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Liyanage P, Tozan Y, Tissera HA, Overgaard HJ, Rocklöv J. Assessing the associations between Aedes larval indices and dengue risk in Kalutara district, Sri Lanka: a hierarchical time series analysis from 2010 to 2019. Parasit Vectors 2022; 15:277. [PMID: 35922821 PMCID: PMC9351248 DOI: 10.1186/s13071-022-05377-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/26/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Dengue is a major public health problem in Sri Lanka. Aedes vector surveillance and monitoring of larval indices are routine, long-established public health practices in the country. However, the association between Aedes larval indices and dengue incidence is poorly understood. It is crucial to evaluate lagged effects and threshold values of Aedes larval indices to set pragmatic targets for sustainable vector control interventions. METHODS Monthly Aedes larval indices and dengue cases in all 10 Medical Officer of Health (MOH) divisions in Kalutara district were obtained from 2010 to 2019. Using a novel statistical approach, a distributed lag non-linear model and a two-staged hierarchical meta-analysis, we estimated the overall non-linear and delayed effects of the Premise Index (PI), Breteau Index (BI) and Container Index (CI) on dengue incidence in Kalutara district. A set of MOH division-specific variables were evaluated within the same meta-analytical framework to determine their moderator effects on dengue risk. Using generalized additive models, we assessed the utility of Aedes larval indices in predicting dengue incidence. RESULTS We found that all three larval indices were associated with dengue risk at a lag of 1 to 2 months. The relationship between PI and dengue was homogeneous across MOH divisions, whereas that with BI and CI was heterogeneous. The threshold values of BI, PI and CI associated with dengue risk were 2, 15 and 45, respectively. All three indices showed a low to moderate accuracy in predicting dengue risk in Kalutara district. CONCLUSIONS This study showed the potential of vector surveillance information in Kalutara district in developing a threshold-based, location-specific early warning system with a lead time of 2 months. The estimated thresholds are nonetheless time-bound and may not be universally applicable. Whenever longitudinal vector surveillance data areavailable, the methodological framework we propose here can be used to estimate location-specific Aedes larval index thresholds in any other dengue-endemic setting.
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Affiliation(s)
- Prasad Liyanage
- grid.12650.300000 0001 1034 3451Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden ,grid.466905.8Ministry of Health, Colombo, Sri Lanka
| | - Yesim Tozan
- grid.137628.90000 0004 1936 8753School of Global Public Health, New York University, New York, NY 10003 USA
| | | | - Hans J. Overgaard
- grid.19477.3c0000 0004 0607 975XFaculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway ,grid.9786.00000 0004 0470 0856Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Joacim Rocklöv
- grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, SE-901 87 Umeå, Sweden ,grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health & the Interdisciplinary Center for Scientific Computing, University of Heidelberg, Heidelberg, Germany
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Milhim BHGA, da Rocha LC, Terzian ACB, Mazaro CCP, Augusto MT, Luchs A, Zini N, Sacchetto L, dos Santos BF, Garcia PHC, Rocha RS, Liso E, Brienze VMS, da Silva GCD, Vasilakis N, Estofolete CF, Nogueira ML. Arboviral Infections in Neurological Disorders in Hospitalized Patients in São José do Rio Preto, São Paulo, Brazil. Viruses 2022; 14:1488. [PMID: 35891468 PMCID: PMC9323204 DOI: 10.3390/v14071488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Arbovirus infections are increasingly important causes of disease, whose spectrum of neurological manifestations are not fully known. This study sought to retrospectively assess the incidence of arboviruses in cerebrospinal fluid samples of patients with neurological symptoms to inform diagnosis of central and peripheral nervous system disorders. A total of 255 cerebrospinal fluid (CSF) samples collected from January 2016 to December 2017 were tested for dengue virus (DENV 1-4), Zika virus (ZIKV), and Chikungunya virus (CHIKV) in addition to other neurotropic arboviruses of interest, using genetic and serologic assays. Of the 255 CSF samples analyzed, 3.53% (09/255) were positive for arboviruses presenting mainly as meningitis, encephalitis, and cerebrovascular events, of which ZIKV was detected in 2.74% (7/255), DENV in 0.78% (2/255), in addition to an identified ILHV infection that was described previously. All the cases were detected in adults aged 18 to 74 years old. Our findings highlight the scientific and clinical importance of neurological syndromes associated with arboviruses and demonstrate the relevance of specific laboratory methods to achieve accurate diagnoses as well as highlight the true dimension of these diseases to ultimately improve public health planning and medical case management.
