Abstract
The record-breaking number of dengue cases reported in Guangdong, China in 2014 has been topic for many studies. However, the spatial and temporal characteristics of this unexpectedly explosive outbreak are still poorly understood. We adopt an integrated approach to ascertain the spatial-temporal progression of the outbreak in each city in Guangdong as well as in each district in Guangzhou, where the majority of cases occurred. We utilize the Richards model, which determines the waves of reported cases at each location and identifies the turning point for each wave, in combination with a spatial association analysis conducted by computing the standardized G* statistic that measures the degree of spatial autocorrelation of a set of geo-referenced data from a local perspective. We found that Yuexiu district in Guangzhou was the initial hot spot for the outbreak, subsequently spreading to its neighboring districts in Guangzhou and other cities in Guangdong province. Hospital isolation of cases during early stage of outbreak in neighboring Zhongshan (in effort to prevent disease transmission to the vectors) might have played an important role in the timely mitigation of the disease. Integration of modeling approach and spatial association analysis allows us to pinpoint waves that spread the disease to communities beyond the borders of the initially affected regions.
Highlights
The highest-risk area for DF infection is the Asia-Pacific region, which is home to 75% of the world population exposed to dengue virus[2]
It has been suggested that, some advances have been made in the last decades, simple methods for evaluating dengue epidemiology over time and space are still much needed by public health authorities, since the tools developed in recent decades are rarely used due to their complexity and extensive data requirements[13]
The aim of this research is to examine the spatial-temporal characteristics of the 2014 outbreak in Guangdong province, coupling a mathematical modeling approach, able to describe the temporal dynamic of the epidemic, with a spatial association analysis, for identifying hot spots for infection
Summary
The highest-risk area for DF infection is the Asia-Pacific region, which is home to 75% of the world population exposed to dengue virus[2]. Located in this area, the southern region of China had more than 650,000 reported cases (with 610 fatalities) from 1978 to 2008. The most widely used intervention measures are suppressing vector population and blocking chain of disease transmission (e.g. home isolation of mild cases), as implemented by Guangdong Provincial Health and Family Planning Commission[4]. It has been suggested that, some advances have been made in the last decades, simple methods for evaluating dengue epidemiology over time and space are still much needed by public health authorities, since the tools developed in recent decades are rarely used due to their complexity and extensive data requirements[13]
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