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Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Informationon dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s DemocraticRepublic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. Inthis study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysingseasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet hada higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95%CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notificationrates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously,dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak,but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak.While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers,a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in thoseaged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengueinto new geographical areas in the southern provinces of Lao PDR.

Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Informationon dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s DemocraticRepublic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. Inthis study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysingseasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet hada higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95%CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notificationrates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously,dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak,but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak.While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers,a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in thoseaged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengueinto new geographical areas in the southern provinces of Lao PDR.

Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Informationon dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s DemocraticRepublic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. Inthis study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysingseasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet hada higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95%CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notificationrates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously,dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak,but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak.While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers,a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in thoseaged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengueinto new geographical areas in the southern provinces of Lao PDR.

Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Informationon dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s DemocraticRepublic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. Inthis study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysingseasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet hada higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95%CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notificationrates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously,dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak,but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak.While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers,a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in thoseaged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengueinto new geographical areas in the southern provinces of Lao PDR.

Dengue is a public health issue in tropical south-eastern Asia responsible for significant morbidity and mortality. Informationon dengue epidemiology is necessary for developing strategies to control infections effectively. In the Lao People’s DemocraticRepublic (Lao PDR), Champasak and Savannakhet provinces account for around 30% of the national dengue burden. Inthis study, the dengue epidemiological profile in these two southern provinces of Lao PDR was described by analysingseasonal and spatial dengue notification data from 2003–2020 using the long-term mean (LTM) method. Savannakhet hada higher LTM (132.0 cases/month, 95% confidence interval [Cl]: 92.2–171.7) than Champasak (113.3 cases/month, 95%CI: 86.0–140.5), with peaks in dengue notifications following the rainy season in both provinces. The highest notificationrates were observed in July to September; these months were also when the LTM was most frequently exceeded. Previously,dengue notifications were largely confined to the western districts of Savannakhet and the northern districts of Champasak,but more recently, notifications have increased in the eastern districts of Savannakhet and southern districts of Champasak.While the notification rate remained high in children and young adults (5–30 years), especially among students and farmers,a shift in the age structure of dengue cases was observed, with a greater proportion of notifications now occurring in thoseaged over 30 years. Community-based vector control and prevention programmes are needed to restrict the spread of dengueinto new geographical areas in the southern provinces of Lao PDR.

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. The detection of clinical cases enables us to measure the incidence of dengue infection, whereas serological surveys give insights into the prevalence of infection. This study aimed to determine dengue seroprevalence and seroconversion rates in northeastern Thailand and southern Laos and to assess any association of mosquito control methods and socioeconomic factors with dengue virus (DENV) infection. Cross-sectional seroprevalence surveys were performed in May and November 2019 on the same individuals. Blood samples were collected from one adult and one child, when possible, in each of 720 randomly selected households from two urban and two rural sites in both northeastern Thailand and southern Laos. IgG antibodies against DENV were detected in serum using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Overall, 1071 individuals participated in the study. The seroprevalence rate was high (91.5%) across all 8 study sites. Only age and province were associated with seroprevalence rates. There were 33 seroconversions during the period from May to November, of which seven reported fever. More than half of the seroconversions occurred in the rural areas and in Laos. Dengue seroconversion was significantly associated with young age (<15 years old), female gender, province, and duration of living in the current residence. No socioeconomic factors or mosquito control methods were found to be associated with seroprevalence or seroconversion. Notably, however, the province with most seroconversions had lower diurnal temperature ranges than elsewhere. In conclusion, our study has highlighted the homogeneity of dengue exposure across a wide range of settings and most notably those from rural and urban areas. Dengue can no longer be considered to be solely an urban disease nor necessarily one linked to poverty., Errata: Doum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T, Tongchai P, Rahman MS, Haque U, Phommachanh S, Pongvongsa T, Rocklöv J, Paul R, Pientong C. Correction: Doum, D., et al. Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int. J. Environ. Res. Public Health 2020, 17, 9134. International Journal of Environmental Research and Public Health. 2021; 18(4):1439. DOI: 10.3390/ijerph18041439

