URBAN ARBOVIRUSES IN PRIMARY HEALTH CARE: CLINICAL CARE, TERRITORIAL SURVEILLANCE AND INTEGRATED RESPONSE IN THE SUS

Abstract

Urban arboviral diseases remain among Brazil’s major public health challenges because they combine high transmission potential, seasonality, territorial expansion of the vector, heterogeneous clinical manifestations, and strong dependence on social and environmental conditions. This study aims to analyze the strategic role of Primary Health Care in the response to dengue, chikungunya, and Zika virus infection, emphasizing the integration of clinical care, epidemiological surveillance, entomological surveillance, health education, and intersectoral action. This is a theoretical-reflective narrative study based on technical and normative documents issued by the Brazilian Ministry of Health and the Pan American Health Organization between 2023 and 2025. The analysis was organized around the following axes: clinical complexity and differential diagnosis; organization of the work process; territorial surveillance; integration between community health workers and endemic disease control agents; health education; social participation; and management perspectives. The findings indicate that the effectiveness of Primary Health Care depends on anticipatory planning, risk stratification, timely hydration, qualified notification, longitudinal follow-up, and coordination between care and surveillance. Challenges were also identified regarding clinical differentiation among arboviruses, follow-up of chronic chikungunya manifestations, care for pregnant women exposed to Zika virus, interoperability of information systems, and persistent socio-environmental inequalities. It is concluded that a sustainable response to arboviral diseases requires strengthened Primary Health Care capable of combining qualified clinical care, local epidemiological intelligence, territorial action, and community mobilization beyond epidemic periods.