title: Aedes aegypti larval indices and risk for dengue epidemics.
abstract: We assessed in a case-control study the test-validity of Aedes larval indices for the 2000 Havana outbreak. "Cases" were blocks where a dengue fever patient lived during the outbreak. "Controls" were randomly sampled blocks. Before, during, and after the epidemic, we calculated Breteau index (BI) and house index at the area, neighborhood, and block level. We constructed receiver operating characteristic (ROC) curves to determine their performance as predictors of dengue transmission. We observed a pronounced effect of the level of measurement. The BI(max) (maximum block BI in a radius of 100 m) at 2-month intervals had an area under the ROC curve of 71%. At a cutoff of 4.0, it significantly (odds ratio 6.00, p<0.05) predicted transmission with 78% sensitivity and 63% specificity. Analysis of BI at the local level, with human-defined boundaries, could be introduced in control programs to identify neighborhoods at high risk for dengue transmission.
authors.affiliation: Department of Informatics and Biostatistics, Pedro Kouri Tropical Medicine Institute, Autopista Novia del Mediodia, Km 6, La Lisa AP 601, Marianao 13, Havana City, Havana AP 601, Cuba. lsanchez@ipk.sld.cu
authors.forename: Lizet
authors.initials: L
authors.lastname: Sanchez
authors.forename: Veerle
authors.initials: V
authors.lastname: Vanlerberghe
authors.forename: Lázara
authors.initials: L
authors.lastname: Alfonso
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: Marquetti
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Guzman
authors.forename: Juan
authors.initials: J
authors.lastname: Bisset
authors.forename: Patrick
authors.initials: P
authors.lastname: van der Stuyft
mesh_terms: D000330:Aedes / Q000821:virology*; D000818:Animals; D019540:Area Under Curve; D016022:Case-Control Studies; D003462:Cuba / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission*; D003716:Dengue Virus / Q000472:pathogenicity; D004196:Disease Outbreaks; D006801:Humans; D007303:Insect Vectors / Q000821:virology*; D007814:Larva / Q000821:virology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity