The Role of Serotype Interactions and Seasonality in Dengue Model Selection and Control: Insights from a Pattern Matching Approach

PLoS Negl Trop Dis. 2016 May 9;10(5):e0004680. doi: 10.1371/journal.pntd.0004680. eCollection 2016 May.

Abstract

The epidemiology of dengue fever is characterized by highly seasonal, multi-annual fluctuations, and the irregular circulation of its four serotypes. It is believed that this behaviour arises from the interplay between environmental drivers and serotype interactions. The exact mechanism, however, is uncertain. Constraining mathematical models to patterns characteristic to dengue epidemiology offers a means for detecting such mechanisms. Here, we used a pattern-oriented modelling (POM) strategy to fit and assess a range of dengue models, driven by combinations of temporary cross protective-immunity, cross-enhancement, and seasonal forcing, on their ability to capture the main characteristics of dengue dynamics. We show that all proposed models reproduce the observed dengue patterns across some part of the parameter space. Which model best supports the dengue dynamics is determined by the level of seasonal forcing. Further, when tertiary and quaternary infections are allowed, the inclusion of temporary cross-immunity alone is strongly supported, but the addition of cross-enhancement markedly reduces the parameter range at which dengue dynamics are produced, irrespective of the strength of seasonal forcing. The implication of these structural uncertainties on predicted vulnerability to control is also discussed. With ever expanding spread of dengue, greater understanding of dengue dynamics and control efforts (e.g. a near-future vaccine introduction) has become critically important. This study highlights the capacity of multi-level pattern-matching modelling approaches to offer an analytic tool for deeper insights into dengue epidemiology and control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Computer Simulation
  • Dengue / epidemiology*
  • Dengue / immunology
  • Dengue / prevention & control*
  • Dengue Virus / classification*
  • Humans
  • Models, Biological*
  • Pattern Recognition, Automated*
  • Seasons*
  • Serogroup
  • Trinidad and Tobago / epidemiology

Grants and funding

QAtB acknowledges a graduate student fellowship from the Eck Institute for Global health; EM acknowledges the joint financial support of the Office of the Vice President for Research (OVPR) and the Eck Institute for Global Health, the University of Notre Dame, for completing this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.