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SPATIAL PATTERNS OF AND RISK FACTORS FOR SEROPOSITIVITY FOR DENGUE INFECTION

Spatial patterns of and risk factors for seropositivity of dengue infection were studied in three sites in northern Thailand. A survey was conducted in 2001 among 1,750 persons. Potential risk factors for dengue infection were measured by questionnaire and IgM antibodies against dengue were detected by an enzyme-linked immunosorbent assay. The role of landscape as a risk factor was studied using land cover maps and a geographic information system. Logistic regression identified risk factors for dengue seropositivity. Spatial patterns of seropositive cases were determined by cluster analyses. Six percent of the study population was seropositive. Risk factors for dengue seropositivity differed per site, demonstrating variation in local infection patterns. In the periurban site, seropositivity depended on human behavior and factors related to housing quality rather than environmental factors. In both rural sites, older persons had a higher risk of seropositivity and persons living in houses surrounded by natural and agricultural land covers had a lower risk of seropositivity.

Received March 23, 2004. Accepted for publication September 8, 2004.

Acknowledgments: We thank all participants in the epidemiologic dengue survey for their participation, and the staff of the Vector Borne Disease Control (VBDC) units and VBDC Office No. 2, as well as the local public health volunteers for their collaboration. We also thank our partners of RISKMODEL for their collaboration, and Paul Klatser and Mirjam Bakker for critically reading the manuscript.

Financial support: This study was supported by European Union grant QLRT-1999-31787, provided within the Quality of Life and Management of Living Resources Program (1998–2002).

Authors’ addresses: Birgit H. B. van Benthem and Linda Oskam, Koninklijk Insituut voor de Tropen/Royal Tropical Institute, Biomedical Research, Meibergdreef 39, 1105 AZ Amsterdam, The Netherlands, Telephone: 31-20-566-5450, Fax: 31-20-697-1841, E-mails: b.v.benthem{at}kit.nl and l.oskam{at}kit.nl. Sophie O. Vanwambeke and Eric F. Lambin, Department of Geography, Université Catholique de Louvain, Louvain, Belgium, E-mails: vanwambeke{at}gorg.ucl.ac.be and lambin{at}geog.ucl.ac.be. Nardlada Khantikul and Kamolwan Panart, Office of Vector Borne Disease Control No. 2, 18 Boonruangrit Road, Muang District, Chiang Mai 50200, Thailand, E-mails: ornardlada{at}hotmail.com and malar{at}chmai.loxinfo.co.th. Chantal Burghoorn-Maas, Institute of Virology, Erasmus University, Rotterdam, The Netherlands, E-mail: c.maas{at}erasmusmc.nl. Pradya Somboon, Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand, E-mail: psomboon{at}mail.med.cmu.ac.th.

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