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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Vydané v:	PLoS neglected tropical diseases Ročník 6; číslo 12; s. e1957
Hlavní autori:	Teurlai, Magali, Huy, Rekol, Cazelles, Bernard, Duboz, Raphaël, Baehr, Christophe, Vong, Sirenda
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 01.12.2012 Public Library of Science (PLoS)
Predmet:	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
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Shrnutí:	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.
Bibliografia:	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.
ISSN:	1935-2735 1935-2727 1935-2735
DOI:	10.1371/journal.pntd.0001957