Research ArticleDengue

Mapping global variation in dengue transmission intensity

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Science Translational Medicine  29 Jan 2020:
Vol. 12, Issue 528, eaax4144
DOI: 10.1126/scitranslmed.aax4144

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At last, an atlas of dengue spread

Transmitted by Aedes mosquitos worldwide, dengue virus causes flu-like symptoms and, in severe cases, hemorrhaging and potentially death. In this Research Resource, Cattarino et al. present a downloadable high-resolution map of the global variation in dengue transmission intensity. The authors developed this map by fitting geospatial serology and surveillance data to force of infection estimates derived from environmental and demographic predictors. Using this data to evaluate potential dengue control strategies, they predicted that Wolbachia-based intervention may be more likely than the Sanofi-Pasteur vaccine to reduce the global disease burden.


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 Wolbachia-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 Wolbachia, 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.

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