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What caused the 2012 dengue outbreak in Pucallpa, Peru? A socio-ecological autopsy

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dc.contributor.author Charette, Margot
dc.contributor.author Berrang-Ford, Lea
dc.contributor.author Llanos-Cuentas, Elmer Alejandro
dc.contributor.author Carcamo, Cesar
dc.contributor.author Kulkarni, Manisha
dc.date.accessioned 2019-01-25T16:20:56Z
dc.date.available 2019-01-25T16:20:56Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/4797
dc.description.abstract Dengue is highly endemic in Peru, with increases in transmission particularly since vector re-infestation of the country in the 1980s. Pucallpa, the second largest city in the Peruvian Amazon, experienced a large outbreak in 2012 that caused more than 10,000 cases and 13 deaths. To date, there has been limited research on dengue in the Peruvian Amazon outside of Iquitos, and no published review or critical analysis of the 2012 Pucallpa dengue outbreak. This study describes the incidence, surveillance, and control of dengue in Ucayali to understand the factors that contributed to the 2012 Pucallpa outbreak. We employed a socio-ecological autopsy approach to consider distal and proximal contributing factors, drawing on existing literature and interviews with key personnel involved in dengue control, surveillance and treatment in Ucayali. Spatio-temporal analysis showed that relative risk of dengue was higher in the northern districts of Calleria (RR = 2.18), Manantay (RR = 1.49) and Yarinacocha (RR = 1.25) compared to all other districts between 2004 and 2014. The seasonal occurrence of the 2012 outbreak is consistent with typical seasonal patterns for dengue incidence in the region. Our assessment suggests that the outbreak was proximally triggered by the introduction of a new virus serotype (DENV-2 Asian/America) to the region. Increased travel, rapid urbanization, and inadequate water management facilitated the potential for virus spread and transmission, both within Pucallpa and regionally. These triggers occurred within the context of failures in surveillance and control programming, including underfunded and ad hoc vector control. These findings have implications for future prevention and control of dengue in Ucayali as new diseases such as chikungunya and Zika threaten the region. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof urn:issn:1873-5347
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Dengue en_US
dc.subject Disease Outbreaks en_US
dc.subject Environmental health en_US
dc.subject Infectious disease outbreak en_US
dc.subject Peru en_US
dc.subject Dengue Virus/pathogenicity en_US
dc.subject Dengue/diagnosis/epidemiology/transmission en_US
dc.subject Humans en_US
dc.subject Incidence en_US
dc.subject Peru/epidemiology en_US
dc.subject Population Surveillance/methods en_US
dc.subject Risk Assessment/methods en_US
dc.subject Seasons en_US
dc.subject Spatio-Temporal Analysis en_US
dc.title What caused the 2012 dengue outbreak in Pucallpa, Peru? A socio-ecological autopsy en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.socscimed.2016.12.010
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#6.01.01
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#6.03.01
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.00.00

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