title: Spatial and temporal dynamics of dengue fever in Peru: 1994-2006.
abstract: SUMMARYThe 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 rho=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 rho=-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.
authors.affiliation: School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA. gchowell@asu.edu
authors.forename: G
authors.initials: G
authors.lastname: Chowell
authors.forename: C A
authors.initials: CA
authors.lastname: Torre
authors.forename: C
authors.initials: C
authors.lastname: Munayco-Escate
authors.forename: L
authors.initials: L
authors.lastname: Suárez-Ognio
authors.forename: R
authors.initials: R
authors.lastname: López-Cruz
authors.forename: J M
authors.initials: JM
authors.lastname: Hyman
authors.forename: C
authors.initials: C
authors.lastname: Castillo-Chavez
mesh_terms: D002980:Climate; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission; D003716:Dengue Virus / Q000502:physiology*; D004196:Disease Outbreaks; D005843:Geography; D015994:Incidence; D010568:Peru / Q000453:epidemiology; D011156:Population Density; D012044:Regression Analysis; D013997:Time Factors