Evidence map›Paper›PMID 37031687›Full record

ArticleThe Lancet. Microbe2023

Spatiotemporal dynamics and recurrence of chikungunya virus in Brazil: an epidemiological study.

William M de Souza, Shirlene T S de Lima, Leda M Simões Mello, Darlan S Candido, Lewis Buss, Charles Whittaker, Ingra M Claro, Nilani Chandradeva, Fabiana Granja, Ronaldo de Jesus and 16 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Microbe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed
28.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 97 citations in OpenAlex.

  1. Article
  2. Characterization of the clinical forms of chronic chikungunya: an observational cohort study in Rio de Janeiro.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors at 8 institutions in 3 countries.

William M de SouzaDepartment of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA; World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: wmdesouz@utmb.edu.
Shirlene T S de LimaLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil; Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
Leda M Simões MelloLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Darlan S CandidoMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Department of Zoology, University of Oxford, Oxford, UK; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Lewis BussMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
Charles WhittakerMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; The Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College London, London, UK.
Ingra M ClaroMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Department of Zoology, University of Oxford, Oxford, UK; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Nilani ChandradevaMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
Fabiana GranjaLaboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil; Biodiversity Research Centre, Federal University of Roraima, Boa Vista, Brazil.
Ronaldo de JesusMinistério da Saúde, Departamento de Articulação Estratégica de Vigilância em Saúde, Brasilia, Brazil; Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Poliana S LemosMinistério da Saúde, Departamento de Articulação Estratégica de Vigilância em Saúde, Brasilia, Brazil.
Daniel A Toledo-TeixeiraLaboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
Priscilla P BarbosaLaboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
Antonio Carlos L FirminoLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Mariene R AmorimLaboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
Larissa M F DuarteLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Ivan B PessoaLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Julia ForatoLaboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.
Irihane L VasconcelosLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Ana Carolina B M MaximoLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Emerson L L AraújoMinistério da Saúde, Departamento de Articulação Estratégica de Vigilância em Saúde, Brasilia, Brazil.
Liana Perdigão MelloLaboratório Central de Saúde Pública do Ceará, Fortaleza, Brazil.
Ester C SabinoInstituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
José Luiz Proença-MódenaLaboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil; Hub of Global Health, University of Campinas, Campinas, Brazil.
Nuno R FariaMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; Department of Zoology, University of Oxford, Oxford, UK; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Scott C WeaverDepartment of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA; World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA; Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.
Universidade Estadual do Ceará · BRUniversidade Estadual de Campinas (UNICAMP) · BRImperial College London · GBMinistério da Saúde · BRThe University of Texas Medical Branch at Galveston · USUniversidade de São Paulo · BRHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRUniversidade Federal de Roraima · BR

Funding

West African Center for Emerging Infectious DiseasesU01AI151801 · NIAID · UNIVERSITY OF TEXAS MED BR GALVESTON · PI Robert W Cross, Scott C Weaver · 2020 to 2026
$10.1M
World Reference Center for Emerging Viruses and Arboviruses (WRCEVA)R24AI120942 · NIAID · UNIVERSITY OF TEXAS MED BR GALVESTON · PI WEAVER, SCOTT C · 2016 to 2024
$8.5M
Trajectory of Vector-adaptive Chikungunya Virus EvolutionR01AI121452 · NIAID · UNIVERSITY OF TEXAS MED BR GALVESTON · PI WEAVER, SCOTT C · 2016 to 2020
$2.3M
Medical Research Council MR/R015600/1Medical Research Council MR/S0195/1Medical Research Council MR/S019510/1NIAID NIH HHS R01 AI121452NIAID NIH HHS R24 AI120942NIAID NIH HHS U01 AI151801Wellcome TrustWellcome Trust 204311/Z/16/ZWellcome Trust 224190/Z/21/ZWellcome Trust 226075/Z/22/Z
6 · The paper itself

Abstract

backgroundChikungunya virus (CHIKV) is an Aedes mosquito-borne virus that has caused large epidemics linked to acute, chronic, and severe clinical outcomes. Currently, Brazil has the highest number of chikungunya cases in the Americas. We aimed to investigate the spatiotemporal dynamics and recurrence pattern of chikungunya in Brazil since its introduction in 2013.

methodsIn this epidemiological study, we used CHIKV genomic sequencing data, CHIKV vector information, and aggregate clinical data on chikungunya cases from Brazil. The genomic data comprised 241 Brazilian CHIKV genome sequences from GenBank (n=180) and the 2022 CHIKV outbreak in Ceará state (n=61). The vector data (Breteau index and House index) were obtained from the Brazilian Ministry of Health for all 184 municipalities in Ceará state and 116 municipalities in Tocantins state in 2022. Epidemiological data on laboratory-confirmed cases of chikungunya between 2013 and 2022 were obtained from the Brazilian Ministry of Health and Laboratory of Public Health of Ceará. We assessed the spatiotemporal dynamics of chikungunya in Brazil via time series, mapping, age-sex distribution, cumulative case-fatality, linear correlation, logistic regression, and phylogenetic analyses.

findingsBetween March 3, 2013, and June 4, 2022, 253 545 laboratory-confirmed chikungunya cases were reported in 3316 (59·5%) of 5570 municipalities, mainly distributed in seven epidemic waves from 2016 to 2022. To date, Ceará in the northeast has been the most affected state, with 77 418 cases during the two largest epidemic waves in 2016 and 2017 and the third wave in 2022. From 2016 to 2022 in Ceará, the odds of being CHIKV-positive were higher in females than in males (odds ratio 0·87, 95% CI 0·85-0·89, p<0·0001), and the cumulative case-fatality ratio was 1·3 deaths per 1000 cases. Chikungunya recurrences in the states of Ceará, Tocantins (recurrence in 2022), and Pernambuco (recurrence in 2021) were limited to municipalities with few or no previously reported cases in the previous epidemic waves. The recurrence of chikungunya in Ceará in 2022 was associated with a new East-Central-South-African lineage. Population density metrics of the main CHIKV vector in Brazil, Aedes aegypti, were not correlated spatially with locations of chikungunya recurrence in Ceará and Tocantins.

interpretationSpatial heterogeneity of CHIKV spread and population immunity might explain the recurrence pattern of chikungunya in Brazil. These results can be used to inform public health interventions to prevent future chikungunya epidemic waves in urban settings.

fundingGlobal Virus Network, Burroughs Wellcome Fund, Wellcome Trust, US National Institutes of Health, São Paulo Research Foundation, Brazil Ministry of Education, UK Medical Research Council, Brazilian National Council for Scientific and Technological Development, and UK Royal Society. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.

Indexed as

AedesChikungunya FeverChikungunya virusAnimalsBrazilEpidemiologic StudiesFemaleHumansMaleMosquito VectorsPhylogeny

Identifiers

PMID37031687
PMCPMC10281060
OpenAlexW4362659117

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.