Neighborhood Violence Impacts Disease Control and Surveillance: Case Study of Cali, Colombia from 2014 to 2016

Arboviruses are responsible for a large burden of disease globally and are thus subject to intense epidemiological scrutiny. However, a variable notably absent from most epidemiological analyses has been the impact of violence on arboviral transmission and surveillance. Violence impedes surveillance...

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Bibliographic Details
Published in:International journal of environmental research and public health 2018-09, Vol.15 (10), p.2144
Main Authors: Krystosik, Amy R, Curtis, Andrew, LaBeaud, A Desiree, Dávalos, Diana M, Pacheco, Robinson, Buritica, Paola, Álvarez, Álvaro A, Bhatta, Madhav P, Rojas Palacios, Jorge Humberto, James, Mark A
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arboviruses
Chikungunya Fever - epidemiology
Chikungunya Fever - transmission
Colombia - epidemiology
Dengue - epidemiology
Dengue - transmission
Disease Outbreaks - prevention & control
Disease Outbreaks - statistics & numerical data
Disease Transmission, Infectious - statistics & numerical data
Female
Humans
Male
Middle Aged
Violence - statistics & numerical data
Zika Virus Infection - epidemiology
Zika Virus Infection - transmission
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Summary:Arboviruses are responsible for a large burden of disease globally and are thus subject to intense epidemiological scrutiny. However, a variable notably absent from most epidemiological analyses has been the impact of violence on arboviral transmission and surveillance. Violence impedes surveillance and delivery of health and preventative services and affects an individual's health-related behaviors when survival takes priority. Moreover, low and middle-income countries bear a disproportionately high burden of violence and related health outcomes, including vector borne diseases. To better understand the epidemiology of arboviral outbreaks in Cali, Colombia, we georeferenced chikungunya (CHIKV), dengue (DENV), and Zika (ZIKV) viral cases from The National System of Surveillance in Public Health between October 2014 and April 2016. We extracted homicide data from the municipal monthly reports and kernel density of homicide distribution from IdeasPaz. Crucially, an overall higher risk of homicide is associated with increased risk of reported DENV, lower rates of acute testing, and higher rates of lab versus clinical discordance. In the context of high violence as a potential barrier to access to preventive health services, a community approach to improve health and peace should be considered.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph15102144