Impact of human mobility on the emergence of dengue epidemics in Pakistan

Abstract

The recent emergence of dengue viruses into new susceptible human populations throughout Asia and the Middle East, driven in part by human travel on both local and global scales, represents a significant global health risk, particularly in areas with changing climatic suitability for the mosquito vector. In Pakistan, dengue has been endemic for decades in the southern port city of Karachi, but large epidemics in the northeast have emerged only since 2011. Pakistan is therefore representative of many countries on the verge of countrywide endemic dengue transmission, where prevention, surveillance, and preparedness are key priorities in previously dengue-free regions. We analyze spatially explicit dengue case data from a large outbreak in Pakistan in 2013 and compare the dynamics of the epidemic to an epidemiological model of dengue virus transmission based on climate and mobility data from ∼40 million mobile phone subscribers. We find that mobile phone-based mobility estimates predict the geographic spread and timing of epidemics in both recently epidemic and emerging locations. We combine transmission suitability maps with estimates of seasonal dengue virus importation to generate fine-scale dynamic risk maps with direct application to dengue containment and epidemic preparedness.dengue | human mobility | Pakistan | mobile phones | epidemiology

Dengue: knowledge gaps, unmet needs, and research priorities

“…ICTs and social networks can play an important role in disease, vector and outbreak reporting from the community to local and regional authorities. A handful of such technologies have been used successfully in pilot implementations and within studies, including using cell phone tower signals to track human movement for prediction of the most likely outbreak locations in Pakistan; 10 online and smart phone applications to report dengue mosquito breeding sites in Mexico 11 , Nicaragua and Colombia; and near real-time search-query data that estimate impending outbreaks globally (Google dengue-trends, DengueMap). While information gained through crowd-sourcing needs to be validated by laboratory confirmation of etiology, the power of these technologies together with the strength of communities mobilized through knowledge should be harnessed as integral aspects of national surveillance systems and for documenting the impact of vaccine introduction.…”

Challenges and Potential Opportunities of Mobile Phone Call Detail Records in Health Research: Review (Preprint)

“…Differential ownership of mobile phones among different sectors, particularly in low and middle income countries where much of CDR research takes place, also calls into question the representativeness of the data and thus the findings that ensue [72]. However, it has also been observed that despite biases, there a few, if any, data sources that can provide such rich spatial and temporal movement data, particularly for much-needed research in LMICs [61,64].…”

“…Wesolowski and team [64] detailed how they complied with the laws and regulations of Pakistan and the MNO Telenor, by using only data aggregated to tehsil level (an administrative unit of Pakistan). This was processed on their behalf by Telenor employees.…”

The ethics of big data as a public good: which public? Whose good?

“…Large-scale datasets from international mobile operators are being used in the realm of big data analytics to model the spread of diseases, such as dengue [11] and cholera [12], and to map poverty [13] and mobility [14]. Data from mobile financial transactions combined with mobile surveying are also showing potential as a way to plan savings and banking interventions [15], and records derived from mobile money platforms also have significant potential value for tracking income and spending.…”