Original articleMapping the ecoepidemiology of Zika virus infection in urban and rural areas of Pereira, Risaralda, Colombia, 2015–2016: Implications for public health and travel medicine☆
Introduction
Zika virus (ZIKV) has caused epidemics during 2015–2017 in different countries of the Americas, with more than 50 countries/territories affected in this region, from 148 globally affected in any form (including imported cases) [1], [2]. After Brazil, probably Colombia is the second most affected country in the region [3], [4], [5], with over 100,000 cases having been reported from this Northern South American country, reflecting overall incidence rates above 150 cases/100,000 [3]. However, as previously demonstrated; when detailed analyses, at primary, secondary and tertiary territory levels are conducted, incidence rates found tend to be highly variable, and higher [3], [6], [7], [8].
Early-developed ZIKV epidemiological maps for Colombia using geographical information systems (GIS) at high incidence departments, such as La Guajira [8] and Sucre [7] (Caribbean region), Tolima [6] and Valle del Cauca [3] (Central and Western region), Santander and Norte de Santander (Northeastern area) were published, but these did not include ecoepidemiological analyses that would allow to a better understand the pattern of temporo-spatial distribution of ZIKV infection in these newly-endemic areas. This has been shown to be significant in other vector-borne and arboviral diseases, such as dengue [9], [10], [11], [12], where multiple studies have documented the influence of climate variables on its epidemiology, including reports from Colombia [9], [10], [11], [12]. Even more, there is a clear need from public health authorities to develop and use GIS-based maps not just for ZIKV, but also for dengue and chikungunya, which are co-circulating in Pereira, in Risaralda, as well Colombia and Latin America at the same time, even co-infecting [1], [13], [14].
ZIKV and other arboviral diseases could be associated with multiple factors including changes in environmental and social conditions that may influence their epidemiology [15], [16], [17], [18]. Up to date, there is a lack of studies assessing eco-epidemiological factors that would be related to ZIKV in Latin America, including Colombia, during ongoing epidemics [19].
Eco-epidemiological information is of utmost importance, which should include the availability of risk maps to address recommendations related to prioritize interventions as well for identification of areas of risk by visitors or people returning from visiting specific places [8], [11], [20], [21]. Linked to educational programs and other interventional measures [10], [20], [21], [22], [23], eco-epidemiological data should be considered in an integrated and systematic approach for ZIKV and other arboviral diseases control by national and local health authorities, as well at the community level in order to reduce and mitigate the disease impact.
In the current study, we set out to obtain estimates of ZIKV infection incidence rates in the municipality of Pereira, the capital of Risaralda department and the major city of the Coffee-Triangle region of Colombia; which included the development of GIS-based maps for disease, as well as its ecosystems, rainfall, economical classification as well as entomological indicators, among other ecoepidemiological aspects, in 2015–2016.
Section snippets
Methods
Scientific publications using GIS for development of epidemiological maps in ZIKV in Latin America are still lacking [6], [7], [8], [20], [24]. Pereira is the major city of the Coffee-Triangle region, which includes three departments (first administrative territory level) and 53 municipalities (second administrative territory level). This is the capital of Risaralda (957,250 habitants in 2016), a department surrounded by six other western departments (Antioquia, Caldas, Tolima, Quindio, Valle
Results
Up to October 8, 2016, 439 cases of ZIKV were reported in Pereira (33.85% of Risaralda department), for cumulated rates of 93/100,000 (Table 1). Of the total number of cases, 50 (11.4%) were laboratory confirmed by RT-PCR.
From the total number of cases, 77.7% occurred in the urban area, with a global incidence rate of 85.5 cases/100,000 (Table 1) (Fig. 1), and 94.1/100,000 in the rural area (1.1 times higher). Rates differed from 0 to 460/100,000 (Caimalito, rural, 7.3% of the municipality
Discussion
Colombia has reported a total of 104,724 cases of ZIKV infection during 2015–2016 (up to October 15, 2016), 8826 (8.4%) of them confirmed by RT-PCR [27], [28]. From the total, 1298 have been from Risaralda (1.24%) and 439 from Pereira city. Although the Ministry of Health, through its National Institute of Health, have declared the end of the epidemic phase in the country (during epidemiological 28th, July 16, 2016), certainly ZIKV has become endemic with stable transmission in most of its
Ethical approval
Not required.