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Affiliation(s)
- Bruno H. G. A. Milhim
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Leonardo C. da Rocha
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Ana C. B. Terzian
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
- Laboratório de Imunologia Celular e Molecular (LICM), Avenida Augusto de Lima, 1715, Centro, Belo Horizonte 30190-002, MG, Brazil
- Instituto René Rachou Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Centro, Belo Horizonte 30190-002, MG, Brazil
| | - Carolina C. P. Mazaro
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Marcos T. Augusto
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Adriana Luchs
- Enteric Disease Laboratory, Department of Virology, Adolfo Lutz Institute, Avenida Dr. Arnaldo, 355, São Paulo 01246-902, SP, Brazil;
| | - Nathalia Zini
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Livia Sacchetto
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Barbara F. dos Santos
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Pedro H. C. Garcia
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Rodrigo S. Rocha
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Elisabete Liso
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544-Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (E.L.); (V.M.S.B.)
| | - Vânia M. S. Brienze
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544-Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (E.L.); (V.M.S.B.)
| | - Gislaine C. D. da Silva
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA;
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX 77555-1150, USA
- Center for Vector-Borne and Zoonotic Diseases, The University of Texas Medical Branch, Galveston, TX 77555-0609, USA
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA
| | - Cássia F. Estofolete
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Maurício L. Nogueira
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA;
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Carabali M, Schmidt AM, Restrepo BN, Kaufman JS. A joint spatial marked point process model for dengue and severe dengue in Medellin, Colombia. Spat Spatiotemporal Epidemiol 2022; 41:100495. [DOI: 10.1016/j.sste.2022.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
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Cunha HS, Sclauser BS, Wildemberg PF, Fernandes EAM, dos Santos JA, Lage MDO, Lorenz C, Barbosa GL, Quintanilha JA, Chiaravalloti-Neto F. Water tank and swimming pool detection based on remote sensing and deep learning: Relationship with socioeconomic level and applications in dengue control. PLoS One 2021; 16:e0258681. [PMID: 34882711 PMCID: PMC8659416 DOI: 10.1371/journal.pone.0258681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 10/03/2021] [Indexed: 12/20/2022] Open
Abstract
Studies have shown that areas with lower socioeconomic standings are often more vulnerable to dengue and similar deadly diseases that can be spread through mosquitoes. This study aims to detect water tanks installed on rooftops and swimming pools in digital images to identify and classify areas based on the socioeconomic index, in order to assist public health programs in the control of diseases linked to the Aedes aegypti mosquito. This study covers four regions of Campinas, São Paulo, characterized by different socioeconomic contexts. With mosaics of images obtained by a 12.1 MP Canon PowerShot S100 (5.2 mm focal length) carried by unmanned aerial vehicles, we developed deep learning algorithms in the scope of computer vision for the detection of water tanks and swimming pools. An object detection model, which was initially created for areas of Belo Horizonte, Minas Gerais, was enhanced using the transfer learning technique, and allowed us to detect objects in Campinas with fewer samples and more efficiency. With the detection of objects in digital images, the proportions of objects per square kilometer for each region studied were estimated by adopting a Chi-square distribution model. Thus, we found that regions with low socioeconomic status had more exposed water tanks, while regions with high socioeconomic levels had more exposed pools. Using deep learning approaches, we created a useful tool for Ae. aegypti control programs to utilize and direct disease prevention efforts. Therefore, we concluded that it is possible to detect objects directly related to the socioeconomic level of a given region from digital images, which encourages the practicality of this approach for studies aimed towards public health.
