Can human movements explain heterogeneous propagation of dengue fever in Cambodia?
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...
Saved in:
Published in | PLoS Neglected tropical diseases Vol. 6; no. 12 |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
2012
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Summary: | 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. (Résumé d'auteur) |
---|---|
Bibliography: | http://publications.cirad.fr/une_notice.php?dk=567015 Population rurale http://dx.doi.org/10.1371/journal.pntd.0001957 Maladies des animaux |