Funding
Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia. This study is part of the project “Desarrollo de Mapas Epidemiológicos a través de Sistemas de Información Geográfica para la Caracterización Geográfica de Enfermedades Infecciosas y Tropicales en el Eje Cafetero de Colombia” (Code 5-15-5 [2015–2017]), Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
Author contributions
Study design: AJRM, Data collection: PR, JT, CAO, Data analysis: AJRM, COLR, PR, JT, Writing: All authors. All authors contributed to, and approved the final version submitted.
Data availability
Raw data for is available and will be provided on request.
Grant information
This study was funded by the Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia (Code 5-15-5 [2015–2017]). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflicts of interest
The authors have no conflict of interest to disclose.
Acknowledgments
To Yuan Lian (USA) and Bao Cai (USA), for their critical review and English improvement of the manuscript. This manuscript has been previously presented in part at the XVIII Pan-American Congress of Infectious Diseases (Pan-American Association of Infectious Diseases, API), Panama City, Panama, May 2017 (Poster H-16). The Faculty of Health Sciences and Vice-Rectorship of Research of the Universidad Tecnologica de Pereira, the Colombian Association of Infectious Diseases (ACIN) (Coffee-Triangle
References (46)
- et al.
The arboviral burden of disease caused by co-circulation and co-infection of dengue, chikungunya and Zika in the Americas
Travel Med Infect Dis
(2016) - et al.
Zika virus associated deaths in Colombia
Lancet Infect Dis
(2016) - et al.
Severe abdominal pain in a patient with Zika infection: a case in Risaralda
Colomb J Infect Public Health
(2016) - et al.
Mapping Zika in municipalities of one coastal department of Colombia (Sucre) using geographic information systems during the 2015-2016 outbreak: implications for public health and travel advice
Int J Infect Dis
(2016) - et al.
Zika infection GIS-based mapping suggest high transmission activity in the border area of La Guajira, Colombia, a northeastern coast Caribbean department, 2015-2016: implications for public health, migration and travel
Travel Med Infect Dis
(2016) - et al.
Effect of climate variables on dengue incidence in a tropical Caribbean municipality of Colombia, Cerete, 2003-2008
Int J Infect Dis
(2013) - et al.
Potential impact of climatic variability on the epidemiology of dengue in Risaralda, Colombia, 2010-2011
J Infect Public Health
(2015) - et al.
Zika, dengue, and chikungunya co-infection in a pregnant woman from Colombia
Int J Infect Dis
(2016) - et al.
Dengue, chikungunya and Zika co-infection in a patient from Colombia
J Infect Public Health
(2016) - et al.
Potential for Zika virus introduction and transmission in resource-limited countries in Africa and the Asia-Pacific region: a modelling study
Lancet Infect Dis
(2016)
Applying geographical information systems (GIS) to arboviral disease surveillance and control: a powerful tool
Travel Med Infect Dis
Ecological diversity of Trypanosoma cruzi transmission in the Amazon basin. The main scenaries in the Brazilian Amazon
Acta Trop
A bibliometric analysis of global Zika research
Travel Med Infect Dis
Mapping malaria in municipalities of the coffee triangle region of Colombia using geographic information systems (GIS)
J Infect Public Health
Using geographic information system (GIS) to mapping and assess changes in transmission patterns of chikungunya fever in municipalities of the Coffee-Triangle region of Colombia during 2014-2015 outbreak: implications for travel advice
Travel Med Infect Dis
Differences in TB incidence between prison and general populations, Pereira, Colombia, 2010-2011
Tuberc (Edinb)
Epidemiology of opportunistic diseases in AIDS patients from Pereira municipality, Colombia, 2010-2011
J Infect Public Health
The 2014 FIFA World Cup: communicable disease risks and advice for visitors to Brazil–a review from the Latin American society for travel medicine (SLAMVI)
Travel Med Infect Dis
Diagnosis, management and follow-up of pregnant women with Zika virus infection: a preliminary report of the ZIKERNCOL cohort study on Sincelejo
Colomb Travel Med Infect Dis
El Nino and climate change–contributing factors in the dispersal of Zika virus in the Americas?
Lancet
Bibliometric assessment of the scientific production of literature regarding Mayaro
J Infect Public Health
Why is the yellow fever outbreak in Angola a ‘threat to the entire world’?
Int J Infect Dis
Zika: the new arbovirus threat for Latin America
J Infect Dev Ctries
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- ☆
This study was partially presented at the XVIII Pan-American Congress of Infectious Diseases (API), Panama City, Panama, May 2017 (Poster H-16).