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Picinini Freitas L, Douwes-Schultz D, Schmidt AM, Ávila Monsalve B, Salazar Flórez JE, García-Balaguera C, Restrepo BN, Jaramillo-Ramirez GI, Carabali M, Zinszer K. Zika emergence, persistence, and transmission rate in Colombia: a nationwide application of a space-time Markov switching model. Sci Rep 2024; 14:10003. [PMID: 38693192 PMCID: PMC11063144 DOI: 10.1038/s41598-024-59976-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 04/17/2024] [Indexed: 05/03/2024] Open
Abstract
Zika, a viral disease transmitted to humans by Aedes mosquitoes, emerged in the Americas in 2015, causing large-scale epidemics. Colombia alone reported over 72,000 Zika cases between 2015 and 2016. Using national surveillance data from 1121 municipalities over 70 weeks, we identified sociodemographic and environmental factors associated with Zika's emergence, re-emergence, persistence, and transmission intensity in Colombia. We fitted a zero-state Markov-switching model under the Bayesian framework, assuming Zika switched between periods of presence and absence according to spatially and temporally varying probabilities of emergence/re-emergence (from absence to presence) and persistence (from presence to presence). These probabilities were assumed to follow a series of mixed multiple logistic regressions. When Zika was present, assuming that the cases follow a negative binomial distribution, we estimated the transmission intensity rate. Our results indicate that Zika emerged/re-emerged sooner and that transmission was intensified in municipalities that were more densely populated, at lower altitudes and/or with less vegetation cover. Warmer temperatures and less weekly-accumulated rain were also associated with Zika emergence. Zika cases persisted for longer in more densely populated areas with more cases reported in the previous week. Overall, population density, elevation, and temperature were identified as the main contributors to the first Zika epidemic in Colombia. We also estimated the probability of Zika presence by municipality and week, and the results suggest that the disease circulated undetected by the surveillance system on many occasions. Our results offer insights into priority areas for public health interventions against emerging and re-emerging Aedes-borne diseases.
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Affiliation(s)
- Laís Picinini Freitas
- Université de Montréal, École de Santé Publique, Montreal, H3N 1X9, Canada.
- Centre de Recherche en Santé Publique, Montreal, H3N 1X9, Canada.
| | - Dirk Douwes-Schultz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, H3A 1G1, Canada.
| | - Alexandra M Schmidt
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, H3A 1G1, Canada
| | - Brayan Ávila Monsalve
- Universidad Cooperativa de Colombia, Faculty of Medicine, Villavicencio, 500003, Colombia
| | - Jorge Emilio Salazar Flórez
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, 055450, Colombia
- Infectious and Chronic Diseases Study Group (GEINCRO), San Martín University Foundation, Medellín, 050031, Colombia
| | - César García-Balaguera
- Universidad Cooperativa de Colombia, Faculty of Medicine, Villavicencio, 500003, Colombia
| | - Berta N Restrepo
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, 055450, Colombia
| | | | - Mabel Carabali
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, H3A 1G1, Canada
| | - Kate Zinszer
- Université de Montréal, École de Santé Publique, Montreal, H3N 1X9, Canada
- Centre de Recherche en Santé Publique, Montreal, H3N 1X9, Canada
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Lefebvre B, Karki R, Misslin R, Nakhapakorn K, Daudé E, Paul RE. Importance of Public Transport Networks for Reconciling the Spatial Distribution of Dengue and the Association of Socio-Economic Factors with Dengue Risk in Bangkok, Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10123. [PMID: 36011755 PMCID: PMC9408777 DOI: 10.3390/ijerph191610123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Dengue is the most widespread mosquito-borne viral disease of man and spreading at an alarming rate. Socio-economic inequality has long been thought to contribute to providing an environment for viral propagation. However, identifying socio-economic (SE) risk factors is confounded by intra-urban daily human mobility, with virus being ferried across cities. This study aimed to identify SE variables associated with dengue at a subdistrict level in Bangkok, analyse how they explain observed dengue hotspots and assess the impact of mobility networks on such associations. Using meteorological, dengue case, national statistics, and transport databases from the Bangkok authorities, we applied statistical association and spatial analyses to identify SE variables associated with dengue and spatial hotspots and the extent to which incorporating transport data impacts the observed associations. We identified three SE risk factors at the subdistrict level: lack of education, % of houses being cement/brick, and number of houses as being associated with increased risk of dengue. Spatial hotspots of dengue were found to occur consistently in the centre of the city, but which did not entirely have the socio-economic risk factor characteristics. Incorporation of the intra-urban transport network, however, much improved the overall statistical association of the socio-economic variables with dengue incidence and reconciled the incongruous difference between the spatial hotspots and the SE risk factors. Our study suggests that incorporating transport networks enables a more real-world analysis within urban areas and should enable improvements in the identification of risk factors.
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Affiliation(s)
- Bertrand Lefebvre
- French Institute of Pondicherry, UMIFRE 21 CNRS-MEAE, Pondicherry 605001, India
| | - Rojina Karki
- CNRS, ARENES—UMR 6051, EHESP, Université de Rennes, 35000 Rennes, France
| | | | - Kanchana Nakhapakorn
- Faculty of Environment and Resource Studies, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Eric Daudé
- CNRS, UMR 6266 IDEES, 7 rue Thomas Becket, 76821 Rouen, France
| | - Richard E. Paul
- Institut Pasteur, Université de Paris, CNRS, UMR 2000, Unité de Génétique Fonctionnelle des Maladies Infectieuses, 75015 Paris, France
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