Vigilância entomológica e estudos sobre a dengue no interior do Estado de São Paulo, Brasil
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Data
2016-06-13
Autores
Piovezan, Rafael [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
As atividades de controle da dengue são preconizadas pelo Ministério da Saúde e pelas Secretarias de Estado da Saúde. A Superintendência de Controle de Endemias no Estado de São Paulo é o órgão responsável pelo acompanhamento e auxílio, em algumas situações, nas atividades de combate à dengue. A cargo dos municípios paulistas fica a execução das ações. Nesse contexto, é de amplo conhecimento técnico que atividades de vigilância epidemiológica e entomológica se mostram fundamentais para a redução dos riscos causados pela transmissão de agentes patogênicos, através dos mosquitos, à sociedade. Com esse intuito, diversos trabalhos foram executados no município de Santa Bárbara d'Oeste, interior do Estado de São Paulo, com o objetivo de melhorar a compreensão da dinâmica da dengue. Foram realizados dois estudos sobre o perfil epidemiológico da dengue, o primeiro analisou a epidemia ocorrida durante o ano de 2010, e o segundo apresentou análises espaciais sobre a doença no período de 1995 a 2010. No aspecto entomológico, três trabalhos foram executados. O primeiro verificou a distribuição de culicídeos no bairro Cruzeiro do Sul, que apresenta características rurais, ainda que em transição para a condição urbana. No segundo trabalho foram analisados os resultados obtidos através de dois métodos de aplicação de inseticida, conhecidos como nebulização leve e nebulização com equipamento pesado acoplado a veículo. E o último trabalho apresentou resultados sobre as coletas realizadas em cinco bairros rurais do município através da instalação de larvitrampas. Os resultados obtidos nos estudos sobre as epidemias demonstraram que, durante o ano de 2010, os homens foram mais acometidos por dengue e a faixa etária com maior número de casos foi entre 15 e 19 anos. Os sintomas mais comuns relatados foram febre, mialgia, cefaléia e artralgia. Também verificou-se que duas áreas do município apresentaram maior risco com relação a dengue e que o histórico das epidemias apresentou como ponto de início da transmissão a zona leste da cidade. Nas pesquisas com enfoque entomológico, foi possível verificar cinco espécies de mosquitos capturadas nas armadilhas durante a pesquisa no bairro rural Cruzeiro do Sul, e seis espécies identificadas nas pesquisas realizadas em diferentes áreas rurais do município. Especificamente para o bairro Cruzeiro do Sul, a comparação entre esses dois trabalhos desenvolvidos demonstrou que Aedes albopictus sofreu redução em sua freqüência, enquanto Aedes aegypti ampliou o número de ocorrências nessa área. Nos dois estudos realizados, o primeiro apenas no Cruzeiro do Sul e o segundo em cinco localidades rurais distintas, o índice de diversidade de Simpson obteve resultados maiores nos locais onde a presença de Ae. aegypti era menos freqüente. No trabalho sobre a comparação dos métodos de nebulização foi possível observar que o número de ovos coletados nas armadilhas foi menor onde se utilizou o equipamento de nebulização pesado. Também se observou diferença no número de pacientes acometidos pela dengue entre as duas áreas estudadas. Diante dos resultados obtidos, conclui-se que os métodos apresentados para estabelecimento do perfil epidemiológico da doença na cidade e as pesquisas que permitiram identificar a dinâmica das espécies de mosquitos em áreas rurais, são importantes indicadores que devem ser considerados nos trabalhos de controle, assim como as autoridades competentes devem executar os métodos mais efetivos de combate ao vetor frente à complexidade e à importância que as doenças relacionadas ao Ae. aegypti impõem à sociedade.