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Affiliation(s)
- Higor Souza Cunha
- Department of Electrical Engineering, Polytechnic School, Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
| | - Brenda Santana Sclauser
- Department of Electrical Engineering, Polytechnic School, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Mariana de Oliveira Lage
- Environmental Science Graduation Program (PROCAM), Institute of Energy and Environment, Universidade de São Paulo, São Paulo, Brazil
| | - Camila Lorenz
- Department of Epidemiology, Faculty of Public Health, Universidade de São Paulo, São Paulo, Brazil
| | | | - José Alberto Quintanilha
- Scientific Division of Environmental Management, Science and Technology, Institute of Energy and Environment, Universidade de São Paulo, São Paulo, Brazil
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de Sousa SC, Carneiro M, Eiras ÁE, Bezerra JMT, Barbosa DS. Factors associated with the occurrence of dengue epidemics in Brazil: a systematic review. Rev Panam Salud Publica 2021; 45:e84. [PMID: 34377143 PMCID: PMC8344382 DOI: 10.26633/rpsp.2021.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify and describe broadly the factors related to the occurrence of dengue epidemics in Brazil. METHODS Systematic review of studies published in Medline, Lilacs, PubMed, Cochrane, BVS, Web of Science, Scopus, and thesis and dissertations databases using descriptors cataloged in DeCs and MeSH on dengue and factors associated with the occurrence of epidemics, published from 2008 to 2018. RESULTS Thirty-five studies carried out in the country were selected. The epidemics recorded in Brazil were associated and/or correlated with multiple factors such as environment, socioeconomic conditions, climate, and aspects related to the vector, among others. CONCLUSIONS Dengue epidemics are complex and multifactorial. The continuity of the vector control actions was found to be relevant to the reduction of Aedes aegypti and for disease control. To contain the spread of the disease, effective measures are needed in all sectors, including health, education, economy, population, business, and government. Actions for the early detection of cases of the disease can prevent new outbreaks of epidemics.
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Affiliation(s)
- Selma Costa de Sousa
- Universidade Federal de Minas GeraisBelo HorizonteBrazilUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariângela Carneiro
- Universidade Federal de Minas GeraisBelo HorizonteBrazilUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Álvaro Eduardo Eiras
- Universidade Federal de Minas GeraisBelo HorizonteBrazilUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - David Soeiro Barbosa
- Universidade Federal de Minas GeraisBelo HorizonteBrazilUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Lee SA, Jarvis CI, Edmunds WJ, Economou T, Lowe R. Spatial connectivity in mosquito-borne disease models: a systematic review of methods and assumptions. J R Soc Interface 2021; 18:20210096. [PMID: 34034534 PMCID: PMC8150046 DOI: 10.1098/rsif.2021.0096] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/26/2021] [Indexed: 12/14/2022] Open
Abstract
Spatial connectivity plays an important role in mosquito-borne disease transmission. Connectivity can arise for many reasons, including shared environments, vector ecology and human movement. This systematic review synthesizes the spatial methods used to model mosquito-borne diseases, their spatial connectivity assumptions and the data used to inform spatial model components. We identified 248 papers eligible for inclusion. Most used statistical models (84.2%), although mechanistic are increasingly used. We identified 17 spatial models which used one of four methods (spatial covariates, local regression, random effects/fields and movement matrices). Over 80% of studies assumed that connectivity was distance-based despite this approach ignoring distant connections and potentially oversimplifying the process of transmission. Studies were more likely to assume connectivity was driven by human movement if the disease was transmitted by an Aedes mosquito. Connectivity arising from human movement was more commonly assumed in studies using a mechanistic model, likely influenced by a lack of statistical models able to account for these connections. Although models have been increasing in complexity, it is important to select the most appropriate, parsimonious model available based on the research question, disease transmission process, the spatial scale and availability of data, and the way spatial connectivity is assumed to occur.
