Estimative and analysis of death caused by dengue fever Brazil, 2007 and 2008

Background: Dengue Fever is a mild to severe acute febrile viral disease. The objectives were estimate the Dengue death rate in Brazil and its risk factors based on the Notification Disease Information (SINAN) and the Mortality Information (SIM) Systems. Methods: Probabilistic Record Linkage Methodology (RecLink III) was applied to identify pairs of severe and fatal Dengue cases on SINAN and SIM in 2007-2008, and to obtain the number of deaths (ND), variance (V) and confidence intervals at 95% (IC95). A case control study (1:4) was performed considering confirmed death pair SINAN/SIM as case and severe case of SINAN with cure (not paired at SIM) as control. Results: During the period, 701 severe cases on SINAN and 879 deaths on SIM were notified; 444 pairs were identified, with ND=1,387, V=782 and IC95=1,332-1,442. Sub-notification was of 49% on SINAN. Majority of pairs were from Rio de Janeiro (27%), age < 15 years (40%), female (54%); hemorrhage (70%), plasma leakage (57%), platelet count < 50,000 /mm3 (81%) and hypovolemic shock (14%). Total of 322/444 (73%) cases were within the case definition; 1,288 cases were randomly selected as controls. Associated factor were: age > 65 years old [OR=2.8(IC95%=1.7-4.6)], gastro-intestinal bleeding [5.0(3.7-6.9)], hematuria [2.8(1.8-4.2)], cavitary effusion [2.8(2.0-3.9)], tourniquet test [0.5(0.3-0.7)] and hemoconcentration [0.4(0.3-0.5)]. Conclusions: SINAN showed death sub-notification. Results of tourniquet and hemoconcentration tests may be helpful for early detection of case severity in patients with no death, particularly older than 65 years. Concomitant SINAN and SIM use is recommended for lethality evaluation of Dengue in Brazil. For more information, email the presenter at:

Author (s): 

G. Coelho, L. Vinhal, A. Biondo, J. Siqueira-J?nior, W. Ara?jo and G. Dimech

Presenter (s): 
Mr. Juliano Hoffmann
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