title: Event history analysis of dengue fever epidemic and inter-epidemic spells in Barbados, Brazil, and Thailand.
abstract: OBJECTIVE
  This study investigated meteorological and demographic factors affecting the length of dengue fever epidemics and the length of time between epidemics in Barbados, Brazil, and Thailand.
  
  
  METHODS
  Region-specific meteorological and demographic data were collected for 104 sites from public sources. Fixed effects piecewise logistic event history analysis was used to quantify the effects of time-varying covariates on the duration of inter-epidemic spells and for the duration of epidemics.
  
  
  RESULTS
  Mean monthly temperature was the most important factor affecting the duration of both inter-epidemic spells (β=0.543; confidence interval (CI) 0.4954, 0.5906) and epidemic spells (β=-0.648; CI -0.7553, -0.5405). Drought conditions increased the time between epidemics. Increased temperature hastened the onset of an epidemic, and during an epidemic, higher mean temperature increased the duration of the epidemic.
  
  
  CONCLUSIONS
  By using a duration analysis, this study offers a novel approach for investigating the dynamics of dengue fever epidemiology. Furthermore, these results offer new insights into prior findings of a correlation between temperature and the geographic range and vector efficiency of dengue fever.
authors.affiliation: Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA. dmp336@psu.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Parker
authors.forename: Darryl
authors.initials: D
authors.lastname: Holman
mesh_terms: D000465:Algorithms; D001460:Barbados / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology*; D003716:Dengue Virus / Q000302:isolation & purification*; D058872:Epidemics; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D013785:Thailand / Q000453:epidemiology; D014887:Weather