Whooping cough metapopulation dynamics in tropical conditions: disease persistence and impact of vaccination.

Recent insights in compiling metapopulation models and infectious disease dynamics have enabled a better understanding of spatial and temporal persistence of diseases. The concept of the critical community size (CCS) has been developed with major consideration on analyses of whooping cough and measles dynamics from temperate countries for which large datasets are available. However, few studies have questioned the generality of CCS curves for other regions, i.e. tropical areas, mainly because data are very sparse. This work constitutes, to our knowledge, the first study of whooping cough persistence in a tropical area, in a rural part of Senegal (Western Africa) where the population has been followed for 20 years. In this small community, the CCS is not reached even if we observe CCS-like curves showing persistence increasing with population size. In addition, our analysis supports the idea that vaccination has impacted the spatiotemporal dynamics and persistence of the disease. These findings suggest the need for more comparative analyses of spatio-temporal data series from a wide range of contrasted countries, for example developed and developing nations, so as to have a better understanding of vaccination effects on disease dynamics and persistence.