Developing a Social Autopsy Tool for Dengue Mortality: A Pilot Study

Article by María José Arauz, Valéry Ridde, Libia Milena Hernández, Yaneth Charris, Mabel Carabali & Luis Ángel Villar published February 6, 2015 in PLoS ONE 10(2).


Background: Dengue fever is a public health problem in the tropical and sub-tropical world. Dengue cases have grown dramatically in recent years as well as dengue mortality. Colombia has experienced periodic dengue outbreaks with numerous dengue related-deaths, where the Santander department has been particularly affected. Although social determinants of health (SDH) shape health outcomes, including mortality, it is not yet understood how these affect dengue mortality. The aim of this pilot study was to develop and pre-test a social autopsy (SA) tool for dengue mortality.

Methods and Findings: The tool was developed and pre-tested in three steps. First, dengue fatal cases and ‘near misses’ (those who recovered from dengue complications) definitions were elaborated. Second, a conceptual framework on determinants of dengue mortality was developed to guide the construction of the tool. Lastly, the tool was designed and pre-tested among three relatives of fatal cases and six near misses in 2013 in the metropolitan zone of Bucaramanga. The tool turned out to be practical in the context of dengue mortality in Colombia after some modifications. The tool aims to study the social, individual, and health systems determinants of dengue mortality. The tool is focused on studying the socioeconomic position and the intermediary SDH rather than the socioeconomic and political context.

Conclusions: The SA tool is based on the scientific literature, a validated conceptual framework, researchers’ and health professionals’ expertise, and a pilot study. It is the first time that a SA tool has been created for the dengue mortality context. Our work furthers the study on SDH and how these are applied to neglected tropical diseases, like dengue. This tool could be integrated in surveillance systems to provide complementary information on the modifiable and avoidable death-related factors and therefore, be able to formulate interventions for dengue mortality reduction.


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Arauz, M. J., Ridde, V., Hernández, L. M., Charris, Y., Carabali, M., & Villar, L. Á. (2015). Developing a Social Autopsy Tool for Dengue Mortality: A Pilot Study. PLoS ONE, 10(2). Download

Presence of dengue fever in semi-urban areas of two health districts in Burkina Faso

The global incidence of dengue has grown dramatically in recent decades. In Burkina Faso, the last description of acute cases was back in 1982. During an annual population-based survey in Kaya and Zorgho, two semi-urban areas, febrile individuals from 0-10 years old were evaluated for malaria and dengue virus (DENV). Rapid tests were performed and additional samples on filter paper were taken from every patient with a positive result and every tenth negative, to perform reverse transcription-polymerase chain reaction (RT-PCR) assays. From 259 children (150 in Kaya and 109 in Zorgho), 52.1% were positive for malaria and 6.9% for dengue while 45.2% remained undifferentiated. The RT-PCR results show the presence of DENV2 and DENV4. These findings reveal the presence of DENV in the country and the need to conduct research and actions on non-malaria febrile diseases in the region. (more…)