The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility
Background Dengue is one of the major public health problems in Sri Lanka. Its outbreak pattern depends on a multitude of drivers, including human mobility. Here we evaluate the impact of COVID–19 related mobility restriction (lockdown) on the risk of dengue in Sri Lanka. Methodology Two-stage hiera...
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ftdoajarticles:oai:doaj.org/article:245f98a70da54809b548c38c10908668 2023-05-15T15:17:56+02:00 The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility Prasad Liyanage Joacim Rocklöv Hasitha Aravinda Tissera 2021-06-01T00:00:00Z https://doaj.org/article/245f98a70da54809b548c38c10908668 EN eng Public Library of Science (PLoS) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192006/?tool=EBI https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 https://doaj.org/article/245f98a70da54809b548c38c10908668 PLoS Neglected Tropical Diseases, Vol 15, Iss 6 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles 2022-12-31T06:52:07Z Background Dengue is one of the major public health problems in Sri Lanka. Its outbreak pattern depends on a multitude of drivers, including human mobility. Here we evaluate the impact of COVID–19 related mobility restriction (lockdown) on the risk of dengue in Sri Lanka. Methodology Two-stage hierarchical models were fitted using an interrupted time-series design based on the notified dengue cases, January 2015 to July 2020. In the first stage model, the district level impact was estimated using quasi-Poisson regression models while accounting for temporal trends. Estimates were pooled at zonal and national levels in the second stage model using meta-analysis. The influence of the extended period of school closure on dengue in children in the western province was compared to adults. Findings Statistically significant and homogeneous reduction of dengue risk was observed at all levels during the lockdown. Overall an 88% reduction in risk (RR 0.12; 95% CI from 0.08 to 0.17) was observed at the national level. The highest impact was observed among children aged less than 19 years showing a 92% reduction (RR 0.8; 95% CI from 0.03 to 0.25). We observed higher impact in the dry zone having 91% reduction (RR 0.09; 95% CI from 0.05 to 0.15) compared to wet zone showing 83% reduction (RR 0.17; 95% CI from 0.09 to 0.30). There was no indication that the overall health-seeking behaviour for dengue had a substantial influence on these estimates. Significance This study offers a broad understanding of the change in risk of dengue during the COVID–19 pandemic and associated mobility restrictions in Sri Lanka. The analysis using the mobility restrictions as a natural experiment suggests mobility patterns to be a very important driver of dengue transmission. Author summary Every year about 100 million symptomatic dengue cases occur with the highest-burden reported in Southeast Asia followed by Latin America. The burden is increasing and considered driven by population densities, human mobility, vector proliferation, and ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Prasad Liyanage Joacim Rocklöv Hasitha Aravinda Tissera The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Dengue is one of the major public health problems in Sri Lanka. Its outbreak pattern depends on a multitude of drivers, including human mobility. Here we evaluate the impact of COVID–19 related mobility restriction (lockdown) on the risk of dengue in Sri Lanka. Methodology Two-stage hierarchical models were fitted using an interrupted time-series design based on the notified dengue cases, January 2015 to July 2020. In the first stage model, the district level impact was estimated using quasi-Poisson regression models while accounting for temporal trends. Estimates were pooled at zonal and national levels in the second stage model using meta-analysis. The influence of the extended period of school closure on dengue in children in the western province was compared to adults. Findings Statistically significant and homogeneous reduction of dengue risk was observed at all levels during the lockdown. Overall an 88% reduction in risk (RR 0.12; 95% CI from 0.08 to 0.17) was observed at the national level. The highest impact was observed among children aged less than 19 years showing a 92% reduction (RR 0.8; 95% CI from 0.03 to 0.25). We observed higher impact in the dry zone having 91% reduction (RR 0.09; 95% CI from 0.05 to 0.15) compared to wet zone showing 83% reduction (RR 0.17; 95% CI from 0.09 to 0.30). There was no indication that the overall health-seeking behaviour for dengue had a substantial influence on these estimates. Significance This study offers a broad understanding of the change in risk of dengue during the COVID–19 pandemic and associated mobility restrictions in Sri Lanka. The analysis using the mobility restrictions as a natural experiment suggests mobility patterns to be a very important driver of dengue transmission. Author summary Every year about 100 million symptomatic dengue cases occur with the highest-burden reported in Southeast Asia followed by Latin America. The burden is increasing and considered driven by population densities, human mobility, vector proliferation, and ... |
format |
Article in Journal/Newspaper |
author |
Prasad Liyanage Joacim Rocklöv Hasitha Aravinda Tissera |
author_facet |
Prasad Liyanage Joacim Rocklöv Hasitha Aravinda Tissera |
author_sort |
Prasad Liyanage |
title |
The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility |
title_short |
The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility |
title_full |
The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility |
title_fullStr |
The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility |
title_full_unstemmed |
The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility |
title_sort |
impact of covid–19 lockdown on dengue transmission in sri lanka; a natural experiment for understanding the influence of human mobility |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doaj.org/article/245f98a70da54809b548c38c10908668 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 6 (2021) |
op_relation |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192006/?tool=EBI https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 https://doaj.org/article/245f98a70da54809b548c38c10908668 |
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1766348179136053248 |