Charmaine P Mutucumarana1, Champica K Bodinayake2, Ajith Nagahawatte3, Vasantha Devasiri4, Ruvini Kurukulasooriya5, Thamali Anuradha5, Aruna Dharshan De Silva6, Mark M Janko7, Truls Østbye7,8, Duane J Gubler7,9, Christopher W Woods7,10, Megan E Reller7,10, L Gayani Tillekeratne7,10, Paul M Lantos7,11,12. 1. Duke University School of Medicine, Durham, NC 27710, USA. 2. Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. 3. Department of Microbiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. 4. Department of Pediatrics, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. 5. Duke Ruhuna Collaborative Research Center, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. 6. Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka. 7. Duke Global Health Institute, Durham, NC 27710, USA. 8. Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC 27710, USA. 9. Emerging Infectious Diseases Program, Duke-NUS Medical School, Singapore 169857. 10. Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA. 11. Division of Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA. 12. Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
Abstract
BACKGROUND: Dengue is a major cause of acute febrile illness in Sri Lanka. Dengue has historically been considered an urban disease. In 2012-2013, we documented that acute dengue was surprisingly associated with self-reported rural residence in the Southern Province of Sri Lanka. METHODS: Patients admitted with an acute febrile illness were enrolled from June 2012-May 2013 in a cross-sectional surveillance study at the largest tertiary care hospital in the Southern Province. Acute dengue was diagnosed by serology and virology testing. Site visits were performed to collect residential geographical coordinates. Spatial variation in odds of acute dengue was modeled using a spatial generalized additive model predicted onto a grid of coordinate pairs covering the Southern Province. RESULTS: Of 800 patients, 333 (41.6%) had laboratory-confirmed acute dengue. Dengue was spatially heterogeneous (local probability of acute dengue 0.26 to 0.42). There were higher than average odds of acute dengue in the rural northeast of the Southern Province and lower than average odds in the urbanized southwest of the Southern Province, including the city Galle. CONCLUSIONS: Our study further affirms the emergence of dengue in rural southern Sri Lanka and highlights both the need for real-time geospatial analyses to optimize public health activities as well as the importance of strengthening dengue surveillance in non-urban areas.
BACKGROUND: Dengue is a major cause of acute febrile illness in Sri Lanka. Dengue has historically been considered an urban disease. In 2012-2013, we documented that acute dengue was surprisingly associated with self-reported rural residence in the Southern Province of Sri Lanka. METHODS:Patients admitted with an acute febrile illness were enrolled from June 2012-May 2013 in a cross-sectional surveillance study at the largest tertiary care hospital in the Southern Province. Acute dengue was diagnosed by serology and virology testing. Site visits were performed to collect residential geographical coordinates. Spatial variation in odds of acute dengue was modeled using a spatial generalized additive model predicted onto a grid of coordinate pairs covering the Southern Province. RESULTS: Of 800 patients, 333 (41.6%) had laboratory-confirmed acute dengue. Dengue was spatially heterogeneous (local probability of acute dengue 0.26 to 0.42). There were higher than average odds of acute dengue in the rural northeast of the Southern Province and lower than average odds in the urbanized southwest of the Southern Province, including the city Galle. CONCLUSIONS: Our study further affirms the emergence of dengue in rural southern Sri Lanka and highlights both the need for real-time geospatial analyses to optimize public health activities as well as the importance of strengthening dengue surveillance in non-urban areas.
Authors: Champica K Bodinayake; L Gayani Tillekeratne; Ajith Nagahawatte; Vasantha Devasiri; Wasantha Kodikara Arachichi; John J Strouse; October M Sessions; Ruvini Kurukulasooriya; Anna Uehara; Shiqin Howe; Xin Mei Ong; Sharon Tan; Angelia Chow; Praveen Tummalapalli; Aruna D De Silva; Truls Østbye; Christopher W Woods; Duane J Gubler; Megan E Reller Journal: PLoS Negl Trop Dis Date: 2016-10-06
Authors: Muhammad Shahzad Sarfraz; Nitin K Tripathi; Taravudh Tipdecho; Thawisak Thongbu; Pornsuk Kerdthong; Marc Souris Journal: BMC Public Health Date: 2012-10-09 Impact factor: 3.295
Authors: Samir Bhatt; Peter W Gething; Oliver J Brady; Jane P Messina; Andrew W Farlow; Catherine L Moyes; John M Drake; John S Brownstein; Anne G Hoen; Osman Sankoh; Monica F Myers; Dylan B George; Thomas Jaenisch; G R William Wint; Cameron P Simmons; Thomas W Scott; Jeremy J Farrar; Simon I Hay Journal: Nature Date: 2013-04-07 Impact factor: 49.962
Authors: Sophie A Lee; Christopher I Jarvis; W John Edmunds; Theodoros Economou; Rachel Lowe Journal: J R Soc Interface Date: 2021-05-26 Impact factor: 4.118