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Published on: March 13, 2018
A deviation bar chart for detecting dengue outbreaks in Puerto Rico
J G Rigau-Pérez1, P S Millard, D R Walker
1Dengue Branch, Centers for Disease Control and Prevention, Atlanta, Ga., USA. jor1@cdc.gov
American Journal of Public Health
|March 17, 1999
Summary
A new surveillance system using Centers for Disease Control and Prevention (CDC) deviation bar charts effectively detects dengue outbreaks in Puerto Rico. This statistically based method provides timely signals for public health control efforts.
Area of Science:
- Public Health Surveillance
- Epidemiology
- Infectious Disease Dynamics
Background:
- Dengue outbreaks pose a significant public health challenge in tropical regions like Puerto Rico.
- Effective surveillance systems are crucial for early detection and control of dengue transmission.
Purpose of the Study:
- To evaluate the utility of a Centers for Disease Control and Prevention (CDC) deviation bar chart and laboratory data for detecting dengue outbreaks in Puerto Rico.
- To assess the statistical performance of the surveillance system in identifying outbreak conditions.
Main Methods:
- Defined significant increase in dengue incidence as >2 SDs above the mean for 4-week periods during low incidence season (April-June, 1989-1993).
- Defined an outbreak as a cumulative annual rate of reported dengue >3 per 1000 population.
- Applied the system retrospectively to 1994-1996 data, comparing municipalities with and without significant increases in case reports.
Main Results:
- The system showed high specificity (near 89%) and accuracy (near 84%) in classifying municipalities.
- Municipalities with significant increases in reports had a higher likelihood of experiencing a dengue outbreak (36.4% in 1995, 27.3% in 1996) compared to those without (9.0% in 1995, 6.0% in 1996).
- Sensitivity was near 40%.
Conclusions:
- The CDC deviation bar chart method offers a statistically sound and visually clear signal for dengue surveillance.
- This approach provides timely and specific information crucial for implementing effective dengue control measures.
- The system demonstrates practical utility for public health surveillance in identifying dengue outbreak risks.
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