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Can human movements explain heterogeneous propagation of dengue fever in Cambodia?

Teurlai M., Huy R., Cazelles B., Duboz R., Baehr C., Vong S.. 2012. PLoS Neglected Tropical Diseases, 6 (12) : 8 p..

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. (Résumé d'auteur)

Mots-clés : genre humain; migration; transmission des maladies; flavivirus; cambodge; virus de la dengue

Thématique : Maladies des animaux; Population rurale

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