MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
Department of Medicine, University of California San Francisco, San Francisco, CA 94110, USA.
Sci Transl Med. 2020 Jan 29;12(528). doi: 10.1126/scitranslmed.aax4144.
Intervention planning for dengue requires reliable estimates of dengue transmission intensity. However, current maps of dengue risk provide estimates of disease burden or the boundaries of endemicity rather than transmission intensity. We therefore developed a global high-resolution map of dengue transmission intensity by fitting environmentally driven geospatial models to geolocated force of infection estimates derived from cross-sectional serological surveys and routine case surveillance data. We assessed the impact of interventions on dengue transmission and disease using -infected mosquitoes and the Sanofi-Pasteur vaccine as specific examples. We predicted high transmission intensity in all continents straddling the tropics, with hot spots in South America (Colombia, Venezuela, and Brazil), Africa (western and central African countries), and Southeast Asia (Thailand, Indonesia, and the Philippines). We estimated that 105 [95% confidence interval (CI), 95 to 114] million dengue infections occur each year with 51 (95% CI, 32 to 66) million febrile disease cases. Our analysis suggests that transmission-blocking interventions such as , even at intermediate efficacy (50% transmission reduction), might reduce global annual disease incidence by up to 90%. The Sanofi-Pasteur vaccine, targeting only seropositive recipients, might reduce global annual disease incidence by 20 to 30%, with the greatest impact in high-transmission settings. The transmission intensity map presented here, and made available for download, may help further assessment of the impact of dengue control interventions and prioritization of global public health efforts.
登革热干预规划需要可靠的登革热传播强度估计。然而，目前的登革热风险图提供的是疾病负担或流行地区的估计，而不是传播强度。因此，我们通过拟合环境驱动的地理空间模型，将来自横断面血清学调查和常规病例监测数据的地理定位感染力估计值，制作了一张全球高分辨率登革热传播强度图。我们使用感染蚊子和赛诺菲巴斯德疫苗作为具体例子，评估了干预措施对登革热传播和疾病的影响。我们预测所有跨越热带的大陆都存在高强度传播，热点地区在南美洲（哥伦比亚、委内瑞拉和巴西）、非洲（西部和中部非洲国家）和东南亚（泰国、印度尼西亚和菲律宾）。我们估计每年有 1.05 亿（95%置信区间 [CI]，95%到 1.14 亿）例登革热感染，5100 万（95%CI，3200 万至 6600 万）例发热疾病病例。我们的分析表明，即使在中等效果（减少 50%的传播）的情况下，阻断传播的干预措施，如，可能将全球每年的疾病发病率降低高达 90%。赛诺菲巴斯德疫苗仅针对血清阳性接受者，可能将全球每年的疾病发病率降低 20%至 30%，在高传播环境中的影响最大。本文提供的传播强度图可下载，这可能有助于进一步评估登革热控制干预措施的影响，并为全球公共卫生工作确定优先事项。
