Dengue on islands: a Bayesian approach to understanding the global ecology of dengue viruses.
Bottom Line: Minimum temperature was strongly associated with suitability for DENV transmission.Increased population size and precipitation were associated with increased outbreak frequency, but did not capture all of the variability.Wealth and connectivity, in contrast, had no discernable effects.
Affiliation: Children's Hospital Informatics Program, Boston Children's Hospital, 1 Autumn St., Boston, MA 02215, USA Center for Statistics and Quantitative Infectious Diseases, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; USA.Show MeSH
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Mentions: To assess the accuracy of the model to estimate endemicity, we multiplied pSuit and pOut, to consider locations that are suitable and likely to have frequent outbreaks. This index was strongly correlated with increased numbers of outbreaks in consecutive years and within a decade, accounting for 55 and 58% of the variability, respectively (Figure 4A–4B). While four training islands had long-term data indicative of endemicity (yearly outbreaks for a decade or more), 14 islands had less clear data, with 5–9 outbreak years in a decade. These islands and those with fewer outbreaks may be non-endemic areas with frequent outbreaks or areas with under-recognized transmission, a difference that is critical but difficult to assess. We thus evaluated the model accuracy against a somewhat arbitrary threshold, assuming that islands with at least five consecutive years of transmission were endemic and should have pSuitpOut >0.5. There were 49 training islands with pSuitpOut <0.5. Of these, all 49 had less than five consecutive years with outbreaks and 47 had less than five outbreak years in a decade (Figure 3C). Of the 25 training islands with pSuitpOut >0.5, 12 had at least five consecutive years with outbreaks and 16 had five or more outbreaks observed within a decade. The overall accuracy on the training data was 82% for consecutive years with outbreaks and 85% for outbreak years in a decade.Figure 4.
Affiliation: Children's Hospital Informatics Program, Boston Children's Hospital, 1 Autumn St., Boston, MA 02215, USA Center for Statistics and Quantitative Infectious Diseases, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; USA.