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Space‐time analysis of hospitalised dengue patients in rural Thailand reveals important temporal intervals in the pattern of dengue virus transmission
Authors:Jared Aldstadt  In‐Kyu Yoon  Darunee Tannitisupawong  Richard G. Jarman  Stephen J. Thomas  Robert V. Gibbons  Angkana Uppapong  Sopon Iamsirithaworn  Alan L. Rothman  Thomas W. Scott  Timothy Endy
Affiliation:1. Department of Geography, University at Buffalo, Buffalo, NY, USA;2. Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand;3. Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA;4. Department of Pediatrics, Kamphaeng Phet Provincial Hospital, Ministry of Public Health, Kamphaeng Phet, Thailand;5. Bureau of Epidemiology, Ministry of Public Health, Nonthaburi, Thailand;6. Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, USA;7. Department of Entomology, University of California at Davis, Davis, CA, USA;8. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA;9. Department of Infectious Diseases, State University of New York at Syracuse, Syracuse, NY, USA
Abstract:
Objective To determine the temporal intervals at which spatial clustering of dengue hospitalisations occurs. Methods Space‐time analysis of 262 people hospitalised and serologically confirmed with dengue virus infections in Kamphaeng Phet, Thailand was performed. The cases were observed between 1 January 2009 and 6 May 2011. Spatial coordinates of each patient’s home were captured using the Global Positioning System. A novel method based on the Knox test was used to determine the temporal intervals between cases at which spatial clustering occurred. These intervals are indicative of the length of time between successive illnesses in the chain of dengue virus transmission. Results The strongest spatial clustering occurred at the 15–17‐day interval. There was also significant spatial clustering over short intervals (2–5 days). The highest excess risk was observed within 200 m of a previous hospitalised case and significantly elevated risk persisted within this distance for 32–34 days. Conclusions Fifteen to seventeen days are the most likely serial interval between successive dengue illnesses. This novel method relies only on passively detected, hospitalised case data with household locations and provides a useful tool for understanding region‐specific and outbreak‐specific dengue virus transmission dynamics.
Keywords:dengue  transmission  serial interval  space‐time  clustering  Thailand  dengue  transmission  intervalle de sé  ries  spatio‐temporel  regroupement  Thaï  lande  dengue  transmisió  n  intervalo seriado  espacio‐temporal  conglomerado  Tailandia
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