Dengue Hemorrhagic Fever Cases Research Articles

Resistance status of aedes sp strain from high land in central java, indonesia, as an indicator of increasing vector's capacity of dengue hemorrhagic fever

Context: The increased cases of dengue hemorrhagic fever (DHF) have been reported in the highland of Wonosobo District. Vector-control program are used for prevention and control of dengue cases. Vector's profile toward insecticide efficacy is important which need to be elucidated. Aims: The aim of this study was to describe the resistance status of the vector against malathion insecticide. Settings and Design: A cross-sectional survey was done in the highland area, Wonosobo sub-district, Indonesia. Methods and Material: The study included a sample of 37 villages, which were located at Wonosobo sub-district. At every village, we observed 15 houses. The observed variables were mosquito bionomic, and their resistance status was based on the biochemical and molecular parameters. To detect resistance status, we used ELISA equipment. Statistical analysis used: Data were collected by entomology students and were analyzed using descriptive statistics. Results: The study results showed that the population of Aedes sp in the Wonosobo District was higher than the standard control of dengue program. Vector indexes were HI (14.75%), CI (6.8%), BI (15.6%), and OI (11.3%). We identified that vectors have already developed resistant to organophosphate insecticide, as many as 50% out of the total sample tested. Conclusions: This finding indicated that Aedes sp strain in the Wonosobo District highland has competence to be dengue vectors. Therefore, it is important to use another type of insecticide such as pyrethroid.

Biological, Physical, Social, and Environmental Factors Associated with Dengue Hemorrhagic Fever in Nganjuk, East Java

Background:Â Dengue Hemorrhagic Fever (DHF) is an infectious disease transmitted by mosquitoes that carry dengue virus (DV). This disease is endemic in more than 100 countries. Nganjuk district, East Java, is a DHF endemic area with sharp increase in DHF incidence by 286% from 2014 to 2015, of which 9 cases died. This study aimed to examine biological, physical, social, and environmental factors associated with dengue hemorrhagic fever in Nganjuk, East Java. Subjects and Method:Â This study was observational analytic with case control design. It was conducted in Nganjuk District, East Java, from May to June, 2017. A sample of 120 children aged less than 15 years old were selected for this study by fixed disease sampling. This sample consisted of 40 children with DHF selected as cases and 80 neighboring children without DHF selected as controls. The independent variables were the existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control (PSN), and activity of larva monitoring cadre. The dependent variable was DHF cases. The data were collected by a set of pre-tested questionnaire and observation with a checklist. Logistic regression was employed for data analysis. Results:Â Incidence of DHF case was determined by the existence of bush surrounding the house (OR=2.14; 95% CI =0.99 to 4.6; p=0.052), existence of mosquito larvae (OR=14.94; 95% CI =5.91 to 37.73; p<0.001), still water (OR=11.42; 95% CI= 4.68 to 27.89; p<0.001), hung clothes (OR=4.31; 95% CI =1.92 to 9.70; p<0.001), mosquito breeding place control (OR=0.06; 95% CI= 0.02 to 0.15; p<0.001), and activity of larva monitoring cadre (OR=0.14; 95% CI= 0.06 to 0.32; p<0.001). Conclusion: Â Existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control, and activity of larva monitoring cadre, are the determinants of DHF incidence. Keywords: Â biological, physical, social, environmental factor, mosquito breeding place control, Dengue Hemorrhagic Fever Correspondence:Â Ike Nurrochmawati. Diploma Program in Midwifery, STIKes Satria Bhakti, Nganjuk, East Java. Email: ike.nurrochma@gmail.com. Â Mobile: +6282141578108. Journal of Epidemiology and Public Health (2017), 2(2):Â 93-105 https://doi.org/10.26911/jepublichealth.2017.02.02.01

Sanitation-Related Behavior, Container Index, and Their Associations with Dengue Hemorrhagic Fever Incidence in Karanganyar, Central Java

