since the mid-1990s. Due to incomplete vector-control and transmission prevention efforts, all four serotypes of the dengue virus now circulate in Brazil. Communities such as Pau da Lima, an urban slum in the city of Salvador, Brazil, face a high burden of disease. Beginning in 2009 enhanced surveillance for dengue fever and other acute febrile illnesses has been conducted at the São Marcos Emergency Center (CESM), the only public urgent care health center in Pau da Lima. This sentinel surveillance site serves as a model for acute febrile illness surveillance site for Brazil and other dengue-endemic countries. However, dengue epidemiology and patterns of disease transmission within the community are poorly understood. The objective of this study is to assess dengue risk factors by comparing the demographics of laboratory-confirmed dengue patients with the population of patients who presented to CESM with fever within a two-year period, from January 2009 to December 2010. A total of 282 laboratory-confirmed cases were identified. Univariate logistic regression revealed that young age, brown/mixed race, lower income, and fewer self-reported days of illness at the time of presentation were statistically significant predictors of dengue infection. Dengue cases were significantly clustered in space and time, indicating local transmission of dengue within and between households. The presence of these factors serves as an impetus for targeting vector control and other preventive measures in this community and throughout the rest of the city.

Comments

This is an Open Access Thesis.

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