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. The detection of clinical cases enables us to measure the incidence of dengue infection, whereas serological surveys give insights into the prevalence of infection. This study aimed to determine dengue seroprevalence and seroconversion rates in northeastern Thailand and southern Laos and to assess any association of mosquito control methods and socioeconomic factors with dengue virus (DENV) infection. Cross-sectional seroprevalence surveys were performed in May and November 2019 on the same individuals. Blood samples were collected from one adult and one child, when possible, in each of 720 randomly selected households from two urban and two rural sites in both northeastern Thailand and southern Laos. IgG antibodies against DENV were detected in serum using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Overall, 1071 individuals participated in the study. The seroprevalence rate was high (91.5%) across all 8 study sites. Only age and province were associated with seroprevalence rates. There were 33 seroconversions during the period from May to November, of which seven reported fever. More than half of the seroconversions occurred in the rural areas and in Laos. Dengue seroconversion was significantly associated with young age (<15 years old), female gender, province, and duration of living in the current residence. No socioeconomic factors or mosquito control methods were found to be associated with seroprevalence or seroconversion. Notably, however, the province with most seroconversions had lower diurnal temperature ranges than elsewhere. In conclusion, our study has highlighted the homogeneity of dengue exposure across a wide range of settings and most notably those from rural and urban areas. Dengue can no longer be considered to be solely an urban disease nor necessarily one linked to poverty., Errata: Doum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T, Tongchai P, Rahman MS, Haque U, Phommachanh S, Pongvongsa T, Rocklöv J, Paul R, Pientong C. Correction: Doum, D., et al. Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int. J. Environ. Res. Public Health 2020, 17, 9134. International Journal of Environmental Research and Public Health. 2021; 18(4):1439. DOI: 10.3390/ijerph18041439

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. The detection of clinical cases enables us to measure the incidence of dengue infection, whereas serological surveys give insights into the prevalence of infection. This study aimed to determine dengue seroprevalence and seroconversion rates in northeastern Thailand and southern Laos and to assess any association of mosquito control methods and socioeconomic factors with dengue virus (DENV) infection. Cross-sectional seroprevalence surveys were performed in May and November 2019 on the same individuals. Blood samples were collected from one adult and one child, when possible, in each of 720 randomly selected households from two urban and two rural sites in both northeastern Thailand and southern Laos. IgG antibodies against DENV were detected in serum using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Overall, 1071 individuals participated in the study. The seroprevalence rate was high (91.5%) across all 8 study sites. Only age and province were associated with seroprevalence rates. There were 33 seroconversions during the period from May to November, of which seven reported fever. More than half of the seroconversions occurred in the rural areas and in Laos. Dengue seroconversion was significantly associated with young age (<15 years old), female gender, province, and duration of living in the current residence. No socioeconomic factors or mosquito control methods were found to be associated with seroprevalence or seroconversion. Notably, however, the province with most seroconversions had lower diurnal temperature ranges than elsewhere. In conclusion, our study has highlighted the homogeneity of dengue exposure across a wide range of settings and most notably those from rural and urban areas. Dengue can no longer be considered to be solely an urban disease nor necessarily one linked to poverty., Errata: Doum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T, Tongchai P, Rahman MS, Haque U, Phommachanh S, Pongvongsa T, Rocklöv J, Paul R, Pientong C. Correction: Doum, D., et al. Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int. J. Environ. Res. Public Health 2020, 17, 9134. International Journal of Environmental Research and Public Health. 2021; 18(4):1439. DOI: 10.3390/ijerph18041439

