Spatial Analysis of the Environmental and Demographic Drivers of Dengue, Chikungunya and Zika in Natal, Brazil Open Access

Abstract

Background: Dengue, Chikungunya and Zika are vector borne diseases of major public health concern with common vectors Aedes aegypti and Aedes albopictus. Prevention and vector control have been a major issue, especially in resource scarce settings. Understanding similarities in spatial pattern can provide invaluable information in decision making for stake holders efforts in management of scarce resources used in vector control and public health preparedness. 

Objective: To identify similarities in spatial patterns of Dengue, Chikungunya and Zika in the city of Natal, Brazil and how these patterns are associated with demographic and environmental factors.

Methods: Spatial analytical methods such as overlay analysis, and Local Identification of Spatial Autocorrelation (LISA) were used to investigate similarities in spatial patterns of disease spread as well as relationships between areas of spread and demographic and environmental factors. Chi-square test of independence was used to test and establish relationships between clustering of disease cases and Aedes mosquito population using Aedes mosquito eggs as a proxy.

Results: Presence of a relationship between high population density and high number of cases was observed from overlay analysis. Identification of clusters also showed similarities in areas where cases of Dengue, Chikungunya and Zika clustered. Statically significant association was established between significant cluster of high number of Aedes mosquito eggs and hotspot areas of all three diseases.

Discussion: The results of this study provides positive indications of the possibility of predicting either Dengue, Chikungunya and Zika in areas where at least one is present and the other two are not. It also shows that conditions that promotes the spread of one can likely promote the spread, outbreak or emergence of the other two.

Table of Contents

Abstract ……………………………………………………………………………………………………………………..i

Acknowledgments……………………………………………………………………………………………......………iii

Table of Contents…………………………………………………………………………………………………..……..iv

INTRODUCTION…………………………………………………………………………………………………..……...1

MATERIALS AND METHODS …………………………………………………………………………………....……13

RESULTS ……………………………………………………………………………………………………………………17

DISCUSSION……………………………………………………………………………………………………..………..22

REFERENCES ……………………………………………………………………………………………………………..24

FIGURE……………………………………………………………………………………………………………….…….28

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Environmental Health Environmental Sciences Health Sciences, Public Health
Keyword	Aedes albopictus Disease Cold spots Dengue Chikungunya Arthropods Zika Spatial Analysis Disease Hotspots Natal Brazil Cluster Aedes aegypti
Committee Chair / Thesis Advisor	Gonzalo M. Vazquez-Prokopec, Emory University

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