title: Assessment of gender distribution in dengue surveillance data, the Lao People's Democratic Republic.
abstract: OBJECTIVE
  Adolescent and young adult males account for a large proportion of dengue cases reported through national surveillance systems in the Western Pacific Region. To preliminarily assess the validity of these observed distributions, a field investigation was conducted in the Lao People's Democratic Republic's Savannakhet Province in November 2011.
  
  
  METHODS
  Mixed quantitative and qualitative methods were used. Dengue surveillance data from Savannakhet Province, and aggregate hospital admission data from the Savannakhet Provincial Hospital for outpatients and inpatients were analysed by age and sex. Unstructured informal interviews were conducted with local health care workers, primary and secondary school officials and villagers.
  
  
  RESULTS
  An excess of males was found among reported dengue cases in Savannakhet Province in the 15-49 year age group. Females in the same age group, however, were found to access health care more than their male counterparts. Qualitative assessments attributed this distribution to young females being more health-conscious and having greater health care-seeking behaviour.
  
  
  CONCLUSIONS
  The excess of male dengue cases in the surveillance data appeared to be associated with a truly higher risk of dengue rather than greater health care access or health care-seeking behaviour by young men. This investigation indicated the importance of assessing the reported surveillance data within the context of health care utilization behaviour of the population under surveillance.
authors.affiliation: Savannakhet Provincial Health Office, Savannakhet, Lao People's Democratic Republic.
authors.forename: Nouda
authors.initials: N
authors.lastname: Prasith
authors.forename: Onechanh
authors.initials: O
authors.lastname: Keosavanh
authors.forename: Manilay
authors.initials: M
authors.lastname: Phengxay
authors.forename: Sara
authors.initials: S
authors.lastname: Stone
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Lewis
authors.forename: Reiko
authors.initials: R
authors.lastname: Tsuyuoka
authors.forename: Tamano
authors.initials: T
authors.lastname: Matsui
authors.forename: Panom
authors.initials: P
authors.lastname: Phongmanay
authors.forename: Bouaphanh
authors.initials: B
authors.lastname: Khamphaphongphane
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Arima
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007812:Laos / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult