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A deviation bar chart for detecting dengue outbreaks in Puerto Rico

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  • Rigau-Pérez, J.G.
  • Millard, P.S.
  • Walker, D.R.
  • Deseda, C.C.
  • Casta-Vélez, A.

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.

Suggested Citation

  • Rigau-Pérez, J.G. & Millard, P.S. & Walker, D.R. & Deseda, C.C. & Casta-Vélez, A., 1999. "A deviation bar chart for detecting dengue outbreaks in Puerto Rico," American Journal of Public Health, American Public Health Association, vol. 89(3), pages 374-378.
    • Handle: RePEc:aph:ajpbhl:1999:89:3:374-378_9
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    Cited by:

    1. Laith Hussain-Alkhateeb & Tatiana Rivera Ramírez & Axel Kroeger & Ernesto Gozzer & Silvia Runge-Ranzinger, 2021. "Early warning systems (EWSs) for chikungunya, dengue, malaria, yellow fever, and Zika outbreaks: What is the evidence? A scoping review," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(9), pages 1-25, September.

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