title: Predicting Dengue Fever Outbreaks in French Guiana Using Climate Indicators.
abstract: BACKGROUND
  Dengue fever epidemic dynamics are driven by complex interactions between hosts, vectors and viruses. Associations between climate and dengue have been studied around the world, but the results have shown that the impact of the climate can vary widely from one study site to another. In French Guiana, climate-based models are not available to assist in developing an early warning system. This study aims to evaluate the potential of using oceanic and atmospheric conditions to help predict dengue fever outbreaks in French Guiana.
  
  
  RESULTS
  Lagged correlations and composite analyses were performed to identify the climatic conditions that characterized a typical epidemic year and to define the best indices for predicting dengue fever outbreaks during the period 1991-2013. A logistic regression was then performed to build a forecast model. We demonstrate that a model based on summer Equatorial Pacific Ocean sea surface temperatures and Azores High sea-level pressure had predictive value and was able to predict 80% of the outbreaks while incorrectly predicting only 15% of the non-epidemic years. Predictions for 2014-2015 were consistent with the observed non-epidemic conditions, and an outbreak in early 2016 was predicted.
  
  
  CONCLUSIONS
  These findings indicate that outbreak resurgence can be modeled using a simple combination of climate indicators. This might be useful for anticipating public health actions to mitigate the effects of major outbreaks, particularly in areas where resources are limited and medical infrastructures are generally insufficient.
authors.affiliation: Unité d'épidémiologie, Institut Pasteur de la Guyane, Cayenne, Guyane.|Unité d'entomologie médicale, Institut Pasteur de la Guyane, Cayenne, Guyane.
authors.forename: Antoine
authors.initials: A
authors.lastname: Adde
authors.affiliation: Centre de Recherches de Climatologie, UMR6282 Biogéosciences, CNRS Université de Bourgogne Franche-Comté, Dijon, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Roucou
authors.affiliation: Maison de la Télédétection, UMR 228 ESPACE-DEV, Institut de Recherche pour le Développement, Montpellier, France.
authors.forename: Morgan
authors.initials: M
authors.lastname: Mangeas
authors.affiliation: Cellule de l'Institut de Veille Sanitaire en Régions Antilles - Guyane, Cayenne, Guyane.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ardillon
authors.affiliation: Institut de Veille Sanitaire, Saint-Maurice, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Desenclos
authors.affiliation: Unité de virologie, Institut Pasteur de la Guyane, Cayenne, Guyane.
authors.forename: Dominique
authors.initials: D
authors.lastname: Rousset
authors.affiliation: Unité d'entomologie médicale, Institut Pasteur de la Guyane, Cayenne, Guyane.
authors.forename: Romain
authors.initials: R
authors.lastname: Girod
authors.affiliation: Unité d'entomologie médicale, Institut Pasteur de la Guyane, Cayenne, Guyane.|Direction Interarmées du Service de Santé en Guyane, Cayenne, Guyane.|Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Briolant
authors.affiliation: Laboratoire d'Etudes et de Recherche en Santé-Environnement, Ecole des Hautes Etudes en Santé Publique, Rennes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Quenel
authors.affiliation: Unité d'épidémiologie, Institut Pasteur de la Guyane, Cayenne, Guyane.
authors.forename: Claude
authors.initials: C
authors.lastname: Flamand
mesh_terms: D002980:Climate; D003715:Dengue / Q000453:epidemiology*; D004196:Disease Outbreaks; D004812:Epidemiologic Methods; D005544:Forecasting; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D015233:Models, Statistical