The activities related to the control of dengue fever are recommended by the Ministry of Health and by the Health Secretariat of the State - this latter under the responsibility of the Superintendence of the Control of Endemic Diseases of the State of São Paulo. The execution of the relevant actions is the responsibility of the municipalities of the State. Within this context, both epidemiological and entomological surveillance are fundamental for the reduction of the risks arising from the transmission of diseases by mosquitoes to society. Various studies were undertaken in Santa Bárbara d'Oeste municipality in the interior of São Paulo State, for the purpose of understanding the dynamics of dengue fever better. Two studies were conducted on the epidemiological profile of dengue fever, the first of which analyzed the epidemic which occurred during 2010, and the second presented an analysis of the disease during the period from 1995 to 2010. Three studies were undertaken focusing on the entomological aspect. The first to ascertain the distribution of Culicidae in the Bairro Cruzeiro do Sul suburb, which presents rural characteristics but which is transitional to an urban environment. In the second study the results obtained by means of two methods of the application of insecticide, known as light nebulization and nebulization with heavy equipment coupled to the vehicle, were analyzed. The last study presented the results obtained from the collections undertaken in five rural districts of the municipality by means of the installation of larvitraps. The results obtained by the studies of the epidemics demonstrated that, in 2010, men contracted dengue fever more often than women and that the greatest number of cases occurred in young people between 15 and 19 years of age. The most commonly reported symptoms were fever, myalgia, headache and arthralgia. It was also discovered that two areas of the municipality presented greater risk of dengue fever, and that the history of the epidemics presents the eastern zone of the city as the district in which the epidemic broke out. In the research undertaken with entomological focus, it was ascertained that five mosquito species were captured in the traps during the project in the rural district of Cruzeiro do Sul, and six species were identified in the research undertaken in the various rural areas. Specifically for the Bairro Cruzeiro do Sul suburb, a comparison of the two studies undertaken shows that Aedes albopictus became less frequent, while Aedes aegypti increased its occurrences in this area. In the two studies undertaken in the various rural areas, Simpson’s diversity index obtained the highest results at those sites where the presence of Ae. aegypti was less frequent. In the study comparing the methods of nebulization it was observed that the number of eggs collected on the traps was smaller where the equipment for heavy nebulization was used. A difference between the numbers of patients suffering from dengue fever between these two areas was also observed. In the light of the results obtained it is concluded that the methods presented for the establishment of the epidemiological profile of the disease in the city as also the research which permitted the identification of the dynamics of the mosquito species in the rural areas are important indicators which should be borne in mind in undertaking control actions and also that the competent authorities should make use of the most effective methods to combat the vector in the light of the complexity and gravity of the pathogens which Ae. aegypti transmits to society.
The activities related to the control of dengue fever are recommended by the Ministry of Health and by the Health Secretariat of the State - this latter under the responsibility of the Superintendence of the Control of Endemic Diseases of the State of São Paulo. The execution of the relevant actions is the responsibility of the municipalities of the State. Within this context, both epidemiological and entomological surveillance are fundamental for the reduction of the risks arising from the transmission of diseases by mosquitoes to society. Various studies were undertaken in Santa Bárbara d'Oeste municipality in the interior of São Paulo State, for the purpose of understanding the dynamics of dengue fever better. Two studies were conducted on the epidemiological profile of dengue fever, the first of which analyzed the epidemic which occurred during 2010, and the second presented an analysis of the disease during the period from 1995 to 2010. Three studies were undertaken focusing on the entomological aspect. The first to ascertain the distribution of Culicidae in the Bairro Cruzeiro do Sul suburb, which presents rural characteristics but which is transitional to an urban environment. In the second study the results obtained by means of two methods of the application of insecticide, known as light nebulization and nebulization with heavy equipment coupled to the vehicle, were analyzed. The last study presented the results obtained from the collections undertaken in five rural districts of the municipality by means of the installation of larvitraps. The results obtained by the studies of the epidemics demonstrated that, in 2010, men contracted dengue fever more often than women and that the greatest number of cases occurred in young people between 15 and 19 years of age. The most commonly reported symptoms were fever, myalgia, headache and arthralgia. It was also discovered that two areas of the municipality presented greater risk of dengue fever, and that the history of the epidemics presents the eastern zone of the city as the district in which the epidemic broke out. In the research undertaken with entomological focus, it was ascertained that five mosquito species were captured in the traps during the project in the rural district of Cruzeiro do Sul, and six species were identified in the research undertaken in the various rural areas. Specifically for the Bairro Cruzeiro do Sul suburb, a comparison of the two studies undertaken shows that Aedes albopictus became less frequent, while Aedes aegypti increased its occurrences in this area. In the two studies undertaken in the various rural areas, Simpson’s diversity index obtained the highest results at those sites where the presence of Ae. aegypti was less frequent. In the study comparing the methods of nebulization it was observed that the number of eggs collected on the traps was smaller where the equipment for heavy nebulization was used. A difference between the numbers of patients suffering from dengue fever between these two areas was also observed. In the light of the results obtained it is concluded that the methods presented for the establishment of the epidemiological profile of the disease in the city as also the research which permitted the identification of the dynamics of the mosquito species in the rural areas are important indicators which should be borne in mind in undertaking control actions and also that the competent authorities should make use of the most effective methods to combat the vector in the light of the complexity and gravity of the pathogens which Ae. aegypti transmits to society.
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Palavras-chave
Dengue, Aedes aegypti, Mosquitos vetores, Vigilância entomológica, Vector mosquitoes, Entomological surveillance, Spatial analysis, Análise espacial