title: Spatial epidemiology and climatic predictors of paediatric dengue infections captured via sentinel site surveillance, Phnom Penh Cambodia 2011-2012.
abstract: BACKGROUND
  Dengue is a major contributor to morbidity in children aged twelve and below throughout Cambodia; the 2012 epidemic season was the most severe in the country since 2007, with more than 42,000 reported (suspect or confirmed) cases.
  
  
  METHODS
  We report basic epidemiological characteristics in a series of 701 patients at the National Paediatric Hospital in Cambodia, recruited during a prospective clinical study (2011-2012). To more fully explore this cohort, we examined climatic factors using multivariate negative binomial models and spatial clustering of cases using spatial scan statistics to place the clinical study within a larger epidemiological framework.
  
  
  RESULTS
  We identify statistically significant spatial clusters at the urban village scale, and find that the key climatic predictors of increasing cases are weekly minimum temperature, median relative humidity, but find a negative association with rainfall maximum, all at lag times of 1-6 weeks, with significant effects extending to 10 weeks.
  
  
  CONCLUSIONS
  Our results identify clustering of infections at the neighbourhood scale, suggesting points for targeted interventions, and we find that the complex interactions of vectors and climatic conditions in this setting may be best captured by rising minimum temperature, and median (as opposed to mean) relative humidity, with complex and limited effects from rainfall. These results suggest that real-time cluster detection during epidemics should be considered in Cambodia, and that improvements in weather data reporting could benefit national control programs by allow greater prioritization of limited health resources to both vulnerable populations and time periods of greatest risk. Finally, these results add to the increasing body of knowledge suggesting complex interactions between climate and dengue cases that require further targeted research.
authors: Infectious Diseases Programme, Saw Swee Hock School of Public Health, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597, Singapore. andrew.a.lover@gmail.com.
authors: Andrew A
authors: AA
authors: Lover
authors: Philippe
authors: P
authors: Buchy
authors: Anne
authors: A
authors: Rachline
authors: Duch
authors: D
authors: Moniboth
authors: Rekol
authors: R
authors: Huy
authors: Chour Y
authors: CY
authors: Meng
authors: Yee Sin
authors: YS
authors: Leo
authors: Kdan
authors: K
authors: Yuvatha
authors: Ung
authors: U
authors: Sophal
authors: Ngan
authors: N
authors: Chantha
authors: Bunthin
authors: B
authors: Y
authors: Veasna
authors: V
authors: Duong
authors: Sophie
authors: S
authors: Goyet
authors: Jeremy L
authors: JL
authors: Brett
authors: Arnaud
authors: A
authors: Tarantola
authors: Philippe
authors: P
authors: Cavailler
mesh_terms: D000293:Adolescent; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002980:Climate; D003715:Dengue / Q000453:epidemiology*; D005260:Female; D005544:Forecasting; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011446:Prospective Studies; D018571:Sentinel Surveillance; D017062:Small-Area Analysis