Spatiotemporal Variability in Dengue Transmission Intensity in Jakarta, Indonesia
Background: Approximately 70% of the global burden of dengue disease occurs on the Asian continent, where many large urban centres provide optimal environments for sustained endemic transmission and periodic epidemic cycles. Jakarta, the capital of Indonesia, is a densely populated megacity with hyperendemic dengue transmission. Characterization of the spatiotemporal distribution of dengue transmission intensity is of key importance for optimal implementation of novel control and preventative programmes, including vaccination. In this paper we use mathematical models to provide the first detailed description of spatial and temporal variability in dengue transmission in Jakarta.
Methodology/Principal Findings: We used catalytic models in a Bayesian framework to estimate dengue force of infection and reporting probabilities from age-stratified dengue case-notification data reported in 42 subdistricts of Jakarta. The model was fit to yearly and cumulative data covering a 10-year period between 2008 and 2017. We estimated an average annual transmission intensity of 13.0% (95%CrI: 12.9-13.1%) per year in Jakarta province, ranging from 9.0% (95%CrI: 7.7-10.3%) to 16.4% (95%CrI: 15.3-17.4%) per year across subdistricts during 2008-2017. Annual average transmission intensity in Jakarta province ranged from 11.8% (95%CrI: 10.7-12.9%) in 2011 to 15.9% (95%CrI: 14.8-17.1%) in 2017. We estimate higher reporting probabilities in epidemic years, suggesting that local awareness of dengue transmission likely influenced reporting practices during 2008-2017.
Conclusions/Significance: While the absolute number of dengue case-notifications cannot be relied upon as a measure of endemicity, the age-distribution of reported dengue cases provides valuable insights into the underlying nature of transmission. Our estimates from yearly and cumulative case-notification data represent the first detailed estimates of dengue transmission intensity in the subdistricts of Jakarta, which will be important to consider when assessing the population-level impact and cost-effectiveness of potential control and preventative programmes, such as the controlled release of Wolbachia-carrying mosquitoes and vaccination, in Jakarta province.