Authors Response: Reflections on Afro-descendant origin and the outcome of dengue fever cases in Colombia

Translated title (es): Respuesta: Reflecciones sobre el origen Afro-descendiente y el resultado de casos de dengue en Colombia

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Answer letter to the Editor

We have carefully read Rengifo et al. 1 , views on our research on dengue and ethnicity 2 . Most of their observations point to the classification of ethnicity in the study design, in which we recognize a great difficulty to establish the category of Afro-descendant to each one of the individuals. Some proposals to classify that ethnic group in Latin American populations, based on genetic and biological tests, have shown a great miscegenation, which makes classification difficult 3 The method of self-recognition of the ethnicity is imperfect as we see in the methodology of our study; but it is still valid for the scientific community at this time, while other more efficient, reliable and robust methods arise 4 , 5 .

We disagree with the letter correspondents in considering xenophobic any element of this research. The study design considered any risk of discrimination on the grounds that it directly affected the outcome, and that it safeguarded the principle of equity in the selection and evaluation of variables. Significant results were verified by adjusted models that in some cases refuted the original findings (cumulative incidence by age and ethnic origin). Our interpretations of the results also warn of a silent phase of dissemination of the epidemic in communities with a larger Afro-Colombian population, which may require sanitary adjustments to modify the case numbers of dengue and severe dengue.

Finally, we agree on the complexity of the disease and the limitations of ecological studies; but these two arguments do not detract from the value of the conclusions of the study beyond the limitations we recognize in the discussion. Public health research can contribute to better policy decisions in a region by allowing decision-makers to better understand a problem or situation. But defining what decisions authorities should take in health is a responsibility only of decision-makers, in which they have to take into account other aspects, such as social, economic, technical and also reliance on other sciences 6 . In this way, our publication does not encompass defining moral and politically convenient decisions.



Rengifo AC, Durán MA, Ortíz Y, Rodriguez JM, Ospina ML. Reflections on Afro-descendant origin and the outcome of dengue fever cases in Colombia. Colomb Med (Cali). 2017;48(2):98–99


Rojas-Palacios JH, Alzate A, Martinez-Romero HJ, Concha-Eastman AI. Afro-Colombian ethnicity, a paradoxical protectiva factor against Dengue. Colomb Med (Cali). 2016;47(3):133–141


Wang S, Ray N, Rojas W, Parra MV, Bedoya G, Gallo C. Geographic patterns of genome admixture in Latin American mestizos. PLoS Genet. 2008;4(3):e1000037


Agudelo-Suárez AA, Martínez-Herrera E, Posada-López A, Rocha-Buelvas A. Ethnicity and health in Colombia: what do self-perceived health indicators tell us? Ethn Dis. 2016;26(2):147–156


Larifla L, Beaney KE, Foucan L, Bangou J, Michel CT, Martino J. Influence of genetic risk factors on coronary heart disease occurrence in Afro-Caribbeans. Can J Cardiol. 2016;32(8):978–985


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