Arboviral diseases represent a growing public health challenge worldwide, with Brazil reporting the highest number of dengue cases and recent expansion into southern regions. Effective epidemiological surveillance relies on the capacity of health institutions to identify, notify, and manage cases. This study evaluated the role of healthcare facilities of different administrative spheres in arboviral disease surveillance, based on their participation in case notification and hospitalization, in Rio Grande do Sul (RS), the southernmost Brazilian state. The influence of meteorological factors was also assessed. A retrospective ecological study was conducted using data from the National Notifiable Diseases Information System (SINAN) from January 2020 to June 2024 along with healthcare facility data from the National Registry of Healthcare Facilities (CNES). Institutions were classified as public administration, philanthropic organizations, business entities, or individuals. Notification and hospitalization rates were analyzed in absolute and relative numbers (per 100 institutions and per 100,000 inhabitants). Spatial analysis was performed based on intermediate geographic regions, and seasonality of cases was analyzed together with meteorological data (temperature, humidity, and precipitation). A total of 414,569 suspected arboviral cases were reported, including 277,878 confirmed dengue cases. Public administration institutions, although representing only 14.66% of facilities, accounted for 80.35% of notifications and 82.19% of confirmed cases. Philanthropic organizations (1.98% of institutions) contributed disproportionately (11.67%) and showed the highest notification rates per facility. Hospitalizations totaled 14,196, with similar contributions from public (45.79%) and philanthropic (43.78%) sectors. Spatial analysis revealed concentration of cases in major regional hubs, while population-adjusted rates indicated higher burdens in less populous regions. In addition, increases in case numbers were observed following periods of high temperature. Public and philanthropic health institutions play a central role in arboviral disease surveillance and care in RS, despite representing a minority of facilities. Limited participation of private entities underscores the need for improved integration across the healthcare system. Regional disparities and climatic influences further emphasize the importance of targeted, data-driven public health strategies to strengthen surveillance and control efforts.
Kist et al. (Fri,) studied this question.