Assessing health burden risk and control effect on dengue fever infection in the southern region of Taiwan

Cheng, Yi-Hsien; Lin, Yi-Jun; Chen, Szu-Chieh; You, Shu-Han; Chen, Wei-Yu; Hsieh, Nan-Hung; Yang, Ying-Fei; Liao, Chung-Min

To capture temperature and R 0 variability featured dengue burden risk (DALYs), we began with estimating the seasonvaried temperature and R 0 . Figure 6A shows temperature 1 7 1 7 1 7 1 7 1 7 1 7 1 7 1 7 1 7 1 7 1 7 1 7 1 7 Monthly burden of dengue fever (DALYs) Figure 6B ). Figure 6C -F displays ER profiles conceived with DALYsbased dengue health burden given temperature and R 0 variability. Generally, most dengue cases occurred in the fall with a risk probability of 50% (ER=0.5) and had DALYs estimates of 323 (95% CI: 267-379) ( Figure 6D and Table 4 ), whereas the least dengue cases were likely to occur in winter with DALYs estimates of 60 (45-75) ( Figure 6E and Table 4 ). Taking all seasons into consideration, DALYs estimates were more likely (ER=0.8), likely (ER= 0.5), and less likely (ER =0.2) to be 127 (95% CI: 91-163), 148 (115-181), and 419 (358-479), respectively ( Figure 6F and Table 4 ). Among all interventions, repellent spray alone by hosts can achieve the highest control effectiveness of 70.76%, 75.75%, 72.79%, and 76.39% in all seasons, summer, fall, and winter, respectively ( Figure 7E ). Although the combination of the two (e R +e S ) and three (e R +e S +e C ) highest efficacy control measures being considered simultaneously, >77% and >83% control effectiveness for the fall season can be reached, respectively. In addition, in order to achieve optimum containment of dengue outbreak, we further considered a four efficacy control strategy. As shown in control effectiveness, repellent use, pesticide spray, container clean-up, together with Wolbachia infection (e R +e S +e C +e W ) could suppress dengue outbreak by 90%-100% ( Figure 7E ).