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Affiliation(s)
- Sophie A. Lee
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Christopher I. Jarvis
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - W. John Edmunds
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Moura MCBDM, de Oliveira JV, Pedreira RM, Tavares ADM, de Souza TA, de Lima KC, Barbosa IR. Spatio-temporal dynamics of Aedes aegypti and Aedes albopictus oviposition in an urban area of northeastern Brazil. Trop Med Int Health 2020; 25:1510-1521. [PMID: 32959943 DOI: 10.1111/tmi.13491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study was to analyse abundance and spatial distribution of Aedes aegypti and Aedes albopictus oviposition in the city of Natal-RN, 2016 to 2018. METHODS Three hundred and seven oviposition traps were installed covered the whole city and were monitored weekly from January 2016 to December 2018. To verify the abundance of the vector based on its location, the formation of oviposition clusters was studied using the Kernel statistics. Egg Density Index (EDI) and Oviposition Positivity Index (OPI) values were calculated. RESULTS Temperature and humidity presented weak and very weak correlation, respectively, with the oviposition indicators. The median of oviposition positivity index (OPI) was 60.5%, and the egg density index (EDI) was 45.4 eggs/trap. The OPI (71.1%) was higher in the second quarter of the year. The areas with the most persistent oviposition are located in a continuous strip that extends from the extreme of the northern district and extends along the western district of the city. Also noteworthy is the proximity to the strategic points. CONCLUSION The spatio-temporal distribution of oviposition revealed that there is spatial segregation and marked seasonality. Therefore, this study highlights the importance of maintaining surveillance targeting and control strategies focused on these areas, especially during the most important period of the year.
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Affiliation(s)
| | | | | | | | - Talita Araujo de Souza
- Postgratuate in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kenio Costa de Lima
- Postgraduate in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
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Fustec B, Phanitchat T, Hoq MI, Aromseree S, Pientong C, Thaewnongiew K, Ekalaksananan T, Bangs MJ, Corbel V, Alexander N, Overgaard HJ. Complex relationships between Aedes vectors, socio-economics and dengue transmission-Lessons learned from a case-control study in northeastern Thailand. PLoS Negl Trop Dis 2020; 14:e0008703. [PMID: 33001972 PMCID: PMC7553337 DOI: 10.1371/journal.pntd.0008703] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/13/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dengue fever is an important public health concern in most tropical and subtropical countries, and its prevention and control rest on vector surveillance and control. However, many aspects of dengue epidemiology remain unclear; in particular, the relationship between Aedes vector abundance and dengue transmission risk. This study aims to identify entomological and immunological indices capable of discriminating between dengue case and control (non-case) houses, based on the assessment of candidate indices, as well as individual and household characteristics, as potential risk factors for acquiring dengue infection. METHODS This prospective, hospital-based, case-control study was conducted in northeastern Thailand between June 2016 and August 2019. Immature and adult stage Aedes were collected at the houses of case and control patients, recruited from district hospitals, and at patients' neighboring houses. Blood samples were tested by RDT and PCR to detect dengue cases, and were processed with the Nterm-34 kDa salivary peptide to measure the human immune response to Aedes bites. Socioeconomic status, and other individual and household characteristics were analyzed as potential risk factors for dengue. RESULTS Study findings showed complex relationships between entomological indices and dengue risk. The presence of DENV-infected Aedes at the patient house was associated with 4.2-fold higher odds of dengue. On the other hand, Aedes presence (irrespective of infectious status) in the patient's house was negatively associated with dengue. In addition, the human immune response to Aedes bites, was higher in control than in case patients and Aedes adult abundance and immature indices were higher in control than in case houses at the household and the neighboring level. Multivariable analysis showed that children aged 10-14 years old and those aged 15-25 years old had respectively 4.5-fold and 2.9-fold higher odds of dengue infection than those older than 25 years. CONCLUSION DENV infection in female Aedes at the house level was positively associated with dengue infection, while adult Aedes presence in the household was negatively associated. This study highlights the potential benefit of monitoring dengue viruses in Aedes vectors. Our findings suggest that monitoring the presence of DENV-infected Aedes mosquitoes could be a better indicator of dengue risk than the traditional immature entomological indices.
