Search

Objectives: To identify clinical characteristics indicative of dengue and to evaluate the applicability to children of the Health Ministry criteria for suspected cases., Methods: A cross-sectional study undertaken at the General Pediatrics Center of the Fundação Hospitalar de Minas Gerais. Children were enrolled if presenting acute febrile conditions with no definite etiology, lasting > 24 hours and < or = 7 days and if resident in the Metropolitan Region of Belo Horizonte. Clinical variables were investigated, specific tests were performed and aspartate-aminotransferase assayed, during a period considered both endemic and epidemic for the disease. The subset of children who did have dengue was compared with the subset of nonspecific acute febrile diseases. The Health Ministry criteria for suspected cases was evaluated., Results: Dengue was diagnosed in 50.4% of the 117 children studied. There were no statistically significant associations between the disease and the majority of the symptoms analyzed. Only exanthema was more often associated with dengue (Prevalence Ratio = 1.49; 95% CI: 1.05-2.11). The criteria for suspected cases of dengue had a sensitivity of just 50.8% and a positive predictive value of 62.5%. These values were greater among schoolchildren and during the period of greater disease incidence., Conclusions: Dengue is common among febrile diseases of childhood, with prevalence that varies according to the epidemiological situation. The clinical status of children with dengue was very similar to that of children with other nonspecific diseases. The Health Ministry criteria for suspected cases was shown to be of little use, particularly with smaller children and during periods of reduced incidence.

Objective: To assess the association between the proportion of buildings positive for Aedes aegypti larvae measured by means of building infestation rate and dengue incidence rate., Methods: Autochthonous dengue cases were selected and building infestation rates assessed in the coverage areas of health districts in the city of Belo Horizonte, Brazil, from October 1997 to May 2001. After grouping building infestation rates according to their distribution in quartiles, mean dengue incidence rates (for the month following the building infestation assessment) were compared using ANOVA., Results: A weak though statistically significant correlation was observed between monthly dengue incidence and building infestation rates for the health districts (r=0.21; p=0.02) and coverage areas (r=0.14; p=0.00) in the study period. After grouping building infestation rates in quartiles, coverage areas of building infestation between 0.46% and 1.32% (second quartile) showed a mean monthly dengue incidence rate twice as high as areas of building infestation lower or equal to 0.45% (first quartile). Areas of building infestation between 1.33% and 2.76% (third quartile) and equal to or higher than 2.77% had a mean monthly dengue incidence rate five and seven times, respectively, higher than those areas showing 0.45% or less., Conclusions: Despite the well-known limitations of building infestation rates for estimating vector infestation and prediction of dengue epidemics, the study results indicate that higher building infestation rates were associated to a higher risk of disease transmission in the health districts and coverage areas of Belo Horizonte.