{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:50:08Z","timestamp":1790373008330,"version":"4.1.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Research Council Formas project ARBO-prevent","award":["2018\u201301754"],"award-info":[{"award-number":["2018\u201301754"]}]},{"name":"Ume\u00e5 Center of Global Health Research"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Dengue is one of the major public health problems in Sri Lanka. Its outbreak pattern depends on a multitude of drivers, including human mobility. Here we evaluate the impact of COVID\u201319 related mobility restriction (lockdown) on the risk of dengue in Sri Lanka.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methodology<\/jats:title><jats:p>Two-stage hierarchical models were fitted using an interrupted time-series design based on the notified dengue cases, January 2015 to July 2020. In the first stage model, the district level impact was estimated using quasi-Poisson regression models while accounting for temporal trends. Estimates were pooled at zonal and national levels in the second stage model using meta-analysis. The influence of the extended period of school closure on dengue in children in the western province was compared to adults.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Findings<\/jats:title><jats:p>Statistically significant and homogeneous reduction of dengue risk was observed at all levels during the lockdown. Overall an 88% reduction in risk (RR 0.12; 95% CI from 0.08 to 0.17) was observed at the national level. The highest impact was observed among children aged less than 19 years showing a 92% reduction (RR 0.8; 95% CI from 0.03 to 0.25). We observed higher impact in the dry zone having 91% reduction (RR 0.09; 95% CI from 0.05 to 0.15) compared to wet zone showing 83% reduction (RR 0.17; 95% CI from 0.09 to 0.30). There was no indication that the overall health-seeking behaviour for dengue had a substantial influence on these estimates.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Significance<\/jats:title><jats:p>This study offers a broad understanding of the change in risk of dengue during the COVID\u201319 pandemic and associated mobility restrictions in Sri Lanka. The analysis using the mobility restrictions as a natural experiment suggests mobility patterns to be a very important driver of dengue transmission.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0009420","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T23:17:09Z","timestamp":1623367029000},"page":"e0009420","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":51,"title":["The impact of COVID\u201319 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5174-7644","authenticated-orcid":true,"given":"Prasad","family":"Liyanage","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4030-0449","authenticated-orcid":true,"given":"Joacim","family":"Rockl\u00f6v","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9379-1002","authenticated-orcid":true,"given":"Hasitha Aravinda","family":"Tissera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"pntd.0009420.ref001","volume-title":"Comprehensive Guideline for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. 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