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Affiliation(s)
- Benedicte Fustec
- University of Montpellier, Montpellier, France
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Institut de Recherche pour le Developpement, Montpellier, France
| | - Thipruethai Phanitchat
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Mohammad Injamul Hoq
- School of Public Health, Epidemiology and Social Medicine at the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sirinart Aromseree
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Chamsai Pientong
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen, Thailand
| | | | - Tipaya Ekalaksananan
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Michael J. Bangs
- Public Health & Malaria Control, PT Freeport Indonesia/International SOS, Mimika, Papua, Indonesia
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| | - Vincent Corbel
- University of Montpellier, Montpellier, France
- Institut de Recherche pour le Developpement, Montpellier, France
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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9
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Milhim BHGA, Estofolete CF, da Rocha LC, Liso E, Brienze VMS, Vasilakis N, Terzian ACB, Nogueira ML. Fatal Outcome of Ilheus Virus in the Cerebrospinal Fluid of a Patient Diagnosed with Encephalitis. Viruses 2020; 12:v12090957. [PMID: 32872425 PMCID: PMC7552055 DOI: 10.3390/v12090957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 01/06/2023] Open
Abstract
Ilheus virus is an arbovirus with the potential for central nervous system involvement. Accurate diagnosis is a challenge due to similar clinical symptoms and serologic cross-reactivity with other flaviviruses. Here, we describe the first documented case of a fatal outcome following the identification of Ilheus virus in the cerebrospinal fluid (CSF) of a patient with cerebral encephalitis in Brazil.
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Affiliation(s)
- Bruno H. G. A. Milhim
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Cássia F. Estofolete
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Leonardo C. da Rocha
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Elisabete Liso
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, SP 15090-000 São José do Rio Preto, Brazil; (E.L.); (V.M.S.B.)
| | - Vânia M. S. Brienze
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, SP 15090-000 São José do Rio Preto, Brazil; (E.L.); (V.M.S.B.)
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA;
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA
| | - Ana C. B. Terzian
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Maurício L. Nogueira
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
- Correspondence: ; Tel.: +55-1798811-0550
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10
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Estofolete CF, Milhim BHGA, Zini N, Scamardi SN, Selvante JD, Vasilakis N, Nogueira ML. Flavivirus Infection Associated with Cerebrovascular Events. Viruses 2020; 12:v12060671. [PMID: 32580374 PMCID: PMC7354470 DOI: 10.3390/v12060671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022] Open
Abstract
Arthropod-borne viruses (arboviruses) of the genus Flavivirus are distributed globally and cause significant human disease and mortality annually. Flavivirus infections present a spectrum of clinical manifestations, ranging from asymptomatic to severe manifestations, including hemorrhage, encephalitis and death. Herein, we describe 3 case reports of cerebrovascular involvement in patients infected by dengue and Zika viruses in Sao Jose do Rio Preto, São Paulo State, Brazil, a hyperendemic area for arbovirus circulation, including dengue, yellow fever, chikungunya and Saint Louis encephalitis viruses. Our findings highlight the potential threat that unusual clinical manifestations may pose to arbovirus disease management and recovery.
