[Aedes aegypti larval indices and dengue incidence: an ecological study in the state of Rio de Janeiro, Brazil]

Sociodemographic and environmental factors associated with dengue, Zika, and chikungunya among adolescents from two Brazilian capitals

Among the emerging and reemerging arboviral diseases, Zika, dengue and chikungunya deserve special attention due to their wide geographical distribution and clinical severity. The three arboviruses are transmitted by the same vector and can present similar clinical syndromes, bringing challenges to their identification and register. Demographic characteristics and individual and contextual social factors have been associated with the three arboviral diseases. However, little is known about such associations among adolescents, whose relationships with the social environment are different from those of adult populations, implying potentially different places, types, and degrees of exposure to the vector, particularly in the school context. This study aims to identify sociodemographic and environmental risk factors for the occurrence of Zika, dengue, and chikungunya in a cohort of adolescents from the Study of Cardiovascular Risks in Adolescents-ERICA-in the cities of Rio de Janeiro/RJ and Fortaleza/CE, from January 2015 to March 2019. Cases were defined as adolescents with laboratory or clinical-epidemiological diagnosis of Zika, dengue, or chikungunya, notified and registered in the Information System for Notifiable Diseases (SINAN). The cases were identified by linkage between the databases of the ERICA cohort and of SINAN. Multilevel Cox regression was employed to estimate hazard ratios (HR) as measures of association and respective 95% confidence intervals (95%CI). In comparison with adolescents living in lower socioeconomic conditions, the risk of becoming ill due to any of the three studied arboviral diseases was lower among those living in better socioeconomic conditions (HR = 0.43; 95%CI: 0.19-0.99; p = 0.047) and in the adolescents who attended school in the afternoon period (HR = 0.17; 95%CI: 0.06-0.47; p<0.001). When compared to areas whose Building Infestation Index (BII) for Aedes aegypti was considered satisfactory, a BII in the school region classified as "alert" and "risk" was associated with a higher risk of arboviral diseases (HR = 1.62, 95%CI: 0.98-2.70; p = 0.062; HR = 3.72, 95%CI: 1.27-10.9; p = 0.017, respectively). These findings indicate that living in less favored socioeconomic conditions, attending school in the morning, and having a high BII for Ae. aegypti in school's region can contribute to an increased risk of infection by Zika, dengue, or chikungunya in adolescents. The identification of residential or school areas based on those variables can contribute to the implementation of control measures in population groups and priority locations.

Spatial analysis of Chikungunya fever incidence and the associated socioeconomic, demographic, and vector infestation factors in municipalities of Pernambuco, Brazil, 2015-2021

OBJECTIVE

To identify the spatial patterns of chikungunya fever (CHIKF) and the associated socioeconomic, demographic, and vector infestation factors in the 1st Health Region of Pernambuco (1st HRP).

METHODS

This ecological study used a spatial analysis of Mean Incidence Rates (MIR) of probable cases of CHIKF reported among residents of the 19 municipalities of the 1st HRP, in 2015-2021. The univariate and bivariate global Moran indexes (I) were estimated. From the significant associations (p<0.05), clusters were identified using the local Moran index and maps.

RESULTS

A predominance of the largest CHIKF rates was identified in the east. However, there was a heterogeneous distribution of rates across municipalities, which may have contributed to the absence of spatial autocorrelation of CHIKF (I=0.03; p=0.294) in univariate I. The bivariate I revealed a positive spatial correlation between CHIKF and the Municipal Human Development Index (MHDI) (I=0.245; p=0.038), but with a cluster of cities with low incidences and low MHDI in the west. There was no spatial correlation between CHIKF and the other variables analyzed: population density, Gini index, social vulnerability index, and building infestation index for Aedes aegypti.

CONCLUSIONS

The results suggest that only the MHDI influenced the occurrence of CHIKF in the 1st HRP, so that municipalities in the west demonstrated spatial dependence between lower values of MHDI and MIR. However, this spatial correlation may have occurred due to possible underreporting in the area. These findings can assist in the (re)orientation of resources for surveillance and health care services.

