title: The global distribution and burden of dengue.
abstract: Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes. For some patients, dengue is a life-threatening illness. There are currently no licensed vaccines or specific therapeutics, and substantial vector control efforts have not stopped its rapid emergence and global spread. The contemporary worldwide distribution of the risk of dengue virus infection and its public health burden are poorly known. Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modelling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010. We predict dengue to be ubiquitous throughout the tropics, with local spatial variations in risk influenced strongly by rainfall, temperature and the degree of urbanization. Using cartographic approaches, we estimate there to be 390 million (95% credible interval 284-528) dengue infections per year, of which 96 million (67-136) manifest apparently (any level of disease severity). This infection total is more than three times the dengue burden estimate of the World Health Organization. Stratification of our estimates by country allows comparison with national dengue reporting, after taking into account the probability of an apparent infection being formally reported. The most notable differences are discussed. These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue. We anticipate that they will provide a starting point for a wider discussion about the global impact of this disease and will help to guide improvements in disease control strategies using vaccine, drug and vector control methods, and in their economic evaluation.
authors.affiliation: Spatial Ecology and Epidemiology Group, Tinbergen Building, Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK.
authors.forename: Samir
authors.initials: S
authors.lastname: Bhatt
authors.forename: Peter W
authors.initials: PW
authors.lastname: Gething
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Brady
authors.forename: Jane P
authors.initials: JP
authors.lastname: Messina
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Farlow
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Moyes
authors.forename: John M
authors.initials: JM
authors.lastname: Drake
authors.forename: John S
authors.initials: JS
authors.lastname: Brownstein
authors.forename: Anne G
authors.initials: AG
authors.lastname: Hoen
authors.forename: Osman
authors.initials: O
authors.lastname: Sankoh
authors.forename: Monica F
authors.initials: MF
authors.lastname: Myers
authors.forename: Dylan B
authors.initials: DB
authors.lastname: George
authors.forename: Thomas
authors.initials: T
authors.lastname: Jaenisch
authors.forename: G R William
authors.initials: GR
authors.lastname: Wint
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scott
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
authors.forename: Simon I
authors.initials: SI
authors.lastname: Hay
mesh_terms: D015331:Cohort Studies; D016208:Databases, Factual / Q000592:standards; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D003716:Dengue Virus / Q000502:physiology; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D011634:Public Health / Q000706:statistics & numerical data; D011786:Quality Control; D011891:Rain; D012307:Risk Factors; D013696:Temperature; D014329:Tropical Climate; D014507:Urbanization; D014944:World Health Organization
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