Epidemiological and entomological characteristics of dengue in rural area of Anapoima municipality, Colombia
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Investigación y estudios
|Medio de publicación||
In Colombia the number of dengue cases has increased over the past 10 years and the geographical distribution of dengue transmission expanded widely. While dengue has traditionally occurred mainly in urban areas, many cases are now occurring in rural areas. Rural propagation of dengue is caused by the interaction between socio-demographic, environmental, and entomological factors. Little is known about dengue in Colombia's rural areas. The aim of this study was to characterize the epidemiological, social, entomological, and environmental factors that influence the risk of dengue transmission in a rural area of Colombia. Material and Methods: Anapoima municipality is located in Cundinamarca, Colombia. The altitude is 700 m.a.s.l., the annual temperature ±26 ºC, the annual precipitation 1300 mm. Anapoima has 11,225 inhabitants, 36% in urban areas and 64% in rural areas. There are 30 veredas (non-administrative subdivisions). A descriptive study was carried out in 684 rural households to determine the infestation levels of Aedes aegypti; assess the knowledge, attitudes and practices about dengue; and to assess environmental aspects that might influence dengue transmission. Epidemiological information was obtained from the national health surveillance database 2010. Results: In 2010, there were 69 probable cases of dengue in the municipality. The incidence in the urban area was 4 times higher than the rural area. 20 (29%) were rural cases, coming from 14 veredas. Most rural cases were from areas located close to an urban area. 30% of rural cases occurred in May. The average age of cases in rural areas was 31 yrs, with 60% occurring in people aged 20-64 yrs. Of all rural cases 55% were women. Although 90% of rural patients consulted a clinic during the first 5 days of onset of symptoms, laboratory confirmation was not performed. The rural population had moderate knowledge of the types of mosquito breeding places, dengue symptoms and methods of disease prevention. Only 30% of those surveyed washed their tanks weekly. A total of 4006 adult mosquitoes and 1433 immatures were collected. 42.3% of the adults and 50.5% of the immatures were Ae. aegypti. 97% of the veredas were Ae. aegypti positive (all with Breteau index ≥ 5). The house index for adults was 46%. The main breeding sites were ground tanks (69%) and discarded objects (22%). The most important environmental factors that favor the presence of dengue vector breeding sites were lack of water supply and households having inappropriate rubbish disposal practices. Main Conclusions: High levels of Ae. aegypti infestation and presence of dengue cases are the main risk factors for transmission of dengue in rural Anapoima. However, the precise transmission dynamics are unknown, since it is unclear whether the reported dengue cases were locally transmitted or imported. Interventions for vector control should be directed toward the water storage tanks and rubbish removal in rural areas of Anapoima.
Vargas SL, Olano VA, Jaramillo JF, Matiz MI, Lenhart A, Stenström TA, Overgaard HJ.
|Fecha de publicación||24 de septiembre de 2012|
|Fecha de aceptación||12 de marzo de 2013|
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