The Importance of Socio-Economic Versus Environmental Risk Factors for Reported Dengue Cases in Java, Indonesia.
Dengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country.



Hospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power.



Our data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment.
MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom.|Public Health Department, Faculty of Health Sciences, University of Jenderal Soedirman, Purwokerto, Indonesia.
Siwi P M
SP
Wijayanti
Centre for Immunity, Infection and Evolution (CIIE), Ashworth Laboratories, University of Edinburgh, Edinburgh, United Kingdom.
Thibaud
T
Porphyre
Centre for Immunity, Infection and Evolution (CIIE), Ashworth Laboratories, University of Edinburgh, Edinburgh, United Kingdom.
Margo
M
Chase-Topping
MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom.
Stephanie M
SM
Rainey
MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom.
Melanie
M
McFarlane
MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom.
Esther
E
Schnettler
MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom.|Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Roman
R
Biek
MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, United Kingdom.
Alain
A
Kohl
D000330:Aedes / Q000821:virology; D000818:Animals; D001499:Bayes Theorem; D019352:Censuses; D016208:Databases, Factual; D003710:Demography; D003715:Dengue / Q000453:epidemiology*; D003716:Dengue Virus; D004781:Environmental Exposure; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors