title: A climate-based prediction model in the high-risk clusters of the Mekong Delta region, Vietnam: towards improving dengue prevention and control.
abstract: OBJECTIVE
  To develop a prediction score scheme useful for prevention practitioners and authorities to implement dengue preparedness and controls in the Mekong Delta region (MDR).
  
  
  METHODS
  We applied a spatial scan statistic to identify high-risk dengue clusters in the MDR and used generalised linear-distributed lag models to examine climate-dengue associations using dengue case records and meteorological data from 2003 to 2013. The significant predictors were collapsed into categorical scales, and the β-coefficients of predictors were converted to prediction scores. The score scheme was validated for predicting dengue outbreaks using ROC analysis.
  
  
  RESULTS
  The north-eastern MDR was identified as the high-risk cluster. A 1 °C increase in temperature at lag 1-4 and 5-8 weeks increased the dengue risk 11% (95% CI, 9-13) and 7% (95% CI, 6-8), respectively. A 1% rise in humidity increased dengue risk 0.9% (95% CI, 0.2-1.4) at lag 1-4 and 0.8% (95% CI, 0.2-1.4) at lag 5-8 weeks. Similarly, a 1-mm increase in rainfall increased dengue risk 0.1% (95% CI, 0.05-0.16) at lag 1-4 and 0.11% (95% CI, 0.07-0.16) at lag 5-8 weeks. The predicted scores performed with high accuracy in diagnosing the dengue outbreaks (96.3%).
  
  
  CONCLUSIONS
  This study demonstrates the potential usefulness of a dengue prediction score scheme derived from complex statistical models for high-risk dengue clusters. We recommend a further study to examine the possibility of incorporating such a score scheme into the dengue early warning system in similar climate settings.
authors.affiliation: Centre for Environment and Population Health, Griffith University, Nathan, Brisbane, Qld, Australia. d.phung@griffith.edu.au.
authors.forename: Dung
authors.initials: D
authors.lastname: Phung
authors.affiliation: Centre for Environment and Population Health, Griffith University, Nathan, Brisbane, Qld, Australia. radwan.talukder@griffithuni.edu.au.
authors.forename: Mohammad Radwanur Rahman
authors.initials: MR
authors.lastname: Talukder
authors.affiliation: Centre for Environment and Population Health, Griffith University, Nathan, Brisbane, Qld, Australia.
authors.forename: Shannon
authors.initials: S
authors.lastname: Rutherford
authors.affiliation: Centre for Environment and Population Health, Griffith University, Nathan, Brisbane, Qld, Australia.
authors.forename: Cordia
authors.initials: C
authors.lastname: Chu
mesh_terms: D002980:Climate; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D006801:Humans; D015994:Incidence; D015233:Models, Statistical; D011237:Predictive Value of Tests; D012307:Risk Factors; D014744:Vietnam / Q000453:epidemiology
keywords: Delta del Mekong; Delta du Mékong; Mekong Delta; Predicción; Vietnam; dengue incidence; incidence de la dengue; incidencia del dengue; prediction; prédiction