The co-epidemic of Dengue and COVID-19 in Brazil: between challenges in their management and the consequences of socioeconomic inequality

Abstract

SARS-CoV-2, the etiological agent of COVID-19, spread worldwide, reaching pandemic status in March 2020. In this scenario, dengue epidemics continue to impact endemic countries. Taking into account an increase in dengue cases worldwide, the COVID-19 pandemic may signal a serious danger to global public health. In some countries the pandemic coincided with already installed dengue epidemics. Thus, understanding the collective constituents of arboviruses in pandemic times is fundamental for a significant analysis. The present work brings a narrative review elucidating important impacts resulting from the co-epidemic and its consequences in a broader perspective. Problems with the differential diagnosis of these infections are aggravating factors for the decision of clinical management and prognosis of infected individuals. In addition, socioeconomic characteristics and ethnicity are fundamental factors for both dengue transmission dynamics and COVID-19. It also stands out, a scenario that represents a high risk of collapse for health services in facing challenges for combating and managing resources. Therefore, we conclude that in order to overcome the crisis of simultaneous epidemics and their serious consequences, historical aspects and their relationship with the conditions of social vulnerability need to be taken into account, in addition to promoting specific actions for their combat.

A one health approach to leishmaniasis in a slum: another piece of a global scenario.

“…Já está bem estabelecido que fatores socioeconômicos podem ser componentes importantes para a distribuição espacial de Ae. aegypti 74,75 , uma vez que o ciclo de vida desses mosquitos pode ser proporcionado por ambientes que permeiam a precariedade das moradias periurbanas. Devi-do à escassez de acesso ao saneamento básico, populações mais pobres armazenam água em galões residenciais, aumentando o número de criadouros, ocasionando aumento da população de mosquitos vetores e, consequentemente, intensificando o risco de transmissão 76,77 .…”

“…Muitos arbovírus surgiram ou reapareceram em vários países do mundo nas últimas décadas 78,79 mostrando--se complexo para determinar o risco de emergência de patógenos, que muitas vezes envolve interações multifacetadas entre fatores biológicos, ecológicos e socioeconômicos 74 . Mas mesmo em continentes com diferentes realidades de desenvolvimento, os arbovírus parecem demonstrar propensão a atingir a população mais vulnerável socioeconomicamente 74,75,80 .…”

Data science for epidemiology: a case study of dengue in Brazil.

“…Given the overlap with common symptoms of COVID-19, including fever, headache, nausea or vomiting, and myalgia, symptom-based misreporting of the two diseases in the early pandemic period is plausible. This hypothesis is strengthened by the fact that cross-reactivity of lab tests for both DENV and SARS-CoV-2 infections has been reported (RABIU et al, ;MILAGRES et al, 2021;LUSTIG et al, 2020).…”

“…The literature suggests the possibility of over-reporting of dengue cases during the COVID-19 pandemic, due to similarity of symptoms and cross-reactivity of laboratory tests for DENV and SARS-CoV-2 (RABIU et al, ;MILAGRES et al, 2021;LUSTIG et al, 2020). The historically low dengue case-fatality rate of only 4% in 2020 suggests that over-reporting may have also been a reality in Brazil (PAHO, 2020; PAHO, 2021a).…”

“…These symptoms overlap with common symptoms of COVID-19. Additionally, cross-reactivity of laboratory tests for COVID-19 and dengue has been reported (RABIU et al, ;MILAGRES et al, 2021;LUSTIG et al, 2020).…”