Background : Dengue Hemorrhagic Fever (DHF) causes not only epidemic but also social and economic impacts. Environmental sanitation, water reservoirs, and community behavior can influence the incidence of DHF. This study aimed to examine sanitation-related behavior, container index, and their associations with dengue hemorrhagic fever incidence. Subjects and Method : This was an analytic observational field study using case control design. The study was conducted in sub-districts with the highest and lowest DHF cases in Karanganyar, Central Java, from May to July, 2017. A total sample of 120 study subjects was selected for this study using fixed disease sampling, including 40 people with DHF and 80 people without DHF. The dependent variable was DHF. The independent variables were age, education level, family income, container index, and sanitation behavior. The data were measured by a set of questionnaire and examined using path analysis. Results : Sanitation behavior (b=1.50; 95% CI= 0.57 to 2.42, p=0.001) and Container Index (b=0.90; 95% CI= 0.03 to 1.84; p=0.057) were directly and positively associated with DHF incidence. Container Index was associated with sanitation behavior (b=2.09, 95% CI = 1.21 to 2.97, p<0.001). Age (b=-0.76, 95% CI = -1.60 to 0.08, p=0.074), education level (b=-1.02, 95% CI = -1.87 to -0.17, p=0.019), and family income (b=-0.70, 95% CI= -1.60 to 0.19, p=0.122) were associated with sanitation behavior. Conclusion : DHF incidence is directly and positively associated with sanitation behavior, and container index. DHF incidence is indirectly associated with age, education level, and family income. Keywords : dengue haemorhagic fever, sanitation, container index, behavior, path analysis Correspondence : Nunik Maya Hastuti. School of Health Science Mitra Husada, Karanganyar, Central Java. Email: nunikmaya21@gmail.com. Mobile: +6285647279291. Journal of Epidemiology and Public Health (2017), 2(2): 174-185 https://doi.org/10.26911/jepublichealth.2017.02.02.08

A Model for Forecasting the Number of Cases and Distribution Pattern of Dengue Hemorrhagic Fever in Indonesia

Dengue Hemorrhagic Fever (DHF) ourbreaks is one of the lethal health problems in Indonesia. Aedes aegypti type of insect prolefiration as the main vector of DHF has affected climate factors, such as temperature, humidity, rainfall, and irradiation time. Therefore, to project the number of DHF cases is a very important assignment for the Ministry of Health to initiate contingencies planning as a prevention step in confronting the increasing number of DHF cases in nearby future. This study aims in developing a forecasting model in anticipating the number of cases and distribution pattern of DHF with multivariate time series using Vector Autoregressive Spatial Autocorrelation (VARSA). VARSA model uses multivariate time series, such as a number of DHF case, minimum temperature, maximum temperature, rainfall, average humidity, irradiation time and population density. This modeling is done in two steps: Vector Autoregressive modeling to predict the number of DHF cases and Local Indicators of Spatial Association (LISA) method to visualize distribution pattern of DHF based on the spatial connectivity of the number of DHF cases among the neighboring districts. This study covers 17 districts in Sleman Yogyakarta, resulting in low errors with Root Means Square Error (RMSE) of 2.10 and Mean Absolute Error (MAE ) of 1.51. This model produces smaller errors than using univariate time series methods, such as Linear regression and Autoregressive Integrated Moving Average (ARIMA).

Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

PLATELET DEMAM BERDARAH DENGUE

Dengue Hemorrhagic Fever (DHF) is usually diagnosed based on the clinical symptoms and laboratory examinations of platelet index, including platelets count,: the Mean Platelet Volume (MPV), and the Platelet Distribution Width (PDW), but the most common use is the serological tests which can distinguish between the primary and secondary infection. The aim of this study was to know the three parameters in primary and secondary infections of the dengue patients during the hospitalization. This study was performed by a retrospective cohort study at the pediatric ward of Dr. Wahidin Sudirohusodo Hospital Makassar during the period of March−June 2010. Forty five samples have been examined, where 37.8% were men and 62.2% were women. Most DHF cases were at the age of 8−14 years (47%). The mean platelets count after the day five of their hospitalization in both primary and secondary infections showed a significant increase (p&lt;0.05), with the mean of 124.3í—103/μL and 109.7í—103/μL respectively. The same result was obtained with the MPV (p&lt;0.05). In contrast of the finding, the mean of PDW showed no significant increase (p&gt;0.05). It can be concluded that platelet count and MPV can be used as the early markers for the improvement of DHF patients during their hospitalization, so that the patients can be discharge and the period of their hospitalization will become shorten.

A new approach to detect epidemic of DHF by combining ARIMA model and adjusted Tukey's control chart with interpretation rules.

The aim of this study was to propose a new method to detect the epidemic of dengue hemorrhagic fever (DHF) using seasonal autoregressive integrated moving average model [ARIMA(1,0,2)(0,1,2)12] with no constant and adjusted Tukey's control chart and the results obtained were interpreted using seventh interpretation rule. Data on the number of DHF cases in Chonburi reported during 2007-2013 were used. The results indicated that this new approach efficiently detected the epidemic of DHF in October 2015 with the forecasted number of DHF (257 cases) and root-mean-squared error (RMSE = 46.71).

Transcriptome Sequencing Analysis and Functional Identification of Sex Differentiation Genes from the Mosquito Parasitic Nematode, Romanomermis wuchangensis.

Mosquito-transmitted diseases like malaria and dengue fever are global problem and an estimated 50–100 million of dengue or dengue hemorrhagic fever cases are reported worldwide every year. The mermithid nematode Romanomermis wuchangensis has been successfully used as an ecosystem-friendly biocontrol agent for mosquito prevention in laboratory studies. However, this nematode can not undergo sex differentiation in vitro culture, which has seriously affected their application of biocontrol in the field. In this study, based on transcriptome sequencing analysis of R. wuchangensis, Rwucmab-3, Rwuclaf-1 and Rwuctra-2 were cloned and used to investigate molecular regulatory function of sex differentiation. qRT-PCR results demonstrated that the expression level of Rwucmab-3 between male and female displayed obvious difference on the 3rd day of parasitic stage, which was earlier than Rwuclaf-1 and Rwuctra-2, highlighting sex differentiation process may start on the 3rd day of parasitic stage. Besides, FITC was used as a marker to test dsRNA uptake efficiency of R. wuchangensis, which fluorescence intensity increased with FITC concentration after 16 h incubation, indicating this nematode can successfully ingest soaking solution via its cuticle. RNAi results revealed the sex ratio of R. wuchangensis from RNAi treated groups soaked in dsRNA of Rwucmab-3 was significantly higher than gfp dsRNA treated groups and control groups, highlighting RNAi of Rwumab-3 may hinder the development of male nematodes. These results suggest that Rwucmab-3 mainly involves in the initiation of sex differentiation and the development of male sexual dimorphism. Rwuclaf-1 and Rwuctra-2 may play vital role in nematode reproductive and developmental system. In conclusion, transcript sequences presented in this study could provide more bioinformatics resources for future studies on gene cloning and other molecular regulatory mechanism in R. wuchangensis. Moreover, identification and functional analysis of sex differentiation genes may clarify the sex differentiation mechanism of R. wuchangensis, which are helpful to solve the uncompleted sex differentiation problem in vitro culture and the potential large-scale field application controlling the larvae of C. quinquefasciatus, A. aegypti and A. albopictus.

Dengue seropositivity in a randomly selected sample from Yucatan analyzed in the context of dengue cases reported between 1996 and 2006

Introduction: Dengue virus (Denv) was first reported in Yucatan in 1979. Since then, Denv has been associated with multiplecases of Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF), becoming an endemic disease in Yucatan, Mexico. Objectives: To determine the seropositivity to dengue infections in random sample of the Yucatan general population in 1996and 2006 and analyze it along with the reported dengue cases in the state during that ten-year-period. Methods: Samples from the randomly selected participants were tested for IgG dengue antibodies in both serosurveys, whilelaboratory confirmed DF and DHF were obtained from the epidemiologic surveillance system from 1996 to 2006. Results: The overall seropositivity to Denv infection was 59.9% in 1996 and 81.5% in 2006, according to the serosurveys. Theincrease in seropositivity can be at least partially explained by the peak in DF and DHF cases that took place in 1997, as reportedin the surveillance system. Conclussion: Data drawn from the 1996 and 2006 serosurveys showed an increase of seropositivity to Denv infections, which canpartially be explained by the 1997 outbreak in the Yucatan. While seroprevalence studies were useful to identify the proportion ofseropositive population, the case reports from the epidemiologic surveillance system were useful to identify the epidemic year,meaning that both sources of information are complementary to better understand the Denv dynamics during the ten-year-periodelapsed between 1996 and 2006.

Factors That Affect The Severity of Dengue

Dengue is the most important viral vector transmitted disease world wide in terms of morbidity and mortality. According to WHO around 5,00,000 cases of DHF(Dengue hemorrhagic Fever) and DSS(Dengue Shock Syndrome) occur annually with 22,000 deaths. It is found that some individuals have only undifferentiated fever while others progress to DHF. Our study is an attempt to find out the factors that determine the severity of dengue in our population. Among the 50 individuals with dengue fever that were studied those with hypertension, diabetes, renal failure and alcohol abuse tended to have severe dengue.

