Can Human Movements Explain Heterogeneous Propagation of Dengue Fever in Cambodia?
Résumé
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.
Domaines
Géophysique [physics.geo-ph]Origine | Fichiers éditeurs autorisés sur une archive ouverte |
---|