Hand hygiene program: "Go for 100*". Whole impact (hospital cost, MRSA attack, nosocomial infections and device related infections)
International Journal of Infectious Diseases
Dengue fever, a diseases caused by Dengue virus (DENV) and transmitted to humans by Aedes aegypti and Aedes albopictus mosquitoes, has been hyper-endemic in Singapore for several decades. In the absence of an effective vaccine or specific treatment to mitigate the infections, control of Aedes mosquitoes plays a critical role in controlling the disease. In recent years, Singapore's vector control operations have been overwhelmed by geographical expansion of dengue transmission as well as
... as well as increasing magnitude of epidemics. At the same time, they have been hampered by the lack of tools to assess the impending risk of dengue fever outbreaks spatially and manpower insufficiency. Methods & Materials: To help operation department allocate limited resources, we developed a predictive risk map for dengue transmission using the Random Forest algorithm, incorporating various risk factors and accounting for temporal and spatial lag effects of the factors. A wide range of factors representing the characteristics of past dengue situation (total number of cases in previous year and number of non-resident cases in previous year), human population (estimated population density), vector population (estimated ratio of Aedes aegypti mosquitoes out of all Aedes moquitoes-breeding percentage) and environment (vegetation index, connectivity index and ratio of residential area) were examined and incorporated in the model. Results: Validation using most recent data showed that the observed and the predicted risk ranks had a Pearson correlation of 0.87 (P < 0.001) and a weighted Kappa agreement of 0.814 (P < 0.001) when categorised to risk groups. In addition, the model was able to estimate the partial effects and relative importance of individual risk factors, which can strengthen our understanding of the risk factors of dengue transmission. Conclusion: Our risk map has strong predictive capability, hence may be an important tool in guiding targeted vector control interventions for dengue. http://dx.