Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017
Ano de defesa: | 2020 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Não Informado pela instituição
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Programa de Pós-Graduação: |
Não Informado pela instituição
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Departamento: |
Não Informado pela instituição
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País: |
Não Informado pela instituição
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Palavras-chave em Português: | |
Link de acesso: | http://www.repositorio.ufc.br/handle/riufc/57619 |
Resumo: | In recent years, viruses such as dengue (DENV), Zika (ZIKV) and chikungunya (CHIKV) have produced a large number of epidemic outbreaks causing a significant increase in morbidity and mortality rates. Cocirculation between arboviruses is an additional challenge, not only for diagnosis and assistance to patients, but for epidemiological surveillance. The objective here was to conduct a seroepidemiological and molecular study of chikungunya in the state of Ceará during the epidemic season of 2017, identifying possible cases of codetection and / or coinfection of CHIKV with DENV and / or ZIKV. Through a cross-sectional study, 370 were selected from the biorepository at the Central Laboratory of Public Health of Ceará (LACEN-CE), consisting of samples referred for chikungunya diagnosis between April and September of 2017 that were reactive for IgM anti-CHIKV and that was up to 100 days of symptoms at the time of collection. These samples were aditionally tested by ELISA for IgG anti-CHIKV, both IgM and IgG anti-DENV and anti-ZIKV and NS1 antigen of dengue, as well as by molecular biology (qRT-PCR) for each CHIKV, DENV and ZIKV. Sociodemographic data were obtained from both epidemiological records and laboratory environment management system (GAL) and then compiled with laboratory results generated by this study for statistical analyses (Stata, v. 14.0). Of these 370 selected samples, 11 were excluded due to technical issues and 359 kept in the study. The results showed a predominance of females (64.9%), aged between 30-59.9 years (49.6%) with a median of 37.9 years. Samples with self-reported onset of symptoms between 6 and 10 days were the majority (76.9%), with a median of 6 days, and regarding the origin of the referral, the largest number of cases were from the city of Fortaleza (18 , 6%). Remarkably, in approximately 1 out of 4 samples examined (24.8%, 89/359) codetection of CHIK was observed with other studied arboviruses, the most frequent of which was between CHIKV / DENV (88.8%, 79/89), with statistical significance when compared to CHIKV / ZIKV (7.8%, 7/89). A triple detection (CHIKV / DENV / ZIKV) was demonstrated in 3.4% of that total (3/89). The frequency of IgG anti-CHIKV was 29.2%, IgG anti-DENV (82.6%) and IgG anti-ZIKV (49.3%); 59.4% had reactive serology for both (anti-DENV / ZIKV IgG). The NS1-DENV antigen was reactive in 1.76% of the samples, while the detection by qRT-PCR for CHIKV was confirmed in 53 of the 359 samples (14.8%), however there was no significant associations of these parameters with the time of symptoms reported. The results of this study confirmed that arboviral co-circulation during the chikungunya epidemic period in 2017 and revealed an elevated co-detection rate, particularly with DENV, in patients with a primary diagnosis of chikungunya. It also highlights the importance of undertaking complementary laboratory tests for establishing differential diagnosis in areas of endemic cocirculation of arboviruses, thus crucially contributing towards more effective surveillance measures to monitoring outbreaks. |
