Article Text
Abstract
Introduction Although it has been established that poverty is one of the determinants of the majority of infectious and parasitic diseases, in the case of dengue this is still a matter of some controversy. The objective of this study was to describe the distribution of dengue seroprevalence and seroincidence and to investigate the relationship between the intensity of virus circulation and the population's living conditions or between group immunity and Aedes aegypti infestation rates, in different intra-urban spaces within a large city in north-eastern, Salvador-Brazil.
Methods A prospective study was conducted by means of serological investigations among a sample of people living in 30 different spaces (“sentinel areas”) in the city of Salvador, which was selected according to extreme differences in living conditions.
Results High rates of seroprevalence (67.7%) and seroincidence (70.6%) were found for the circulating serotypes (DENV-1 and 2). The seroincidence was high (55%) even when the group immunity had already been partially established (42%) and the Ae. aegypti infestation rates were relatively low (<3%). Contrary to the ecological analysis, at the individual level, substantial heterogeneity in dengue exposure was observed.
Conclusion The observation that the dengue virus in our environment does not respect social spaces strengthens the principle that vector control measures must always be universally applied in each territory. On the other hand, the identification of specific risk factors in the domestic domain may indicate a need for other evidence-based interventions which can help to eliminate the disease from cities such as Salvador.