The impact of COVID-19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility.
PLoS Negl Trop Dis
; 15(6): e0009420, 2021 06.
Article
in English
| MEDLINE | ID: covidwho-1264205
ABSTRACT
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.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Dengue
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Reviews
Limits:
Adult
/
Child
/
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
PLoS Negl Trop Dis
Journal subject:
Tropical Medicine
Year:
2021
Document Type:
Article
Affiliation country:
Journal.pntd.0009420
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