title: Dynamic spatiotemporal trends of dengue transmission in the Asia-Pacific region, 1955-2004.
abstract: BACKGROUND
  Dengue fever (DF) is one of the most important emerging arboviral human diseases. Globally, DF incidence has increased by 30-fold over the last fifty years, and the geographic range of the virus and its vectors has expanded. The disease is now endemic in more than 120 countries in tropical and subtropical parts of the world. This study examines the spatiotemporal trends of DF transmission in the Asia-Pacific region over a 50-year period, and identified the disease's cluster areas.
  
  
  RESULTS
  The World Health Organization's DengueNet provided the annual number of DF cases in 16 countries in the Asia-Pacific region for the period 1955 to 2004. This fifty-year dataset was divided into five ten-year periods as the basis for the investigation of DF transmission trends. Space-time cluster analyses were conducted using scan statistics to detect the disease clusters. This study shows an increasing trend in the spatiotemporal distribution of DF in the Asia-Pacific region over the study period. Thailand, Vietnam, Laos, Singapore and Malaysia are identified as the most likely clusters (relative risk = 13.02) of DF transmission in this region in the period studied (1995 to 2004). The study also indicates that, for the most part, DF transmission has expanded southwards in the region.
  
  
  CONCLUSIONS
  This information will lead to the improvement of DF prevention and control strategies in the Asia-Pacific region by prioritizing control efforts and directing them where they are most needed.
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
authors.forename: Shahera
authors.initials: S
authors.lastname: Banu
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
authors.forename: Wenbiao
authors.initials: W
authors.lastname: Hu
authors.affiliation: School of Population Health, University of Queensland, Brisbane, Australia.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Guo
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
authors.forename: Suchithra
authors.initials: S
authors.lastname: Naish
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
authors.forename: Shilu
authors.initials: S
authors.lastname: Tong
mesh_terms: D001208:Asia; D016000:Cluster Analysis; D003715:Dengue / Q000517:prevention & control / Q000635:transmission*; D004196:Disease Outbreaks; D006801:Humans; D013029:Space-Time Clustering