A climate-based prediction model in the high-risk clusters of the Mekong Delta region, Vietnam: towards improving dengue prevention and control

Trop Med Int Health. 2016 Oct;21(10):1324-1333. doi: 10.1111/tmi.12754. Epub 2016 Jul 27.

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%).

Conclusion: 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.

Keywords: Delta del Mekong; Delta du Mékong; Mekong Delta; Predicción; Vietnam; dengue incidence; incidence de la dengue; incidencia del dengue; prediction; prédiction.

MeSH terms

  • Climate*
  • Dengue / epidemiology
  • Dengue / prevention & control*
  • Disease Outbreaks*
  • Humans
  • Incidence
  • Models, Statistical
  • Predictive Value of Tests
  • Risk Factors
  • Vietnam / epidemiology