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EARLY WARNING SYSTEM FOR DENGUE HEMORRHAGIC FEVER (DHF) EPIDEMICS IN MAKASSAR*

Halmar Halide1 , Rais1 and Peter Ridd2

Physics Dept. FMIPA Unhas, Makassar 90245, Indonesia 2 School of Engineering and Physical Sciences, Townsville, 4811 Australia *James Cook University, Th Oral presentation at the 54 Anniversary of Universitas
Hasanuddin, 16-17th August 2010, Makassar - Indonesia. The paper is then published in Jurnal Matematika dan Sains ITB vol 16 (1): pp. 26-34 year 2011 (it is free on the internet)

Introduction:
What are the problems? DHF is escalating and spreading DHF is a costly disease, i.e. US$ 139 per case(4) almost twice the minimum monthly salary of US$79(5) DHF has no vaccine available(6) DHF mosquito-control fails to prevent outbreaks

DHF is escalating and spreading

Figure 1. DH/DHF cases around the world from 1955-1999(1))

Figure 2. DHF cases and places affected Figure 3. Projected Dengue Fever in Indonesia from 1968-2003(2) spreads under warmer temperature. Estimated population at risk in year 1990 (A) and 2085 (B)(3).

DHF mosquito-control fails to prevent outbreaks

Figure 4. Fogging activity (depicted in arrows) has no-clear effect on preventing DHF outbreaks(2)

How should we response? be prepared for any outbreak by inventing a timely and accurate early warning system Systems available at present require: extensive data(7) and high computing power(3).

Aims of this study: To develop an early warning system for accurately predicting DHF outbreaks at sufficient lead times. Here an outbreak is defined when the number of cases above 50% quartile(8)

Data and Model


Model formulation: Multiple linear regression. Predictant: present DHF case; Predictors: past meteo-climate data and DHF cases. Predictors are selected using a stepwise method (at significant level of 0.95). Model cross-validation: Leave one-out Model skill: Peirce score measures(9),(10) SPSS, MATLAB and Visual Basic Figure 5. Meteorological, climatological DHF cases in Makassar(11). packages for computation.

Prediction Skill: time series


30 5 30 0 20 5 d ta a P 1 P 6 P2 1

D cases HF

20 0 10 5 10 0 5 0 0 -5 0 19 99

20 00

20 01

20 02

20 03

20 04

20 05

20 06

Ya er

Figure 6. Out-of-sample predictions(11)

Prediction Skill: skill measures


1

P irc S o e e c re

0 . 5

-. 0 5 0 2 4 6 8 1 0 1 2

Latmmt s ed e oh i ( n)

Figure 7. Prediction skill using peirce skill score for both the regression (o) and no-skill models (x)(11)

Early warning system

Figure 8. Three months ahead DHF early warning system(12)

Conclusion:
An early warning system has been developed using a simple model. The model is able to predict DHF outbreaks up to six month in advance using past data. The system is a useful tool for managing DHF epidemics(13).

Acknowledgement:
We thank Mr. M. A. Abdi, Mr. B. Hargiyono, Dr. H. Ishak, and the CPC-NCEP-NOAA and JAMSTEC for data used.

References:
(1) D. Gubler, 2002 Trends Microbiol 10: 100-103. (2) Ndoen et al., 2004http://www.pitt.edu/~super1/ lecture/lec17391/index.htm (3) Hales et al., 2002. Lancet 360: 830-834. (4) Shepard et al., 2004 Vaccine 42: 1275-1280 (5) D. Widarti, 2006http://www.ilo.org/public/english/ region/asro/jakarta/download/wagediah.pdf (6) Chadee et al., 2005 Trop Med Int Health 10:748-754. (7) Kuhn et al., 2005. WHO report. (8). Nisalak et al., 2003 Am J. Trop Med Hyg 68:191-202. (9) D.S. Wilks, 1995. Statistical methods in the atmospheric sciences. Academic Press, San Diego. (10) D. B. Stephenson, 2000. Weather Forecast 15: 221-232. (11) Halide, H. and P. Ridd, 2008.. Int. J.Env. Health Res. 18 (4): 253-265. (12) Rais, 2010. Sistem Peringatan Dini DBD (kasus kota Makassar), Thesis S1, Jur. Fisika FMIPA Unhas. (13) Halide, H., 2010. In: Handbook of Disease outbreaks: Prevention, Detection and Control (Editors: A. Holmgren and G. Borg), Nova Publisher, New York.