The role of disease-driven human mobility changes in dengue transmission Restricted; Files Only
Schaber, Kathryn (Fall 2019)
Abstract
Human mobility plays a central role in shaping pathogen transmission by generating spatial and/or individual variability in potential pathogen-transmitting contacts. Fine-scale, daily mobility patterns are of particular importance for viruses spread by Aedes aegypti, a day-biting mosquito with a limited flight range and a propensity for residential locations. Indeed, house-to-house human movement has been shown to underlie spatial patterns of dengue incidence. Recent research has shown, however, that symptomatic infection can influence human mobility and pathogen transmission dynamics. While the mobility changes of a symptomatic individual and their social contacts can significantly influence the spread of directly transmitted pathogens, they have not yet been included in theoretical models of dengue virus (DENV) transmission. This dissertation aims to determine the importance of dynamic human mobility patterns for human-mosquito contact networks that lead to DENV transmission heterogeneity. Data were analyzed on the mobility of symptomatic dengue cases and their social contacts, then the impact of these disease-driven mobility changes on human-mosquito contacts and onward DENV transmission was determined. I found that presence and magnitude of mobility change depended on the day of illness and the individual’s sense of well-being, with the largest decrease in mobility occurring on the first three days of symptoms when infectiousness is peaking. Almost all symptomatic individuals received help from their housemates throughout illness and continued to receive visits from their ‘routine visitors’, most of whom were aware of the illness. Those who did help symptomatic individuals only made mobility changes drastic enough to affect their work in 28% of cases. When accounting for symptomatic mobility change, there were significant changes in the number of expected mosquito bites an infectious individual received, the location the bites occurred, and the individual’s predicted onward transmission. I also found that the role of biting suitability in determining an individual’s onward transmission can be dependent on the density of mosquitoes in the individual’s home. Broadly, these results display a variety of ways symptomatic dengue illness can impact human mobility patterns, further affecting an individual’s exposure to human-mosquito contacts and their overall contribution to DENV transmission.
Table of Contents
CHAPTER I: INTRODUCTION 1
1.1 Human movement, social contacts, and vector-borne disease 1
1.2 Dengue as a model system 3
1.3 Study Area 4
1.4 Dissertation Summary 5
1.5 References 6
CHAPTER II: DENGUE ILLNESS IMPACTS DAILY HUMAN MOBILITY PATTERNS IN IQUITOS, PERU 10
2.1 Introduction 10
2.2 Methods 12
2.3 Results 19
2.4 Discussion 23
2.5 Tables 27
Table 2.1 27
Table 2.2 27
Table 2.3 27
Table 2.4 28
Table 2.5 28
2.6 Figures 29
Figure 2.1 29
Figure 2.2 30
Figure 2.3 31
Figure 2.4 32
2.7 Supplementary materials 33
Text S2.1 33
Table S2.1 33
Table S2.2 34
Table S2.3 34
Table S2.4 35
Table S2.5 36
Table S2.6 37
Table S2.7 38
Table S2.8 38
Table S2.9 38
Table S2.10 39
Table S2.11 39
Table S2.12 39
Table S2.13 39
Figure S2.1 40
Figure S2.2 41
Figure S2.3 42
2.8 References 43
CHAPTER III: THE UNEXPECTED COST OF CAREGIVING FOR SYMPTOMATIC DENGUE CASES 48
3.1 Introduction 48
3.2 Methods 50
3.3 Results 55
3.4 Discussion 59
3.5 Tables 63
Table 3.1 63
Table 3.2 64
Table 3.3 65
3.6 Figures 65
Figure 3.1 65
Figure 3.2 66
Figure 3.3 67
Figure 3.4 68
3.7 Supplementary materials 69
Table S3.1 69
Table S3.2 69
Table S3.3 70
Table S3.4 71
Table S3.5 72
Table S3.6 73
Table S3.7 74
Table S3.8 75
Table S3.9 76
Table S3.10 77
Table S3.11 78
Table S3.12 79
3.8 References 80
CHAPTER IV: THE IMPACT OF SYMPTOMATIC MOBILITY CHANGE ON DENGUE VIRUS TRANSMISSION 84
4.1 Introduction 84
4.2 Methods 86
4.3 Results 96
4.4 Discussion 100
4.5 Tables 103
Table 4.1 103
Table 4.2 103
Table 4.3 104
Table 4.4 104
4.6 Figures 105
Figure 4.1 105
Figure 4.2 106
Figure 4.3 107
Figure 4.4 108
Figure 4.5 109
Figure 4.6 110
Figure 4.7 110
4.7 Supplementary materials 111
Table S4.1 111
Table S4.2 111
Table S4.3 112
Table S4.4 113
Table S4.5 114
Table S4.6 115
Table S4.7 116
Table S4.8 116
Table S4.9 117
Table S4.10 118
Table S4.11 119
Table S4.12 120
Table S4.13 121
Table S4.14 122
Table S4.15 123
Table S4.16 123
Table S4.17 124
Figure S4.1 125
Figure S4.2 125
Figure S4.3 126
Figure S4.4 126
Figure S4.5 127
Figure S4.6 127
Figure S4.7 128
Figure S4.8 129
Figure S4.9 130
Figure S4.10 130
Figure S4.11 131
Figure S4.12 132
Figure S4.13 132
Figure S4.14 133
Figure S4.15 133
4.8 References 134
CHAPTER V: CONCLUSION 138
5.1 Summary of Results 138
5.2 Future Directions 140
5.3 References 141
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