Young Researcher Award: Access to health units impact notifications of dengue fever cases, says study

Publicação: 12 de November de 2014

Research would only identify ¼ of the disease cases in a poor community depending on the official notification system

Studies with this kind of approach should consider that the distribution of the cases is strongly associated to the access conditions to health units

Studies with this kind of approach should consider that the distribution of the cases is strongly associated to the access conditions to health units

A single community in vulnerable conditions can present different risk areas for dengue fever. This was the conclusion of a work conducted in the Pau da Lima neighborhood in Salvador, Bahia, and that was base to the Master’s thesis in Collective Health by Mariana Kikuti, defended this year at the Federal University of Bahia (UFBA). The research was granted with the third place in the 2014 Young Researcher Award, given during the 50th Congress of the Brazilian Society of Tropical Medicine (MEDTROP 2014), that took place from August 26 to 29 in Rio Branco, Acre.

“We tend to think that in socially vulnerable areas, people are uniformly exposed to risk situations, but it is not that way”, explains the researcher. According to her, there is a risk gradient within the poor community of Pau da Lima, where people living in the lower portions of the neighborhood have greater probability of seeking medical assistance for dengue and other acute fever diseases.

The work was conducted along with a team that works in the Salvador area since 2009. The proposal was to analyze territorial units in the city established by the Brazilian Institute of Geography and Statistics (IBGE), known as census sectors. Along the study, environmental, social economical or demographic features were verified if they could explain the difference of the dengue fever risk.

The most interesting data of the study shows that census sectors closer to the health units are among those with greater risk. “When we adjust a statistical model that considers the spatial correlation, the proximity of those residential census sectors to the health unit is the variable most strongly linked to dengue fever detection”, complements the researcher. However, she adds that this variable could mean the difficulty accessing the health units. This means, how far the person lives from the health unit, how long this person takes before seeking medical attention, leading to an under-reporting of these cases. “Since dengue is usually a disease with benign development, a fever that rarely evolves to sever cases, the patient recovers before seeking medical attention”, says.

The diagnostic, in general, is made by clinical suspicion – when the person presents the symptoms, usually in outbreak times. However, the laboratorial verification through the official notification system is only made in part of these patients. “the difference of our study is that we tested all patients, whether they presented clinical suspicion of not. This way we had a greater possibility to identify the cases”, highlights.

Kikuti observes that only ¼ of the Pau da Lima cases would be identified if the work relied only on the official notification system. She stresses that studies with this kind of methodological approach should consider the fact that the cases distribution is strongly associated to access conditions to the health units.…