How heterogeneous is the dengue transmission profile in Brazil? A study in six Brazilian states

PLoS Negl Trop Dis. 2022 Sep 12;16(9):e0010746. doi: 10.1371/journal.pntd.0010746. eCollection 2022 Sep.

Abstract

Dengue is a vector-borne disease present in most tropical countries, infecting an average of 50 to 100 million people per year. Socioeconomic, demographic, and environmental factors directly influence the transmission cycle of the dengue virus (DENV). In Brazil, these factors vary between regions producing different profiles of dengue transmission and challenging the epidemiological surveillance of the disease. In this article, we aimed at classifying the profiles of dengue transmission in 1,823 Brazilian municipalities, covering different climates, from 2010 to 2019. Time series data of dengue cases were obtained from six states: Ceará and Maranhão in the semiarid Northeast, Minas Gerais in the countryside, Espírito Santo and Rio de Janeiro in the tropical Atlantic coast, and Paraná in the subtropical region. To describe the time series, we proposed a set of epi-features of the magnitude and duration of the dengue epidemic cycles, totaling 13 indicators. Using these epi-features as inputs, a multivariate cluster algorithm was employed to classify the municipalities according to their dengue transmission profile. Municipalities were classified into four distinct dengue transmission profiles: persistent transmission (7.8%), epidemic (21.3%), episodic/epidemic (43.2%), and episodic transmission (27.6%). Different profiles were associated with the municipality's population size and climate. Municipalities with higher incidence and larger populations tended to be classified as persistent transmission, suggesting the existence of critical community size. This association, however, varies depending on the state, indicating the importance of other factors. The proposed classification is useful for developing more specific and precise surveillance protocols for regions with different dengue transmission profiles, as well as more precise public policies for dengue prevention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Brazil / epidemiology
  • Dengue Virus*
  • Dengue*
  • Humans
  • Insect Vectors
  • Population Density

Grants and funding

This study was partially supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES - Finance Code 001. The funders had no role in the study design, data collection and analysis, publication decision or manuscript preparation.