Características sociodemográficas e de moradia e distribuição espacial de mulheres para o vírus chikungunya em Fortaleza em 2018

Abstract

INTRODUCTION. Chikungunya fever is a disease caused by the Chikungunya virus (CHIKV), transmitted by mosquitoes of the Aedes genus. Ceará faced a CHIK epidemic in 2016 and 2017, which was considered the largest among arboviruses, with 138,078 confirmed cases. GOAL. To characterize the spatial distribution of CHIKV-positive RT-qPCR participants in the year 2018 in the city of Fortaleza, Ceará. METHODS. A prospective observational prevalence study was carried out from February to December 2018. The study participants are part of the cohort study of women aged 15 to 39 years in Fortaleza, Ceará. Socioeconomic and demographic data, housing conditions and health behaviors were collected in women attended at four Primary Health Care Units in Fortaleza. Serum samples were collected to detect anti-CHIKV IgG and IgM antibodies. Viral RNA extraction followed by RT-qPCR viral detection was also performed using the ZDC Multiplex RT-PCR Assay kit. For georeferencing and spatial distribution, geographic coordinates were collected through the residence addresses of positive CHIKV participants using Google Earth software. RESULTS. A total of 1498 serum samples were evaluated, of which 545 (37.2%) were positive for anti-CHIKV antibodies. Of the total number of participants collected, 1284 samples, 85.7% were analyzed by multiplex RT-qPCR for the differentiation of ZIKV (Zika virus), DENV (Dengue virus) and CHIKV. Among the participants, 8.3% (106/1284) tested positive by RT-qPCR for one or more arboviruses. We identified RNA for single virus (monoinfections) in 5.9% (76/1284) with 22 infections by ZIKV, 39 by DENV and 15 by CHIKV. In 30 participants (2.3%, 30/1284) RNA was identified for more than one virus (co-infections). The spatial distribution showed the UAPS Casemiro Filho, located in the Barra do Ceará neighborhood, with the highest percentage of confirmed participants in Fortaleza in 2018. CONCLUSION. The results showed that even in a non-epidemic year, CHIKV is still present in the studied community and that there were several clusters of asymptomatic cases in regions with low socioeconomic status. The results suggest that Fortaleza is experiencing a current syndemic justified by positive detection of the three arboviruses, either as mono- or co-infections.