Epidemiology and Infection

  • Epidemiology and Infection / Volume 140 / Issue 03 / March 2012, pp 479-490
  • Copyright © Cambridge University Press 2011 The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <http://creativecommons.org/licenses/by-nc-sa/2.5/>. The written permission of Cambridge University Press must be obtained for commercial re-use.
  • DOI: http://dx.doi.org/10.1017/S0950268811000653 (About DOI), Published online: 09 May 2011

Other viruses

Geographical gradient of mean age of dengue haemorrhagic fever patients in northern Thailand


a1 Yao Tokushukai General Hospital, Yao, Osaka, Japan

a2 National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand

a3 Bureau of Vector Borne Disease, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand


Dengue haemorrhagic fever (DHF) is caused by dengue virus transmitted by Aedes mosquitoes; mean age of patients varies temporally and geographically. Variability in age of patients may be due to differences in transmission intensity or demographic structure. To compare these two hypotheses, the mean age of DHF patients from 90 districts in northern Thailand (1994–1996, 2002–2004) was regressed against (i) Aedes abundance or (ii) demographic variables (birthrate, average age) of the district. We also developed software to quantify direction and strength of geographical gradients of these variables. We found that, after adjusting for socioeconomics, climate, spatial autocorrelation, the mean age of patients was correlated only with Aedes abundance. The geographical gradient of mean age of patients originated from entomological, climate, and socioeconomic gradients. Vector abundance was a stronger determinant of mean age of patients than demographic variables, in northern Thailand.

(Accepted March 17 2011)

(Online publication May 09 2011)


c1 Author for correspondence: Dr Y. Nagao, Yao Tokushukai General Hospital, Osaka, 581-0011Japan. (Email: in_the_pacific214@yahoo.co.jp)