Impact of the COVID-19 pandemic on dengue in Brazil: Interrupted time series analysis of changes in surveillance and transmission.

Impact of the COVID-19 pandemic on dengue in Brazil: Interrupted time series analysis of changes in surveillance and transmission.

Publication date: Dec 26, 2024

Measures to curb the spread of SARS-CoV-2 impacted not only COVID-19 dynamics, but also other infectious diseases, such as dengue in Brazil. The COVID-19 pandemic disrupted not only transmission dynamics due to changes in mobility patterns, but also several aspects of surveillance, such as care seeking behavior and clinical capacity. However, we lack a clear understanding of the overall impact on dengue in different parts of Brazil and the contribution of individual causal drivers. In this study, we estimated the gap between expected and observed dengue cases in each Brazilian state from March to April 2020 using an interrupted time series design with forecasts from machine learning models. We then decomposed the gap into the contributions of pandemic-induced changes in disease surveillance and transmission dynamics, using proxies for care availability and care seeking behavior. Of 25 states in the analysis, 19 reported fewer dengue cases than predicted and the gap between expected and observed cases was largely explained by excess under-reporting, as illustrated in several states by a reduction in observed cases below expected levels in early March 2020 in several states. A notable exception is the experience in the Southern states, which reported unusually large dengue outbreaks in 2020. These estimates of dengue case counts adjusted for under-reporting help mitigate some of the data gaps from 2020. Reliable estimates of changes in the disease burden are critical for anticipating future outbreaks.

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Concepts Keywords
April Behavior
Brazil Brazil
Dengue Care
Pandemic Covid
Surveillance Dengue
Dynamics
Expected
Gap
Interrupted
Observed
Pandemic
Seeking
Series
Surveillance
Transmission

Semantics

Type Source Name
disease MESH COVID-19 pandemic
disease MESH dengue
disease MESH infectious diseases
disease MESH infections
disease MESH NEGLECTED TROPICAL DISEASES
disease IDO facility
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
disease IDO country
drug DRUGBANK Polyethylene glycol
drug DRUGBANK Medical air
disease IDO infection
drug DRUGBANK Trestolone
disease MESH secondary infections
disease MESH HIV infections
drug DRUGBANK Flunarizine
drug DRUGBANK Ribostamycin
drug DRUGBANK L-Valine
disease MESH treatment delays
disease IDO susceptibility
disease MESH severe dengue
drug DRUGBANK Guanosine
pathway REACTOME Infectious disease
disease IDO infectious disease
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH Emerging Infectious Diseases
disease MESH AIDS
drug DRUGBANK Tretamine

Original Article

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