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. The detection of clinical cases enables us to measure the incidence of dengue infection, whereas serological surveys give insights into the prevalence of infection. This study aimed to determine dengue seroprevalence and seroconversion rates in northeastern Thailand and southern Laos and to assess any association of mosquito control methods and socioeconomic factors with dengue virus (DENV) infection. Cross-sectional seroprevalence surveys were performed in May and November 2019 on the same individuals. Blood samples were collected from one adult and one child, when possible, in each of 720 randomly selected households from two urban and two rural sites in both northeastern Thailand and southern Laos. IgG antibodies against DENV were detected in serum using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Overall, 1071 individuals participated in the study. The seroprevalence rate was high (91.5%) across all 8 study sites. Only age and province were associated with seroprevalence rates. There were 33 seroconversions during the period from May to November, of which seven reported fever. More than half of the seroconversions occurred in the rural areas and in Laos. Dengue seroconversion was significantly associated with young age (<15 years old), female gender, province, and duration of living in the current residence. No socioeconomic factors or mosquito control methods were found to be associated with seroprevalence or seroconversion. Notably, however, the province with most seroconversions had lower diurnal temperature ranges than elsewhere. In conclusion, our study has highlighted the homogeneity of dengue exposure across a wide range of settings and most notably those from rural and urban areas. Dengue can no longer be considered to be solely an urban disease nor necessarily one linked to poverty., Errata: Doum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T, Tongchai P, Rahman MS, Haque U, Phommachanh S, Pongvongsa T, Rocklöv J, Paul R, Pientong C. Correction: Doum, D., et al. Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int. J. Environ. Res. Public Health 2020, 17, 9134. International Journal of Environmental Research and Public Health. 2021; 18(4):1439. DOI: 10.3390/ijerph18041439

Dengue is the most rapidly spreading mosquito-borne viral disease in the world. The detection of clinical cases enables us to measure the incidence of dengue infection, whereas serological surveys give insights into the prevalence of infection. This study aimed to determine dengue seroprevalence and seroconversion rates in northeastern Thailand and southern Laos and to assess any association of mosquito control methods and socioeconomic factors with dengue virus (DENV) infection. Cross-sectional seroprevalence surveys were performed in May and November 2019 on the same individuals. Blood samples were collected from one adult and one child, when possible, in each of 720 randomly selected households from two urban and two rural sites in both northeastern Thailand and southern Laos. IgG antibodies against DENV were detected in serum using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Overall, 1071 individuals participated in the study. The seroprevalence rate was high (91.5%) across all 8 study sites. Only age and province were associated with seroprevalence rates. There were 33 seroconversions during the period from May to November, of which seven reported fever. More than half of the seroconversions occurred in the rural areas and in Laos. Dengue seroconversion was significantly associated with young age (<15 years old), female gender, province, and duration of living in the current residence. No socioeconomic factors or mosquito control methods were found to be associated with seroprevalence or seroconversion. Notably, however, the province with most seroconversions had lower diurnal temperature ranges than elsewhere. In conclusion, our study has highlighted the homogeneity of dengue exposure across a wide range of settings and most notably those from rural and urban areas. Dengue can no longer be considered to be solely an urban disease nor necessarily one linked to poverty., Errata: Doum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T, Tongchai P, Rahman MS, Haque U, Phommachanh S, Pongvongsa T, Rocklöv J, Paul R, Pientong C. Correction: Doum, D., et al. Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int. J. Environ. Res. Public Health 2020, 17, 9134. International Journal of Environmental Research and Public Health. 2021; 18(4):1439. DOI: 10.3390/ijerph18041439

Background To reduce its high maternal and neonatal mortality rate and meet Millennium Development Goals four and five, Lao PDR has adopted a national ‘Strategy and Planning Framework of Implementation of Maternal, Neonatal and Child Health Services’. This paper reports on implementation constraints identified in three demonstration sites. Methods The objectives of this paper are to analyse health worker perceptions of the implementation of the strategy and constraints faced during implementation. A qualitative design was used with interviews conducted at health facilities in three demonstration provinces. Data were collected through key interviews with provincial/district hospital providers (n = 27), health centre staff (n = 8) and village health volunteers (n = 10). Data was analysed informed by Hanson et al’s health system constraint framework. Results In each of the demonstration sites, the Maternal, Neonatal and Child Health program was generally well-understood and the different activities were being implemented. Perceived implementation constraints related mainly to a mix of supply and demand factors. Supply-side constraints related to inadequate human resources, poor remuneration, weak technical guidance, minimal supervision and limited equipment. Demand-side constraints related mainly to cost, limited access to transport, cultural practices and language. Other constraints related to broader strategic management and cross-sectoral contextual constraints. Contextual constraints included low levels of limited education, women’s position in society and poor transport and communications networks. These factors influenced the implementation process and if not addressed, may reduce the effectiveness of the policy and scale-up. Conclusion The Lao PDR has a well-defined Maternal, Neonatal and Child Health program. Analysis of the constraints experienced by service providers in implementing the program however, is essential for scaling-up