Epidemiological characteristics of dengue disease in Latin America and the Caribbean

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All four dengue serotypes regularly circulate Latin America and the Caribbean, sometimes with hyperendemic pattern, resulting in an increase in numbers of outbreaks and populations affected in recent years, and yet under-reporting continues resulting in under-estimation of the burden of disease.

Existing national epidemiological surveillance often underestimate the burden of dengue disease, but are sufficient to track trends and outbreaks. PAHO and WHO data reveals all four dengue serotypes circulate in the region, but that there is widespread variation in incidence of reported cases.

The study aims to characterise the recent epidemiology of dengue disease in Latin America and Caribbean Islands (excluding Brazil, Colombia and Mexico) in  terms of incidence, mortality, disease severity, age groups affected, circulating serotypes and other risk factors.

While it’s generally accepted that dengue is a climate-sensitive disease, the actual influence on transmission is variable, eg, some studies in Mexico show El Nino is both strongly associated with disease transmission and others show it is not important in interannual variability in dengue incidence. Despite widespread incorporation of WHO/PAHO criteria into national surveillance programmes, reporting still varies considerably. New surveillance approaches are required, as well as closer association between surveillance and disease responses and implementation of control measures during epidemics.

The study used multiple relevant databases, and also included grey literature, but a complete search strategy is not included, and data collection ceased in 2013, 3 years before the article was submitted for publication. Sixty articles were included in the review. Combinations of increased crowding, growing population density, precarious homes, water storage issues and failed of vector control programs are the most likely factors to contribute to permanent dengue transmission.

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