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Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017Cocirculation of Dengue and Zika viruses during the major Chikungunya Epidemic season of 2017 in the State of Ceara (Northeast Brazil)Vírus ChikungunyaVírus da DengueZika vírusCoinfecçãoEpidemiasIn recent years, viruses such as dengue (DENV), Zika (ZIKV) and chikungunya (CHIKV) have produced a large number of epidemic outbreaks causing a significant increase in morbidity and mortality rates. Cocirculation between arboviruses is an additional challenge, not only for diagnosis and assistance to patients, but for epidemiological surveillance. The objective here was to conduct a seroepidemiological and molecular study of chikungunya in the state of Ceará during the epidemic season of 2017, identifying possible cases of codetection and / or coinfection of CHIKV with DENV and / or ZIKV. Through a cross-sectional study, 370 were selected from the biorepository at the Central Laboratory of Public Health of Ceará (LACEN-CE), consisting of samples referred for chikungunya diagnosis between April and September of 2017 that were reactive for IgM anti-CHIKV and that was up to 100 days of symptoms at the time of collection. These samples were aditionally tested by ELISA for IgG anti-CHIKV, both IgM and IgG anti-DENV and anti-ZIKV and NS1 antigen of dengue, as well as by molecular biology (qRT-PCR) for each CHIKV, DENV and ZIKV. Sociodemographic data were obtained from both epidemiological records and laboratory environment management system (GAL) and then compiled with laboratory results generated by this study for statistical analyses (Stata, v. 14.0). Of these 370 selected samples, 11 were excluded due to technical issues and 359 kept in the study. The results showed a predominance of females (64.9%), aged between 30-59.9 years (49.6%) with a median of 37.9 years. Samples with self-reported onset of symptoms between 6 and 10 days were the majority (76.9%), with a median of 6 days, and regarding the origin of the referral, the largest number of cases were from the city of Fortaleza (18 , 6%). Remarkably, in approximately 1 out of 4 samples examined (24.8%, 89/359) codetection of CHIK was observed with other studied arboviruses, the most frequent of which was between CHIKV / DENV (88.8%, 79/89), with statistical significance when compared to CHIKV / ZIKV (7.8%, 7/89). A triple detection (CHIKV / DENV / ZIKV) was demonstrated in 3.4% of that total (3/89). The frequency of IgG anti-CHIKV was 29.2%, IgG anti-DENV (82.6%) and IgG anti-ZIKV (49.3%); 59.4% had reactive serology for both (anti-DENV / ZIKV IgG). The NS1-DENV antigen was reactive in 1.76% of the samples, while the detection by qRT-PCR for CHIKV was confirmed in 53 of the 359 samples (14.8%), however there was no significant associations of these parameters with the time of symptoms reported. The results of this study confirmed that arboviral co-circulation during the chikungunya epidemic period in 2017 and revealed an elevated co-detection rate, particularly with DENV, in patients with a primary diagnosis of chikungunya. It also highlights the importance of undertaking complementary laboratory tests for establishing differential diagnosis in areas of endemic cocirculation of arboviruses, thus crucially contributing towards more effective surveillance measures to monitoring outbreaks.Nos últimos anos, vírus como o Dengue (DENV), Zika (ZIKV) e Chikungunya (CHIKV) produziram um grande número de surtos epidêmicos ocasionando significante incremento nas taxas de morbidade e mortalidade. A cocirculação entre arbovírus constitui um desafio adicional, não apenas para o diagnóstico e a assistência terapêutica aos pacientes, mas para vigilância epidemiológica. Objetivou-se aqui realizar um estudo soroepidemiológico e molecular de chikungunya no estado do Ceará referente ao período epidêmico de 2017, identificando possíveis casos de codetecção e/ou coinfecção de CHIKV com DENV e/ou ZIKV. Através de um estudo transversal, 370 amostras foram selecionadas a partir da soroteca do Laboratório Central de Saúde Pública do Ceará (LACEN-CE), composta por amostras encaminhadas para o diagnóstico de chikungunya entre abril e setembro de 2017 que tiveram sorologia reagente para IgM anti CHIKV e que estavam até o 100 dia de sintomas no momento da coleta. Essas amostras foram testadas por sorologia (ELISA) para IgG anti CHIKV, IgM e IgG anti DENV e anti ZIKV e antígeno NS1-DENV e por biologia molecular (qRT-PCR) para CHIKV, DENV e ZIKV. Os dados sóciodemográficos foram obtidos através das fichas