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Open Access Research article

Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China

Zhongjie Li1, Wenwu Yin1, Archie Clements2, Gail Williams2, Shengjie Lai1, Hang Zhou1, Dan Zhao1, Yansha Guo3, Yonghui Zhang4, Jinfeng Wang3, Wenbiao Hu2* and Weizhong Yang1*

Author Affiliations

1 Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China

2 School of Population Health, The University of Queensland, Brisbane, 4006, QLD, Australia

3 LREIS, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China

4 Guangdong Province Center for Disease Control and Prevention, Guangzhou, Guangdong province, 510300, China

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BMC Infectious Diseases 2012, 12:132  doi:10.1186/1471-2334-12-132

Published: 12 June 2012

Abstract

Background

Dengue fever has been a major public health concern in China since it re-emerged in Guangdong province in 1978. This study aimed to explore spatiotemporal characteristics of dengue fever cases for both indigenous and imported cases during recent years in Guangdong province, so as to identify high-risk areas of the province and thereby help plan resource allocation for dengue interventions.

Methods

Notifiable cases of dengue fever were collected from all 123 counties of Guangdong province from 2005 to 2010. Descriptive temporal and spatial analysis were conducted, including plotting of seasonal distribution of cases, and creating choropleth maps of cumulative incidence by county. The space-time scan statistic was used to determine space-time clusters of dengue fever cases at the county level, and a geographical information system was used to visualize the location of the clusters. Analysis were stratified by imported and indigenous origin.

Results

1658 dengue fever cases were recorded in Guangdong province during the study period, including 94 imported cases and 1564 indigenous cases. Both imported and indigenous cases occurred more frequently in autumn. The areas affected by the indigenous and imported cases presented a geographically expanding trend over the study period. The results showed that the most likely cluster of imported cases (relative risk = 7.52, p < 0.001) and indigenous cases (relative risk = 153.56, p < 0.001) occurred in the Pearl River Delta Area; while a secondary cluster of indigenous cases occurred in one district of the Chao Shan Area (relative risk = 471.25, p < 0.001).

Conclusions

This study demonstrated that the geographic range of imported and indigenous dengue fever cases has expanded over recent years, and cases were significantly clustered in two heavily urbanised areas of Guangdong province. This provides the foundation for further investigation of risk factors and interventions in these high-risk areas.