Epidemiological trends of dengue disease in Colombia (2000-2011): a systematic review

Abstract

A systematic literature review was conducted to describe the epidemiology of dengue disease in Colombia. Searches of published literature in epidemiological studies of dengue disease encompassing the terms "dengue", "epidemiology," and "Colombia" were conducted. Studies in English or Spanish published between 1 January 2000 and 23 February 2012 were included. The searches identified 225 relevant citations, 30 of which fulfilled the inclusion criteria defined in the review protocol. The epidemiology of dengue disease in Colombia was characterized by a stable "baseline" annual number of dengue fever cases, with major outbreaks in 2001-2003 and 2010. The geographical spread of dengue disease cases showed a steady increase, with most of the country affected by the 2010 outbreak. The majority of dengue disease recorded during the review period was among those <15 years of age. Gaps identified in epidemiological knowledge regarding dengue disease in Colombia may provide several avenues for future research, namely studies of asymptomatic dengue virus infection, primary versus secondary infections, and under-reporting of the disease. Improved understanding of the factors that determine disease expression and enable improvement in disease control and management is also important.

Fig 1. Results of literature search and evaluation of identified studies according to PRISMA.

The searches identified 225 relevant citations, 28 of which were dengue-related sources fulfilling the inclusion criteria. All references identified in the on-line database searches were assigned a unique identification number. Following the removal of duplicates and articles that did not satisfy the inclusion criteria from review of the titles and abstracts, the full papers of the first selection of references were retrieved either electronically or in paper form. A further selection was made based on review of the full text of the articles. ASTMH, American Society of Tropical Medicine and Hygiene; EMBASE, Excerpta Medica Database; LILACS, Latin American and Caribbean Health Sciences Database; LRG, Literature Review Group; PAHO, Pan American Health Organization; PRISMA, preferred reporting items of systematic literature reviews and meta-analyses; SciELO, Scientific Electronic Library Online (*includes access to LILACS and PAHO databases); VHL, Virtual Health Library. Other^† includes unique references identified from other reference sources detailed in the protocol and LRG bibliographies.

Fig 2. Cases of (A) dengue fever and (B) severe dengue fever in Colombia, 2000–2011 [7].

The epidemiology of dengue disease in Colombia was characterized by fluctuations in the number of DF cases (there was a slight baseline increase over time) with major outbreaks in 2001–2003 and 2010. Widespread dengue disease epidemics were observed during 2001–2003 and 2010. A significant outbreak of dengue disease occurred between 2001 and 2003. The annual number of severe dengue disease was highest in 2010, and lowest in 2011.

Fig 3. Incidence of reported cases of dengue (per 100,000 population) by age group, 2000–2010 [7].

In the early part of the review period, the highest incidence of dengue disease was in in individuals aged 15–44 years [12]. However, the age distribution of the disease changed and from 2004 to 2010 the highest reported incidence was in the <4-year-old and 5–14-year-old age groups.