EPIDEMIOLOGICAL ANALYSIS OF DENGUE'S INCIDENCE ON CERES-GO COUNTY BETWEEN 2012 AND 2015

Dengue is an infectious disease caused by a virus Flaviirus genus, transmitted by a vector, the Aedes aegypti. The aim of this study was promote an epidemiological study to identify the incidence of dengue cases reported in the city of Ceres, Goiás. Study was conducted epidemiological, descriptive, ecological type, cross-sectional, quantitative, accomplished by the data collection of the number of reported and confirmed cases of dengue, in the 2012 period to 2015, provided by municipal surveillance in the city of Ceres, Goiás, and the site of the Goiás State Department of Health. Between 2012 to 2015 were reported 4556 dengue cases in the municipality of Ceres, and of these, 45.96% were confirmed by serological tests. Of the total cases reported during this period (n = 4.566), 50.53% (2.290) are the only cases reported in 2015. The incidence rate of the disease in 2015, in Ceres, was 11.051 cases / 100.000 inhabitants, values surpass the previous years (2012-2014). This result demonstrates the high burden of disease in the population of this municipality in 2015. The data also suggest the addition of a new serotype in the region. This increase of the risk of dengue hemorrhagic fever, which characterized as a complication of classic disease, however, data for cases of dengue hemorrhagic fever were not available. There was a considerable increase in the number of dengue cases in 2015 compared to previous years, 2012 to 2014. This growth suggests that serological studies focusing on serotypes detection should be conduct on region. KEY WORDS: Aedes aegypti; serogroup; epidemics.

High-throughput screening for the identification of small-molecule inhibitors of the flaviviral protease

The mosquito-borne dengue virus serotypes 1–4 (DENV1-4) and West Nile virus (WNV) cause serious illnesses worldwide associated with considerable morbidity and mortality. According to the World Health Organization (WHO) estimates, there are about 390 million infections every year leading to ∼500,000 dengue haemorrhagic fever (DHF) cases and ∼25,000 deaths, mostly among children. Antiviral therapies could reduce the morbidity and mortality associated with flaviviral infections, but currently there are no drugs available for treatment. In this study, a high-throughput screening assay for the Dengue protease was employed to screen ∼120,000 small molecule compounds for identification of inhibitors. Eight of these inhibitors have been extensively analyzed for inhibition of the viral protease in vitro and cell-based viral replication using Renilla luciferase reporter replicon, infectivity (plaque) and cytotoxicity assays. Three of these compounds were identified as potent inhibitors of DENV and WNV proteases, and viral replication of DENV2 replicon and infectious RNA. Fluorescence quenching, kinetic analysis and molecular modeling of these inhibitors into the structure of NS2B-NS3 protease suggest a mode of inhibition for three compounds that they bind to the substrate binding pocket.

Characteristics and Risk Factors for Fatality in Patients with Dengue Hemorrhagic Fever, Taiwan, 2014.

An unprecedented dengue outbreak involving more than 15,000 infections, including 136 dengue hemorrhagic fever (DHF) cases and 20 fatalities, occurred in Taiwan in 2014. The median age of the DHF cases was 71 years (range: 4-92 years) and most of them (N = 100, 73.5%) had comorbidities, of which the majority were hypertension (56%) and diabetes mellitus (DM; 27%). Only approximately half of the DHF cases (59/136) were classified as severe dengue, based on the 2009 WHO-revised dengue classification. The fatality rate for this DHF outbreak was 14.7%. DM (odds ratio [OR] = 3.60, 95% confidence interval [CI] = 1.22-10.63) and presentation with severe plasma leakage (OR = 6.42, 95% CI = 1.76-23.63) were independent risk factors for fatality.

TEMPAT PERKEMBANGBIAKAN AEDES SPP. SEBAGAI PENULAR VIRUS DENGUE PADA BERBAGAI TEMPAT DI KOTA SUKABUMI

Cases of Dengue Hemorrhagic Fever (DHF) and speed of increased cases in Sukabumi city is highest in West Java, as it was shown by Incidence Rate (IR) of Dengue virus infection in Sukabumi city in 2009 was 430 /100,000 and in 2010 reached 330 /100,000. Slope of the regression line of IR enhancement of dengue virus infection in the period 2004 - 2010 of Sukabumi City have the highest value (55.8) when compared to Cimahi (32.1) and Bandung (12.1). Environmental survey was conducted for entomology examination at home of patient with Dengue virus infection and places visited in the morning until late afternoon the week before illness. Examination results at housing obtained positive Aedes spp 36,8.7%, and 23.5% were found in public places. The results showed that the public places was a potential transmission of dengue virus infection. Results of this study showed that water reservoirs that are most numerous Aedes spp. wasbath tub. The study also reported the House Index (HI) 31.55%, Container Index (CI) 21.72% and Bretau Index (BI) 51.46%. Threshold larvae index obtained by HI was at value 5 or moderate risk but based on CI and BI were in grades 6 means to have a high risk of transmission.

