Epidemiology and Infection

Original Papers

Spatial and temporal dynamics of dengue fever in Peru: 1994–2006

G. CHOWELLa1a2 c1, C. A. TORREa3, C. MUNAYCO-ESCATEa4, L. SUÁREZ-OGNIOa4, R. LÓPEZ-CRUZa5, J. M. HYMANa2 and C. CASTILLO-CHAVEZa3

a1 School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA

a2 Mathematical Modeling and Analysis Group (T-7), Theoretical Division (MS B284), Los Alamos National Laboratory, Los Alamos, NM, USA

a3 Department of Mathematics and Statistics, Arizona State University, Tempe, AZ, USA

a4 Dirección General de Epidemiología, Ministerio de Salud, Peru, Lima, Perú

a5 Universidad Nacional Mayor de San Marcos, Ciudad Universitaria, Lima, Perú

SUMMARY

The weekly number of dengue cases in Peru, South America, stratified by province for the period 1994–2006 were analysed in conjunction with associated demographic, geographic and climatological data. Estimates of the reproduction number, moderately correlated with population size (Spearman ρ=0·28, P=0·03), had a median of 1·76 (IQR 0·83–4·46). The distributions of dengue attack rates and epidemic durations follow power-law (Pareto) distributions (coefficient of determination >85%, P<0·004). Spatial heterogeneity of attack rates was highest in coastal areas followed by mountain and jungle areas. Our findings suggest a hierarchy of transmission events during the large 2000–2001 epidemic from large to small population areas when serotypes DEN-3 and DEN-4 were first identified (Spearman ρ=−0·43, P=0·03). The need for spatial and temporal dengue epidemic data with a high degree of resolution not only increases our understanding of the dynamics of dengue but will also generate new hypotheses and provide a platform for testing innovative control policies.

(Accepted December 13 2007)

(Online publication April 08 2008)

Correspondence:

c1 Author for correspondence: Dr G. Chowell, School of Human Evolution and Social Change, Arizona State University, Arizona State University, Tempe, AZ, USA. (Email: gchowell@asu.edu)

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