[Determinants of dengue transmission in Veracruz: an ecological approach to its control].
OBJECTIVE
To assess the ecological, social, and demographic factors associated with the transmission of dengue virus infection in Veracruz, Mexico, and to identify risk areas to target control measures.


METHODS
This ecological study included data for 1,249 localities within the 11 Health Jurisdictions of the State of Veracruz, Mexico, for the 1995-1998 period. The following data were collected for each locality: total number of cases per year, population by sex, number of households, provision of public services, altitude, latitude, longitude, and deprivation index.


RESULTS
Dengue transmission was registered in 17% of the localities in the State; 70% of the cases were concentrated in only 6% of the localities. Recurrent localities were urban centers with adequate availability of public services and low deprivation indices. Dengue transmission was detected in rural areas, but it was not common. The average number of cases differed according to the size of the locality and the number of years dengue was reported. A population threshold to maintain transmission was found.


CONCLUSIONS
Recurrent localities concentrating 70% of dengue fever cases were identified, as well as the ecological and demographic factors associated with dengue transmission. The risk stratification approach to dengue transmission may improve control and prevention of this disease in high-risk areas.
Escobar-Mesa
Javier
J
División Técnica de Información Estadística en Salud, Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social (IMSS), México.
Gómez-Dantés
Héctor
H
D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D004463:Ecology; D006801:Humans; D008800:Mexico