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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Bibliographic Details
Published in:PLoS neglected tropical diseases Vol. 6; no. 12; p. e1957
Main Authors: Teurlai, Magali, Huy, Rekol, Cazelles, Bernard, Duboz, Raphaël, Baehr, Christophe, Vong, Sirenda
Format: Journal Article
Language:English
Published: United States Public Library of Science 01.12.2012
Public Library of Science (PLoS)
Subjects:
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
Cambodia
East Asia
Vietnam
Mekong River
Thailand
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
ISSN:1935-2735, 1935-2727, 1935-2735
Online Access:Get full text
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Description
Summary: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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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.
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0001957