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Affiliation(s)
- Cássia F Estofolete
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Bruno H G A Milhim
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Nathalia Zini
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Samuel N Scamardi
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Joana D'Arc Selvante
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA
| | - Maurício L Nogueira
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
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11
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Parra MCP, Fávaro EA, Dibo MR, Mondini A, Eiras ÁE, Kroon EG, Teixeira MM, Nogueira ML, Chiaravalloti-Neto F. Using adult Aedes aegypti females to predict areas at risk for dengue transmission: A spatial case-control study. Acta Trop 2018; 182:43-53. [PMID: 29462598 DOI: 10.1016/j.actatropica.2018.02.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/27/2018] [Accepted: 02/13/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Traditional indices for measuring dengue fever risk in a given area are based on the immature forms of the vector (larvae and pupae surveys). However, this is inefficient because only adult female mosquitoes actually transmit the virus. Based on these assumptions, our objective was to evaluate the association between an entomological index obtained from adult mosquito traps and the occurrence of dengue in a hyperendemic area. Additionally, we compared its cost to that of the Breteau Index (BI). MATERIAL AND METHODS We performed this study in São José do Rio Preto, SP, Brazil, between the epidemiological weeks of 36/2012 and 19/2013. BG-Sentinel and BG-Mosquitito traps were installed to capture adult mosquitoes. Positive and negative cases of dengue fever were computed and geocoded. We generated biweekly thematic maps of the entomological index, generated by calculating the number of adult Aedes aegypti females (NAF) per 100 households during a week by kriging, and based on the number of mosquitoes captured. The relation between the occurrence of dengue fever and the NAF was tested using a spatial case-control design and a generalized additive model and was controlled by the coordinates of the positive and negative cases of dengue fever. RESULTS Our analyses showed that increases in dengue fever cases occurred in parallel with increases in the number of Ae. aegypti females. The entomological index produced in our study correlates positively with the incidence of dengue, particularly during intervals when vector control measures were applied less intensively. The operational costs of our index were lower than those of the BI: NAF used 71.5% less human resources necessary to measure the BI. CONCLUSIONS Spatial analysis techniques and the number of adult Ae. aegypti females were used to produce an indicator of dengue risk. The index can be applied at various levels of spatial aggregation for an entire study area, as well as for sub-areas, such as city blocks. Even though the index is adequate to predict dengue risk, it should be tested and validated in various scenarios before routine use.
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12
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Low socioeconomic condition and the risk of dengue fever: A direct relationship. Acta Trop 2018; 180:47-57. [PMID: 29352990 DOI: 10.1016/j.actatropica.2018.01.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 01/11/2018] [Accepted: 01/15/2018] [Indexed: 02/05/2023]
Abstract
This study aimed to characterize the first dengue fever epidemic in Várzea Paulista, São Paulo, Brazil, and its spatial and spatio-temporal distribution in order to assess the association of socioeconomic factors with dengue occurrence. We used autochthonous dengue cases confirmed in a 2007 epidemic, the first reported in the city, available in the Information System on Diseases of Compulsory Declaration database. These cases where geocoded by address. We identified spatial and spatio-temporal clusters of high- and low-risk dengue areas using scan statistics. To access the risk of dengue occurrence and to evaluate its relationship with socioeconomic level we used a population-based case-control design. Firstly, we fitted a generalized additive model (GAM) to dengue cases and controls without considering the non-spatial covariates to estimate the odds ratios of the occurrence of the disease. The controls were drawn considering the spatial distribution of the household of the study area and represented the source population of the dengue cases. After that, we assessed the relationship between socioeconomic variables and dengue using the GAM and obtained the effect of these covariates in the occurrence of dengue adjusted by the spatial localization of the cases and controls. Cluster analysis and GAM indicated that northeastern area of Várzea Paulista was the most affected area during the epidemic. The study showed a positive relationship between low socioeconomic condition and increased risk of dengue. We studied the first dengue epidemic in a highly susceptible population at the beginning of the outbreak and therefore it may have allowed to identify an association between low socioeconomic conditions and increased risk of dengue. These results may be useful to predict the occurrence and to identify priority areas to develop control measures for dengue, and also for Zika and Chikungunya; diseases that recently reached Latin America, especially Brazil.
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Carabali M, Lim JK, Velez DC, Trujillo A, Egurrola J, Lee KS, Kaufman JS, DaSilva LJ, Velez ID, Osorio JE. Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction. Int J Infect Dis 2017; 58:27-36. [PMID: 28284914 PMCID: PMC5421161 DOI: 10.1016/j.ijid.2017.02.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction. METHODS A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years. RESULTS A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n=1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3-10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent. CONCLUSIONS These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.
