Dengue in Brazil: an ecological study of burden, hospitalizations, and mortality trends (2019–2024)

Dengue is the most widespread arboviral disease globally, affecting over 100 countries; Brazil accounts for 83% of cases in the Americas. This is an observational, cross-sectional ecological study encompassed all 27 Brazilian federative units, drawing on data from the Notifiable Diseases Information System (SINAN) and the Department of Informatics of the Unified Health System (DATASUS) from January 1, 2019, to June 30, 2024. Between January 2019 and June 2024, Brazil recorded 12.564.395 dengue cases and 316.519 hospitalizations (2.52% of cases). In the first half of 2024 alone, case counts surged to 6.393.080 with 129.127 hospitalizations, representing 70% of all admissions over the previous five years, and 1.593 dengue-related deaths, the highest six-month toll since 2019. Regional stratification revealed a disproportionately high burden in the Midwest: The Federal District exhibited the highest incidence and hospitalization rates per 100.000 inhabitants, while Goiás and Mato Grosso do Sul recorded mortality rates above the national average. Highest dengue incidence and hospitalization rates were observed in the Center-West and North regions, while mortality peaked in the Southeast, guiding targeted allocation of prevention and control efforts. These cumulative and half-year patterns reveal critical gaps in vector control, disease surveillance, and healthcare preparedness. Integrated public health strategies—including sustained mosquito control efforts, enhanced entomological and clinical monitoring, and bolstered hospital readiness—are essential to mitigate dengue’s impact. Policymakers should prioritize resource allocation and tailored interventions in high-burden regions to reduce transmission, morbidity, and mortality.