Event history analysis of dengue fever epidemic and inter-epidemic spells in Barbados, Brazil, and Thailand

SummaryObjectiveThis study investigated meteorological and demographic factors affecting the length of dengue fever epidemics and the length of time between epidemics in Barbados, Brazil, and Thailand.MethodsRegion-specific meteorological and demographic data were collected for 104 sites from public sources. Fixed effects piecewise logistic event history analysis was used to quantify the effects of time-varying covariates on the duration of inter-epidemic spells and for the duration of epidemics.ResultsMean monthly temperature was the most important factor affecting the duration of both inter-epidemic spells (β = 0.543; confidence interval (CI) 0.4954, 0.5906) and epidemic spells (β = −0.648; CI −0.7553, −0.5405). Drought conditions increased the time between epidemics. Increased temperature hastened the onset of an epidemic, and during an epidemic, higher mean temperature increased the duration of the epidemic.ConclusionsBy using a duration analysis, this study offers a novel approach for investigating the dynamics of dengue fever epidemiology. Furthermore, these results offer new insights into prior findings of a correlation between temperature and the geographic range and vector efficiency of dengue fever.