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 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.
| Main Authors: | , , , , , |
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| Format: | article biblioteca |
| Language: | eng |
| Subjects: | L73 - Maladies des animaux, E51 - Population rurale, flavivirus, transmission des maladies, migration, genre humain, http://aims.fao.org/aos/agrovoc/c_2963, http://aims.fao.org/aos/agrovoc/c_2329, http://aims.fao.org/aos/agrovoc/c_4822, http://aims.fao.org/aos/agrovoc/c_4586, http://aims.fao.org/aos/agrovoc/c_4073, |
| Online Access: | http://agritrop.cirad.fr/567015/ http://agritrop.cirad.fr/567015/1/document_567015.pdf |
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