KEJADIAN DBDDI KELURAHAN MANISREJO KECAMATAN TAMAN KOTA MADIUN TAHUN 2015

Manisrejo village incidence of dengue fever is the highest among the City of Madiun. Thenumber of cases of dengue hemorrhagic fever in that village was as many as 84 cases in2010-2014. This study aims to find out about the incidence of dengue fever. By measuringbehavioral factors, assess physical factors, calculating factor-free numbers larva, evaluate PSN(mosquito nest eradication), evaluates health services, measuring the socio-economic factors,and to describe the incidence of dengue fever. This type of research is a descriptive study. Populations were all cases of dengue fever inthe village Manisrejo District of the City of Madiun. The sample is purposive sampling counted84 cases and the controls. The results generated from the calculation of questionnaires and observation done. It isknown that most of the respondents behavior is bad namely 87.8%, physical factors such astemperature and humidity most of the houses of the respondents have optimum temperatureand humidity which is a mosquito breeding sites by 83.67%. Village ofManisrejois still not freefrom larvae, this is because free larva houseswere still below 95%, the mosquito eradicationis bad that is equal to 59.2%, patients with dengue fever in the village Manisrejo utilize healthservices and are willing to seek treatment when exposed to pain, patients with dengue feverat most households were not poor 84,7%. It is recommended to the citizens in order to improve the attitudes and actions ofmosquito control, as well as the mobilization of mosquito eradication movement cadres inparticular for monitoring larvae, as well as public attention to environmental conditions suchas opening a window or vent, this can help to regulate the temperature and humidity.

Reconstruction of disease transmission rates: Applications to measles, dengue, and influenza

Transmission rates are key in understanding the spread of infectious diseases. Using the framework of compartmental models, we introduce a simple method to reconstruct time series of transmission rates directly from incidence or disease-related mortality data. The reconstruction employs differential equations, which model the time evolution of infective stages and strains. Being sensitive to initial values, the method produces asymptotically correct solutions. The computations are fast, with time complexity being quadratic. We apply the reconstruction to data of measles (England and Wales, 1948–1967), dengue (Thailand, 1982–1999), and influenza (U.S., 1910–1927). The Measles example offers comparison with earlier work. Here we re-investigate reporting corrections, include and exclude demographic information. The dengue example deals with the failure of vector-control measures in reducing dengue hemorrhagic fever (DHF) in Thailand. Two competing mechanisms have been held responsible: strain interaction and demographic transitions. Our reconstruction reveals that both explanations are possible, showing that the increase in DHF cases is consistent with decreasing transmission rates resulting from reduced vector counts. The flu example focuses on the 1918/1919 pandemic, examining the transmission rate evolution for an invading strain. Our analysis indicates that the pandemic strain could have circulated in the population for many months before the pandemic was initiated by an event of highly increased transmission.

Perilaku Keluarga dalam Pencegahan Penyakit Demam Berdarah Dengue (DBD) di Kelurahan Kadipiro Kecamatan Banjarsari Kota Surakarta

Dengue is one of the most infectious diseases in the world. It is estimated one hundred million people are infected with dengue fever every year year. Kadipiro is one of endemic areas of dengue fever and always the case is always increasing in every year. In 2012, there were 7 cases of dengue hemorrhagic fever and increased to 48 cases in 2013. The Purpose of this study was to determine the behavior determinants of the family in the prevention of dengue hemorrhagic fever in the Kadipiro village, Banjarsari district Surakarta city. The research design was descriptive, with 99 respondents used cluster random sampling and univariate analysis techniques. The result; the behavior determinant of the family in the prevention of dengue fever based on knowledge: 76 respondents have a good knowledge and 23 respondents had a poor knowledge. Perception : 69 respondents have a good perception and 30 respondents had a poor perception. Motivation: 65 respondents have a good motivation and 34 respondents had a poor motivation, Cross-tabulation of knowledge and perception: respondents who had a good knowledge and a good perception was 59 respondents, and poor knowledge and perception of good was10 respondents. Cross-tabulation of knowledge and motivation: respondents who had a good knowledge and a good motivation were 57 respondents, and poor knowledge and motivation of good were 8 respondents. The Determinants of family behavior in the prevention of dengue hemorrhagic fever (DHF ) was based on the knowledge which was mostly good. The perceptions and motivations were mostly good. Cross-tabulation of knowledge and perception was good. Cross-tabulation of knowledge and motivation was good.