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Affiliation(s)
- Mabel Carabali
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
| | - Jacqueline Kyungah Lim
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Diana Carolina Velez
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Andrea Trujillo
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Jorge Egurrola
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Kang Sung Lee
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Luiz Jacinto DaSilva
- Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Ivan Dario Velez
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia
| | - Jorge E Osorio
- Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia; Department of Pathobiological Sciences, University of Wisconsin, Madison, Wisconsin, USA
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Xavier DR, Magalhães MDAFM, Gracie R, Reis ICD, Matos VPD, Barcellos C. Spatial-temporal diffusion of dengue in the municipality of Rio de Janeiro, Brazil, 2000-2013. CAD SAUDE PUBLICA 2017; 33:e00186615. [PMID: 28380130 DOI: 10.1590/0102-311x00186615] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 05/02/2016] [Indexed: 11/22/2022] Open
Abstract
The city of Rio de Janeiro, Brazil, shows high potential receptiveness to the introduction, dissemination, and persistence of dengue transmission. The pattern of territorial occupation in the municipality produced a heterogeneous and diverse mosaic, with differential vector distribution between and within neighborhoods, producing distinct epidemics on this scale of observation. The study seeks to identify these epidemics and the pattern of spatial and temporal diffusion of dengue transmission. A model was used for the identification of epidemics, considering the epidemic peak years and months, spatial distribution, and permanence of epidemics from January 2000 to December 2013. A total of 495 epidemic peaks were counted, and the time scale showed the highest occurrence in the months of March, April, and February, respectively. Some neighborhoods appear to present persistent dengue incidence, and the pattern of diffusion allows identifying key trajectories and timely months for intervention.
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Affiliation(s)
- Diego Ricardo Xavier
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | - Renata Gracie
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Izabel Cristina Dos Reis
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.,Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Vanderlei Pascoal de Matos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Christovam Barcellos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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15
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Delmelle E, Hagenlocher M, Kienberger S, Casas I. A spatial model of socioeconomic and environmental determinants of dengue fever in Cali, Colombia. Acta Trop 2016; 164:169-176. [PMID: 27619189 DOI: 10.1016/j.actatropica.2016.08.028] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/29/2016] [Accepted: 08/31/2016] [Indexed: 01/17/2023]
Abstract
Dengue fever has gradually re-emerged across the global South, particularly affecting urban areas of the tropics and sub-tropics. The dynamics of dengue fever transmission are sensitive to changes in environmental conditions, as well as local demographic and socioeconomic factors. In 2010, the municipality of Cali, Colombia, experienced one of its worst outbreaks, however the outbreak was not spatially homogeneous across the city. In this paper, we evaluate the role of socioeconomic and environmental factors associated with this outbreak at the neighborhood level, using a Geographically Weighted Regression model. Key socioeconomic factors include population density and socioeconomic stratum, whereas environmental factors are proximity to both tire shops and plant nurseries and the presence of a sewage system (R2=0.64). The strength of the association between these factors and the incidence of dengue fever is spatially heterogeneous at the neighborhood level. The findings provide evidence to support public health strategies in allocating resources locally, which will enable a better detection of high risk areas, a reduction of the risk of infection and to strengthen the resilience of the population.
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Affiliation(s)
- Eric Delmelle
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, NC, 28223, USA, USA.
| | - Michael Hagenlocher
- Institute for Environment and Human Security, United Nations University (UNU-EHS), UN Campus, Platz der Vereinten Nationen 1, 53113, Bonn, Germany
| | - Stefan Kienberger
- Interfaculty Department of Geoinformatics - Z_GIS, University of Salzburg, 5020, Salzburg, Austria
| | - Irene Casas
- School of History and Social Sciences, Louisiana Tech University, Ruston, LA, 71272, USA, USA
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