Can Human Movements Explain Heterogeneous Propagation of Dengue Fever in Cambodia?
Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national sc...
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| Published in: | PLoS neglected tropical diseases Vol. 6; no. 12; p. e1957 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Public Library of Science
01.12.2012
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| ISSN: | 1935-2735, 1935-2727, 1935-2735 |
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| Abstract | Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern.
We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh.
We suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. |
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| AbstractList | Background: Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern. Methodsand Findings: We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh. Conclusions:We suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. Dengue fever is a mosquito borne viral infection. It has become a major public health problem during the past decades: only 9 countries were affected in the 1970s; dengue is now endemic in more than 100 countries. In the absence of any vaccine or specific treatment, control of dengue fever is currently limited to vector control measures, which are difficult to implement and hardly sustainable, especially in low income countries. To implement efficient control measures, it is crucial to understand the dynamics of propagation of the disease and the key factors underlying these dynamics. In this study, data from 8-year national surveillance in Cambodia were analysed. Dengue fever follows a recurrent pattern of propagation at the national scale. The annual epidemics originate from a few rural areas identified in this work. This study also suggests additional evidence for the role of human movement in the spatial dynamics of the disease, which should be accounted for in control measures. These results differ from the current knowledge about dengue dynamics and are therefore of interest for future research. Background: Determining the factors underlying the long-range spatial spread of infectious diseases is a key issueregarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem intropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here wedescribe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that humanmovements play in the observed pattern.Methods and Findings: We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reportedbetween 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in thepropagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along thebusiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along theMekong River at a speed of ,11 km per week (95% confidence interval 3–18 km per week) towards the capital, PhnomPenh.Conclusions: We suggest human movements – using roads as a surrogate – play a major role in the spread of dengue feverat a national scale. These findings constitute a new starting point in the understanding of the processes driving denguespread. BackgroundDetermining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern.Methods and findingsWe used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh.ConclusionsWe suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern.BACKGROUNDDetermining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern.We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh.METHODS AND FINDINGSWe used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh.We suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread.CONCLUSIONSWe suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. Background Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern. Methods and Findings We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh. Conclusions We suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern. We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh. We suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. Background Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. However the determinants shaping its dynamics at a national scale remain poorly understood. Here we describe the spatial-temporal pattern of propagation of annual epidemics in Cambodia and discuss the role that human movements play in the observed pattern. Methods and Findings We used wavelet phase analysis to analyse time-series data of 105,598 hospitalized cases reported between 2002 and 2008 in the 135 (/180) most populous districts in Cambodia. We reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area along the busiest national road of the country whereas travelling waves emanate from a few rural areas and move slowly along the Mekong River at a speed of ~11 km per week (95% confidence interval 3-18 km per week) towards the capital, Phnom Penh. Conclusions We suggest human movements - using roads as a surrogate - play a major role in the spread of dengue fever at a national scale. These findings constitute a new starting point in the understanding of the processes driving dengue spread. |
| Audience | Academic |
| Author | Teurlai, Magali Vong, Sirenda Huy, Rekol Cazelles, Bernard Duboz, Raphaël Baehr, Christophe |
| AuthorAffiliation | 7 Météo France, CNRM, Toulouse, France 4 Ecologie & Evolution, UMR 7625, CNRS-UPMC-ENS, Paris, France 6 CIRAD UPR Agirs, Montpellier, France Duke University-National University of Singapore, Singapore 5 UMMISCO UMI 209 IRD - UPMC, Bondy, France 1 Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia 8 CNRS, GAME URA 1357, Toulouse, France 2 IRD UMR LOCEAN, UMR ESPACE-DEV, New-Caledonia, France 3 National Dengue Control Program, National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia |
| AuthorAffiliation_xml | – name: 1 Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia – name: 6 CIRAD UPR Agirs, Montpellier, France – name: 2 IRD UMR LOCEAN, UMR ESPACE-DEV, New-Caledonia, France – name: 4 Ecologie & Evolution, UMR 7625, CNRS-UPMC-ENS, Paris, France – name: 8 CNRS, GAME URA 1357, Toulouse, France – name: 7 Météo France, CNRM, Toulouse, France – name: 3 National Dengue Control Program, National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia – name: Duke University-National University of Singapore, Singapore – name: 5 UMMISCO UMI 209 IRD - UPMC, Bondy, France |
| Author_xml | – sequence: 1 givenname: Magali surname: Teurlai fullname: Teurlai, Magali – sequence: 2 givenname: Rekol surname: Huy fullname: Huy, Rekol – sequence: 3 givenname: Bernard surname: Cazelles fullname: Cazelles, Bernard – sequence: 4 givenname: Raphaël surname: Duboz fullname: Duboz, Raphaël – sequence: 5 givenname: Christophe surname: Baehr fullname: Baehr, Christophe – sequence: 6 givenname: Sirenda surname: Vong fullname: Vong, Sirenda |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2012 Public Library of Science 2012 Teurlai et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Teurlai M, Huy R, Cazelles B, Duboz R, Baehr C, et al. (2012) Can Human Movements Explain Heterogeneous Propagation of Dengue Fever in Cambodia? PLoS Negl Trop Dis 6(12): e1957. doi:10.1371/journal.pntd.0001957 Attribution 2012 Teurlai et al 2012 Teurlai et al |
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| DOI | 10.1371/journal.pntd.0001957 |
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| Keywords | Cambodia Dengue Humans Middle Aged Child, Preschool Infant Male Topography, Medical Young Adult Aged, 80 & over Transients & Migrants Time Factors Disease Outbreaks Adolescent Adult Female Aged Child Infant, Newborn |
| Language | English |
| License | Attribution: http://creativecommons.org/licenses/by This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. Creative Commons Attribution License |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 PMCID: PMC3516584 Conceived and designed the experiments: MT BC SV. Analyzed the data: MT RH BC RD CB SV. Wrote the paper: MT RH BC RD CB SV. Provided the data: RH. Designed the toolbox to perform wavelet analysis: BC. The authors have declared that no competing interests exist. |
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| Snippet | Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most important... Background: Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most... Background Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most... Background: Determining the factors underlying the long-range spatial spread of infectious diseases is a key issueregarding their control. Dengue is the most... Dengue fever is a mosquito borne viral infection. It has become a major public health problem during the past decades: only 9 countries were affected in the... BackgroundDetermining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most... Background Determining the factors underlying the long-range spatial spread of infectious diseases is a key issue regarding their control. Dengue is the most... |
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| SubjectTerms | Adolescent Adult Aged Aged, 80 and over Cambodia - epidemiology Care and treatment Child Child, Preschool Demographic aspects Dengue Dengue - epidemiology Dengue fever Diagnosis Disease Disease Outbreaks Driving ability Epidemics Female Geophysics Heterogeneity Hospitals Humans Infant Infant, Newborn Infectious diseases Male Mathematics Medicine Middle Aged Physics Propagation Public health Rural areas Time Factors Topography, Medical Transients and Migrants Tropical diseases Vaccines Vector-borne diseases Viral infections Viruses Young Adult |
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| Title | Can Human Movements Explain Heterogeneous Propagation of Dengue Fever in Cambodia? |
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