Dengue Fever

The Need of a Sustained and Integrated Epidemiological Surveillance Approach

Abstract

This paper provides an updated review of the dengue situation in the Latin-American countries, focusing on Colombia as a highly and historically affected nation. In first instance, it presents a scientific overview about the biology, clinical progress, transmission mode and epidemiology of the disease. Secondly, it describes the different outbreaks in the region during the past five decades. Thirdly, as an illustration of historical trends in most provinces and Colombian territories, early detection and predictive value of a dengue epidemic is inadequate and how a surveillance system should work. Based on these, the document proposes to provide a framework for a pilot model of a sustained and integrated epidemiological surveillance system in Colombia, focused on early detection, prediction (turning point) of outbreaks and recommendation of a model to be implemented by the Colombian local health units of each affected territory.

It emphasizes that a vector-borne disease such as dengue must be addressed locally, having the individual, all the way through a primary health care and population-based approach, at the center of the system. It also highlights a new approach for returning to the basics in primary health attention in which the community health promoter be again one of the main participants. The paper concludes that without a primary health care approach, particularly under the existing decentralized local and regional governments, it will be so difficult to achieve real control over this kind of cyclical public health issues.