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American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Mar;89(3):374–378. doi: 10.2105/ajph.89.3.374

A deviation bar chart for detecting dengue outbreaks in Puerto Rico.

J G Rigau-Pérez 1, P S Millard 1, D R Walker 1, C C Deseda 1, A Casta-Vélez 1
PMCID: PMC1508601  PMID: 10076488

Abstract

OBJECTIVES: A Centers for Disease Control and Prevention deviation bar chart (Statistical Software for Public Health Surveillance) and laboratory-based surveillance data were evaluated for their utility in detecting dengue outbreaks in Puerto Rico. METHODS: A significant increase in dengue incidence was defined as an excess of suspected cases of more than 2 SDs beyond the mean for all 4-week periods from April through June (the period of lowest seasonal incidence), 1989 through 1993. An outbreak was defined as a cumulative annual rate of reported dengue greater than 3 per 1000 population. RESULTS: Retrospective application of the system to 1994 data showed agreement with previous analyses. In 1995 and 1996, 36.4% and 27.3%, respectively, of municipalities with a significant increase in reports for 2 or more consecutive weeks before the first week of September had an outbreak, compared with 9.0% (in 1995, P = .042) and 6.0% (in 1996, P = .054) of towns without a significant increase. The system showed sensitivity near 40%, specificity near 89%, and accuracy in classifying municipalities near 84%. CONCLUSIONS: This method provides a statistically based, visually striking, specific, and timely signal for dengue control efforts.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Gubler D. J., Casta-Valez A. A program for prevention and control of epidemic dengue and dengue hemorrhagic fever in Puerto Rico and the U.S. Virgin Islands. Bull Pan Am Health Organ. 1991;25(3):237–247. [PubMed] [Google Scholar]
  2. Mayer J. D. Medical geography. An emerging discipline. JAMA. 1984 May 25;251(20):2680–2683. [PubMed] [Google Scholar]
  3. Morens D. M., Rigau-Pérez J. G., López-Correa R. H., Moore C. G., Ruiz-Tibén E. E., Sather G. E., Chiriboga J., Eliason D. A., Casta-Velez A., Woodall J. P. Dengue in Puerto Rico, 1977: public health response to characterize and control an epidemic of multiple serotypes. Am J Trop Med Hyg. 1986 Jan;35(1):197–211. doi: 10.4269/ajtmh.1986.35.197. [DOI] [PubMed] [Google Scholar]
  4. Stroup D. F., Wharton M., Kafadar K., Dean A. G. Evaluation of a method for detecting aberrations in public health surveillance data. Am J Epidemiol. 1993 Feb 1;137(3):373–380. doi: 10.1093/oxfordjournals.aje.a116684. [DOI] [PubMed] [Google Scholar]
  5. Stroup D. F., Williamson G. D., Herndon J. L., Karon J. M. Detection of aberrations in the occurrence of notifiable diseases surveillance data. Stat Med. 1989 Mar;8(3):323–332. doi: 10.1002/sim.4780080312. [DOI] [PubMed] [Google Scholar]
  6. Wharton M., Price W., Hoesly F., Woolard D., White K., Greene C., McNabb S. Evaluation of a method for detecting outbreaks of diseases in six states. Am J Prev Med. 1993 Jan-Feb;9(1):45–49. [PubMed] [Google Scholar]

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