Grupo de Ecología Cuantitativa, INIBIOMA-CONICET, Universidad Nacional del Comahue, S.C. de Bariloche, Río Negro, Argentina.
Gerencia Operativa de Epidemiología, Ministerio de Salud de la Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
PLoS Negl Trop Dis. 2021 Jun 11;15(6):e0009465. doi: 10.1371/journal.pntd.0009465. eCollection 2021 Jun.
Dengue is steadily increasing worldwide and expanding into higher latitudes. Current non-endemic areas are prone to become endemic soon. To improve understanding of dengue transmission in these settings, we assessed the spatiotemporal dynamics of the hitherto largest outbreak in the non-endemic metropolis of Buenos Aires, Argentina, based on detailed information on the 5,104 georeferenced cases registered during summer-autumn of 2016. The highly seasonal dengue transmission in Buenos Aires was modulated by temperature and triggered by imported cases coming from regions with ongoing outbreaks. However, local transmission was made possible and consolidated heterogeneously in the city due to housing and socioeconomic characteristics of the population, with 32.8% of autochthonous cases occurring in slums, which held only 6.4% of the city population. A hierarchical spatiotemporal model accounting for imperfect detection of cases showed that, outside slums, less-affluent neighborhoods of houses (vs. apartments) favored transmission. Global and local spatiotemporal point-pattern analyses demonstrated that most transmission occurred at or close to home. Additionally, based on these results, a point-pattern analysis was assessed for early identification of transmission foci during the outbreak while accounting for population spatial distribution. Altogether, our results reveal how social, physical, and biological processes shape dengue transmission in Buenos Aires and, likely, other non-endemic cities, and suggest multiple opportunities for control interventions.
登革热在全球范围内呈稳步上升趋势，并向高纬度地区蔓延。目前非流行地区很快就会流行起来。为了更好地了解这些地区的登革热传播情况，我们评估了迄今为止在阿根廷非流行大都市布宜诺斯艾利斯最大的一次暴发的时空动态，该评估基于对 2016 年夏秋季登记的 5104 例经地理定位病例的详细信息。布宜诺斯艾利斯高度季节性的登革热传播受到温度的调节，并由来自正在暴发疫情地区的输入病例引发。然而，由于人口的住房和社会经济特征，本地传播成为可能，并在城市中异质地巩固，32.8%的本地病例发生在贫民窟，而贫民窟仅占城市人口的 6.4%。一个考虑到病例检测不完美的分层时空模型表明，在贫民窟外，住房（而非公寓）较贫困的街区有利于传播。全球和本地时空点格局分析表明，大多数传播发生在或靠近家中。此外，基于这些结果，我们评估了在暴发期间进行基于人群空间分布的早期识别传播焦点的点格局分析。总之，我们的研究结果揭示了社会、物理和生物过程如何塑造布宜诺斯艾利斯的登革热传播，可能也塑造了其他非流行城市的登革热传播，并为控制干预措施提供了多种机会。