Aedes aegypti in Southern Brazil: Spatiotemporal Distribution Dynamics and Association with Climate and Environmental Factors

In Brazil, the mosquito Aedes (Stegomyia) aegypti is considered the main vector of the dengue, chikungunya, and Zika arbovirus transmission. Recent epidemiological studies in southern Brazil have shown an increase in the incidence of dengue, raising concerns over epidemiological control, monitoring, and surveys. Therefore, this study aimed at performing a historical spatiotemporal analysis of the Ae. aegypti house indices (HI) in southern Brazil over the last 19 years. As vector infestation was associated with climatic and environmental variables, HI data from the Brazilian Ministry of Health, climate data from the Giovanni web-based application, and environmental data from the Mapbiomas project were used in this study. Our results showed an expressive increase in the number of HI surveys in the municipalities confirming the vector presence, as compared to those in 2017. Environmental variables, such as urban infrastructure, precipitation, temperature, and humidity, were positively correlated with the Ae. aegypti HI. This was the first study to analyze Ae. aegypti HI surveys in municipalities of southern Brazil, and our findings could help in developing and planning disease control strategies to improve public health.

Análise espacial da incidência da febre de Chikungunya e dos fatores socioeconômicos, demográficos e de infestação vetorial associados, em municípios de Pernambuco, Brasil, 2015–2021

RESUMO Objetivo: Identificar, na Iᵃ Região de Saúde de Pernambuco (Iᵃ RSP), os padrões espaciais da febre de Chikungunya (CHIKF) e os fatores socioeconômicos, demográficos e de infestação vetorial associados. Métodos: Este estudo ecológico utilizou a análise espacial das Taxas Médias de Incidência (TMI) de casos prováveis da CHIKF notificados entre os residentes dos 19 municípios da Iᵃ RSP no período de 2015–2021. Os índices de Moran global (I) univariados e bivariados foram estimados. Das associações significativas (p<0,05), clusters foram localizados por meio do Índice de Moran Local e de mapas. Resultados: Identificou-se predominância das maiores TMI da CHIKF no leste. Entretanto, houve distribuição heterogênea das taxas dos municípios, o que pode ter contribuído para a ausência de autocorrelação espacial da CHIKF (I=0,03; p=0,294) no I univariado. O I bivariado revelou correlação espacial positiva entre a CHIKF e o Índice de Desenvolvimento Humano Municipal (IDHM) (I=0,245; p=0,038), porém com um cluster de cidades com baixas incidências e baixo IDHM no oeste. Não houve correlação espacial entre a CHIKF e as demais variáveis analisadas: densidade demográfica, Índice de Gini, Índice de Vulnerabilidade Social e Índice de Infestação Predial de Aedes aegypti. Conclusões: Os resultados sugerem que somente o IDHM influenciou na ocorrência da CHIKF na Iᵃ RSP, de forma que municípios do oeste demonstraram dependência espacial entre menores valores de IDHM e TMI. No entanto, essa correlação espacial pode ter ocorrido devido às possíveis subnotificações na área. Tais achados podem auxiliar na (re)orientação de recursos dos serviços de vigilância e assistência à saúde.

Aedes aegypti: egg morphology and embryonic development

Background

The diseases for which Aedes aegypti is a vector are worrisome. The high vector competence of this mosquito, as well as its anthropophilia and ability to adapt to the urban environment, allows it to exploit many habitats, making its prevention an arduous task. Despite current disease control measures focused on the mosquito, the effectiveness in containing its dispersion still requires improvement; thus greater knowledge about this insect is fundamental.

Methods

Aedes aegypti egg morphology and embryonic development were analyzed from eggs of the insectary of the Institute of Biomedical Sciences of the University of São Paulo. Optical (light and confocal) and electronic (transmission and scanning) microscopy were used to analyze the morphological and ultrastructural features of the eggs. Embryos were observed in the initial (0–20.5 h after egg-laying), intermediate (20.6–40.1 h after egg-laying), and final (40.2–61.6 h) stages of development, and kept at a temperature of 28 °C ± 1 °C until collection for processing.

Results

Eggs of Ae. aegypti were whitish at the time of oviposition, and then quickly became black. The egg length was 581.45 ± 39.73 μm and the width was 175.36 ± 11.59. Access to the embryo was difficult due to the egg morphology, point of embryonic development, and difficult permeability of the exochorion (mainly in fixation). Only about 5% of the collected eggs were successfully processed. In the initial stage of embryonic development, characteristics suggestive of intense cellular activity were found. In the intermediate stage, the beginning of the segmentation process was evident. In the final phase, it was possible to differentiate the cephalic region and the thoracic and abdominal segments.

Conclusion

The chorion was found to be an important protective barrier and a limiting factor for the evaluation of the embryos and mosquito embryonic cells, indicating that further studies need to be carried out to identify the reason that this occurs.

Graphical abstract