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HOUSEHOLD SURVEY OF DENGUE INFECTION IN CENTRAL BRAZIL: SPATIAL POINT PATTERN ANALYSIS AND RISK FACTORS ASSESSMENT

Urban dengue fever is now considered a major public health threat in most American countries. A household survey was conducted in the city of Goiânia in central Brazil in 2001 to assess prevalence of dengue infection and individual and area-based risk factors. Spatial point pattern analysis was performed using the dual Kernel method. A total of 1,610 households were surveyed; 1,585 individuals more than five years old had blood and data collected. Sera were tested for IgM/IgG antibodies by an enzyme-linked immunoassay. Area-based indicators derived from census data were linked to geocoded residential address. The seroprevalence of dengue was 29.5% and the estimate prevalence surface reached 50% in the outskirts areas. The risk of infection was significantly associated with older age (P < 0.01), low education (odds ratio [OR] = 3.45, 95% confidence interval [CI] = 1.82–6.55), and low income (OR = 1.32, 95% CI = 1.02–1.71) in multivariate analysis. This study highlighted the heterogeneity of dengue transmission within the city and can assist in spatial targeting control interventions.

Received December 5, 2003. Accepted for publication April 24, 2004.

Acknowledgments: We thank Dr. Christovam Barcellos (Oswaldo Cruz Foundation, Rio de Janeiro, Brazil) for his support in the spatial analysis. We acknowledge the support of Dr. Otaliba Libânio de Morais Neto during all stages of this study. We also thank the staff of the Regional Branch of Dengue Control for helping in fieldwork.

Financial support: This study was supported by the Brazilian Council for Research and Development (CNPq) (research grant 470696/01-1, scholarship 300443/97-3 to Celina M. T. Martelli, and scholarship 304909/2002-5 to Ana Lúcia S. S. Andrade), the Pan-American Health Organization (PAHO), and the Secretaria Municipal de Saúde de Goiânia, Brazil. João B. Sigueira was awarded a scholarship to the workshop "Programa de Pequenas Becas" for research development held in Maracay, Venezuela and sponsored by PAHO in 1999.

Authors’ addresses: João B. Siqueira, Brazilian Ministry of Health, Quadra 4, Bloco N, 7° Andar Sala 715 70 070, 040 Brasilia, DF, Brazil and Tropical Pathology and Public Health Institute, Federal University of Goiás, Rua Delenda Resende de Meio, s/n, Setor Universitário, Goiânia CEP 74605-050, Brazil, Telephone: 55-61-314-6291, Fax: 55-61- 226-4488, E-mail: joao.siqueira{at}funasa.gov.br. Celina M. T. Martelli, Ivan J. Maciel, Renato M. Oliveira, Bruno C. Moreira, Divina D. P. Cardoso, and Ana Lúcia S. S. Andrade, Tropical Pathology and Public Health Institute, Federal University of Goiás, Rua Delenda Resende de Meio, s/n, Setor Universitário, Goiânia CEP 74605-050, Brazil. Maria G. Ribeiro and Flúvia P. Amorim, Ministry of Health, Av. Edmundo Pinheiro de Abreu, Qd. 216-A Lt., 05, Setor Pedro Ludovico, Goiânia, Goiás CEP 74823-030, Brazil. Wayner V. Souza, Oswaldo Cruz Foundation, Aggeu Magalhães Research Center, Av. Moraes Rego s/n, CEP 50670-420, Caixa Postal 7472, Cidade Universitária, Recife, Pernambuco, Brazil.

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