Abstract
BackgroundDengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country.Methodology/Principal findingsHospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power.Conclusions/SignificanceOur data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment.
Highlights
Dengue virus (DENV) is a positive-strand RNA virus (Flaviviridae) that is spread by Aedes aegypti and Ae. albopictus mosquitoes [1]
Dengue has been detected in Indonesia and transmission is progressively rising to account for half of all fatal dengue cases recorded in South-East Asia
Little is known about the epidemiology of the virus, which may hamper the effectiveness of preventive strategies carried out in the country
Summary
Dengue virus (DENV) is a positive-strand RNA virus (Flaviviridae) that is spread by Aedes aegypti and Ae. albopictus mosquitoes [1]. Indonesia has experienced periodic outbreaks of dengue with increasing numbers of infections and severity [3, 4], recording nearly a third of the DENV cases and half of all fatality cases reported in South-East Asia between 2001 and 2010 [5]. Climate is considered a driving force behind DENV epidemics and transmission; behaviour, ecological, demographical and socio-economical changes/conditions are key determinants in local dengue risk (see for example [8,9,10,11]). Dengue is a major mosquito-borne viral disease and an important public health problem. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country
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