Relationship between Transmission Intensity and Incidence of Dengue Hemorrhagic Fever in Thailand
2008

Dengue Hemorrhagic Fever Incidence in Thailand

Sample size: 1000000 publication 10 minutes Evidence: moderate

Author Information

Author(s): Thammapalo Suwich, Nagao Yoshiro, Sakamoto Wataru, Saengtharatip Seeviga, Tsujitani Masaaki, Nakamura Yasuhide, Coleman Paul G., Davies Clive

Primary Institution: Bureau of Vector Borne Disease, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand

Hypothesis

The relationship between the incidence of DHF and transmission intensity may be negative in areas of intense transmission due to cross-immunity.

Conclusion

Insufficient reduction of vector abundance in regions of intense transmission may increase long-term DHF incidence.

Supporting Evidence

  • The study found that DHF incidence increased only up to an HI of about 30, but declined thereafter.
  • Reduction of HI from the currently maximal level to 30 would increase the incidence by more than 40%.
  • Simulations indicated that cross-immunity generates a wide variation in incidence, obscuring the relationship between incidence and transmission intensity.

Takeaway

If we reduce the number of mosquitoes that spread dengue too much in places where it's very common, it could actually make more people sick with a serious form of the disease.

Methodology

The study used House Index (HI) from surveys of one million houses to assess the relationship between DHF incidence and transmission intensity.

Potential Biases

Potential bias from incomplete house registry and non-randomized survey design.

Limitations

The study was based on a single three-year period in one country, which may limit the generalizability of the findings.

Participant Demographics

The study included data from various age categories across the Thai population.

Statistical Information

P-Value

0.006

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pntd.0000263

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