epidemiológicas e do sistema de gerenciamento de ambiente laboratorial (GAL) e juntamente com os resultados laboratoriais foram compilados e analisados em programa estatístico (Stata, v. 14.0). Das 370 amostras selecionadas, 11 foram excluídas por critérios técnicos e 359 mantidas no estudo. Os resultados apontaram o predomínio do sexo feminino (64,9%), da faixa etária entre 30-59,9 anos (49,6%) com mediana de 37,9 anos. Amostras com auto-relato de início de sintomas compreendidos entre 6 e 10 dias foram a maioria (76,9%), com mediana de 6 dias, e quanto à origem do encaminhamento, o maior número de casos foram do município de Fortaleza (18,6%). Em aproximadamente 1 de cada 4 amostras analisadas (24,8%, 89/359) foi observado codetecção de CHIK com as outras arboviroses estudadas, a mais frequente delas foi entre CHIKV/DENV (88,8%, 79/89), com significância estatística quando comparada à CHIKV/ZIKV (7,8%, 7/89). A tripla detecção (CHIKV/DENV/ZIKV) foi demonstrada em 3,4% desse total (3/89). A frequência de IgG anti-CHIKV foi de 29,2%, IgG anti-DENV 82,6% e IgG anti-ZIKV 49,3%; 59,4% tiveram sorologia reativa para ambos (IgG anti-DENV/ZIKV). O antígeno NS1-DENV foi reagente em 1,76% das amostras, enquanto que a detecção por qRT-PCR para CHIKV foi confirmada em 14,8% (53/359) destas. A coinfecção foi demonstrada em 3,8% (2/53) das amostras. Os resultados deste estudo confirmam a cocirculação arboviral durante o surto epidêmico de chikungunya em 2017 e de forma inédita revelam uma alta taxa de codetecção, particularmente com DENV. A identificação da coinfecção entre CHIKV e DENV merece destaque entre os resultados, por comprovar a cocirculação desses arbovírus em um surto epidêmico de grande predominância de chikungunya. Ressalta-se aqui a relevância da realização de testes laboratoriais complementares para o diagnóstico diferencial em áreas de cocirculação de arbovírus, podendo contribuir decisivamente para medidas mais efetivas vigilância e de monitoramento de epidemias.Miyajima, FábioCavalcanti, Luciano Pamplona de GóesSilva, Debora Bezerra2021-04-08T11:45:49Z2021-04-08T11:45:49Z2020-09-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfSILVA, D. B. Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017. 2020. 119 f. Dissertação (Mestrado em Patologia) – Centro de Ciências da Saúde, Universidade Federal do Ceará, Fortaleza, 2020.http://www.repositorio.ufc.br/handle/riufc/57619porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2021-04-08T11:45:49Zoai:repositorio.ufc.br:riufc/57619Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:53:09.320936Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false |
dc.title.none.fl_str_mv |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 Cocirculation of Dengue and Zika viruses during the major Chikungunya Epidemic season of 2017 in the State of Ceara (Northeast Brazil) |
title |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 |
spellingShingle |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 Silva, Debora Bezerra Vírus Chikungunya Vírus da Dengue Zika vírus Coinfecção Epidemias |
title_short |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 |
title_full |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 |
title_fullStr |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 |
title_full_unstemmed |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 |
title_sort |
Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017 |
author |
Silva, Debora Bezerra |
author_facet |
Silva, Debora Bezerra |
author_role |
author |
dc.contributor.none.fl_str_mv |
Miyajima, Fábio Cavalcanti, Luciano Pamplona de Góes |
dc.contributor.author.fl_str_mv |
Silva, Debora Bezerra |
dc.subject.por.fl_str_mv |
Vírus Chikungunya Vírus da Dengue Zika vírus Coinfecção Epidemias |
topic |
Vírus Chikungunya Vírus da Dengue Zika vírus Coinfecção Epidemias |
description |
In recent years, viruses such as dengue (DENV), Zika (ZIKV) and chikungunya (CHIKV) have produced a large number of epidemic outbreaks causing a significant increase in morbidity and mortality rates. Cocirculation between arboviruses is an additional challenge, not only for diagnosis and assistance to patients, but for epidemiological surveillance. The objective here was to conduct a seroepidemiological and molecular study of chikungunya in the state of Ceará during the epidemic season of 2017, identifying possible cases of codetection and / or coinfection of CHIKV with DENV and / or ZIKV. Through a cross-sectional study, 370 were selected from the biorepository at the Central Laboratory of Public Health of Ceará (LACEN-CE), consisting of samples referred for chikungunya diagnosis between April and September of 2017 that were reactive for IgM anti-CHIKV and that was up to 100 days of symptoms at the time of collection. These samples were aditionally tested by ELISA for IgG anti-CHIKV, both IgM and IgG anti-DENV and anti-ZIKV and NS1 antigen of dengue, as well as by molecular biology (qRT-PCR) for each CHIKV, DENV and ZIKV. Sociodemographic data were obtained from both epidemiological records and laboratory environment management system (GAL) and then compiled with laboratory results generated by this study for statistical analyses (Stata, v. 14.0). Of these 370 selected samples, 11 were excluded due to technical issues and 359 kept in the study. The results showed a predominance of females (64.9%), aged between 30-59.9 years (49.6%) with a median of 37.9 years. Samples with self-reported onset of symptoms between 6 and 10 days were the majority (76.9%), with a median of 6 days, and regarding the origin of the referral, the largest number of cases were from the city of Fortaleza (18 , 6%). Remarkably, in approximately 1 out of 4 samples examined (24.8%, 89/359) codetection of CHIK was observed with other studied arboviruses, the most frequent of which was between CHIKV / DENV (88.8%, 79/89), with statistical significance when compared to CHIKV / ZIKV (7.8%, 7/89). A triple detection (CHIKV / DENV / ZIKV) was demonstrated in 3.4% of that total (3/89). The frequency of IgG anti-CHIKV was 29.2%, IgG anti-DENV (82.6%) and IgG anti-ZIKV (49.3%); 59.4% had reactive serology for both (anti-DENV / ZIKV IgG). The NS1-DENV antigen was reactive in 1.76% of the samples, while the detection by qRT-PCR for CHIKV was confirmed in 53 of the 359 samples (14.8%), however there was no significant associations of these parameters with the time of symptoms reported. The results of this study confirmed that arboviral co-circulation during the chikungunya epidemic period in 2017 and revealed an elevated co-detection rate, particularly with DENV, in patients with a primary diagnosis of chikungunya. It also highlights the importance of undertaking complementary laboratory tests for establishing differential diagnosis in areas of endemic cocirculation of arboviruses, thus crucially contributing towards more effective surveillance measures to monitoring outbreaks. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-28 2021-04-08T11:45:49Z 2021-04-08T11:45:49Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
SILVA, D. B. Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017. 2020. 119 f. Dissertação (Mestrado em Patologia) – Centro de Ciências da Saúde, Universidade Federal do Ceará, Fortaleza, 2020. http://www.repositorio.ufc.br/handle/riufc/57619 |
identifier_str_mv |
SILVA, D. B. Cocirculação dos vírus Dengue e Zika durante a epidemia de Chikungunya no Estado do Ceará em 2017. 2020. 119 f. Dissertação (Mestrado em Patologia) – Centro de Ciências da Saúde, Universidade Federal do Ceará, Fortaleza, 2020. |
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http://www.repositorio.ufc.br/handle/riufc/57619 |
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por |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Universidade Federal do Ceará (UFC) |
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UFC |
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Repositório Institucional da Universidade Federal do Ceará (UFC) |
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Repositório Institucional da Universidade Federal do Ceará (UFC) |
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Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC) |
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