Forty Years of Dengue Surveillance at a Tertiary Pediatric Hospital in Bangkok, Thailand, 1973-2012.

Long-term observational studies can provide valuable insights into overall dengue epidemiology. Here, we present analysis of dengue cases at a pediatric hospital in Bangkok, Thailand, during a 40-year period from 1973 to 2012. Data were analyzed from 25,715 hospitalized patients with laboratory-confirmed dengue virus (DENV) infection. Several long-term trends in dengue disease were identified including an increase in mean age of hospitalized cases from an average of 7-8 years, an increase after 1990 in the proportion of post-primary cases for DENV-1 and DENV-3, and a decrease in the proportion of dengue hemorrhagic fever and dengue shock syndrome cases in primary and post-primary cases over time. Exploratory mechanistic analysis of these observed trends considered changes in diagnostic methods, demography, force of infection, and Japanese encephalitis vaccination as possible explanations. Thailand is an important setting for studying DENV transmission as it has a "mature" dengue epidemiology with a strong surveillance system in place since the early 1970s. We characterized changes in dengue epidemiology over four decades, and possible impact of demographic and other changes in the human population. These results may inform other countries where similar changes in transmission and population demographics may now or may soon be occurring.

Extended convolution model to bayesian spatio-temporal for diagnosing the DHF endemic locations

We develop a Bayesian spatio-temporal model based on a spatial Poisson-Lognormal convolution model. The convolution model consists of two component, i.e.; heterogeneity (fixed effects) and uncertainty (local and global random effects). We introduce an additional component in the development model so-called temporal trend. The developed model is adjusted based on dengue hemorrhagic fever (DHF) characteristics data. The DHF cases are considered as two-level hierarchical data since the cases are measured at smallest locations (as level 1) and the locations are nested to larger area (as level 2). Because the data are dis- crete with non-normal distribution, the development model is expressed as a generalized linear model. The parameters of the model are estimated using its full conditional distribu- tion, respectively, by applying Bayesian Markov Chain Monte Carlo (MCMC) computational technique. We apply the model to analyze the endemic locations of DHF cases in the city of Kendari, Southeast Sulawesi, Indonesia. The developed model can be well identifying the DHF prone locations in the city more than the convolution model. In this model we use two predictors, i.e. rainfall and population density, and both of them are statistically significant. Applying the model to the real data, the results show that Kadia and Puwatu districts are endemic locations. The best time to intervene the DHF risk in the both locations to prevent the spread to other locations was in the month of January

The Epidemiology, Virology and Clinical Findings of Dengue Virus Infections in a Cohort of Indonesian Adults in Western Java.

BackgroundDengue has emerged as one of the most important infectious diseases in the last five decades. Evidence indicates the expansion of dengue virus endemic areas and consequently the exponential increase of dengue virus infections across the subtropics. The clinical manifestations of dengue virus infection include sudden fever, rash, headache, myalgia and in more serious cases, spontaneous bleeding. These manifestations occur in children as well as in adults. Defining the epidemiology of dengue in a given area is critical to understanding the disease and devising effective public health strategies.Methodology/Principal FindingsHere, we report the results from a prospective cohort study of 4380 adults in West Java, Indonesia, from 2000–2004 and 2006–2009. A total of 2167 febrile episodes were documented and dengue virus infections were confirmed by RT-PCR or serology in 268 cases (12.4%). The proportion ranged from 7.6 to 41.8% each year. The overall incidence rate of symptomatic dengue virus infections was 17.3 cases/1,000 person years and between September 2006 and April 2008 asymptomatic infections were 2.6 times more frequent than symptomatic infections. According to the 1997 WHO classification guidelines, there were 210 dengue fever cases, 53 dengue hemorrhagic fever cases (including one dengue shock syndrome case) and five unclassified cases. Evidence for sequential dengue virus infections was seen in six subjects. All four dengue virus serotypes circulated most years. Inapparent dengue virus infections were predominantly associated with DENV-4 infections.Conclusions/SignificanceDengue virus was responsible for a significant percentage of febrile illnesses in an adult population in West Java, Indonesia, and this percentage varied from year to year. The observed incidence rate during the study period was 43 times higher than the reported national or provincial rates during the same time period. A wide range of clinical severity was observed with most infections resulting in asymptomatic disease. The circulation of all four serotypes of dengue virus was observed in most years of the study.