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American Journal of Epidemiology Vol. 148, No. 11: 1111-1116
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

other

Determinants of Dengue 2 Infection among Residents of Charters Towers, Queensland, Australia

William John Hannan McBride1, Helen Mullner2, Reinhold Muller2, Justin Labrooy3 and Ian Wronski4

1Department of Pathology, Cairns Base Hospital Cairns, Queensland 4870, Australia
2Department of Public Health and Tropical Medicine, Faculty of Health, Life, and Molecular Sciences, James Cook University of North Queensland Douglas, Queensland 4811, Australia
3North Queensland Clinical School, Department of Medicine, Faculty of Health Sciences, University of Queensland Townsville, Queensland 4810, Australia
4Faculty of Health, Life, and Molecular Sciences, James Cook University of North Queensland Douglas, Queensland 4811, Australia

Dengue fever is caused by one of the four serotypes of the dengue virus and is transmitted by the urban mosquito Aedes aegypti. In 1993, the city of Charters Towers in the tropical north of Australia experienced an epidemic caused by the dengue 2 virus. A cross-sectional sample of 1, 000 people was assessed for determinants of recent symptomatic dengue infection. After exclusion of people with prior exposure to dengue 2, a study group of 797 persons, including 196 patients with recent infection, were evaluated. Stepwise logistic regression analysis identified four determinants of infection: the presence of a case of dengue fever within two residential blocks (odds ratio (OR) = 3.61, 95% confidence interval (Cl) 2.56–5.10), house screening (OR = 0.60, 95% Cl 0.40–0.89), the presence of a water tank within two residential blocks (OR = 1.51, 95% Cl 1.02–2.22), and the use of knockdown insecticide (OR = 1.75, 95% Cl 1.22–2.51). Classification and Regression Tree analysis identified a group of 152 individuals in whom the prevalence of dengue infection was 50%. These people lived within two blocks of a suspected dengue fever case, did not have house screening, and used knockdown sprays. If dengue had not occurred within two residential blocks, there were no additional factors that significantly influenced the prevalence of dengue fever. Control of dengue epidemics should involve attempts to geographically contain the spread of infection, use of house screening, and the removal of mosquito breeding sites such as water tanks. Am J Epidemiol 1998; 148: 1111-16.

arboviruses; dengue; dengue viruses; Flavivirus; logistic models; risk factors


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