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Despite multivariate spatio-temporal counts often containing many zeroes, zero-inflated multinomial models for space-time data have not been considered. We are interested in comparing the transmission dynamics of several co-circulating infectious diseases across space and time where some can be absent for long periods. We first assume there is a baseline disease that is well-established and always present in the region. The other diseases switch between periods of presence and absence in each area through a series of coupled Markov chains, which account for long periods of disease absence, disease interactions and disease spread from neighboring areas. Since we are mainly interested in comparing the diseases, we assume the cases of the present diseases in an area jointly follow an autoregressive multinomial model. We use the multinomial model to investigate whether there are associations between certain factors, such as temperature, and differences in the transmission intensity of the diseases. Inference is performed using efficient Bayesian Markov chain Monte Carlo methods based on jointly sampling all presence indicators. We apply the model to spatio-temporal counts of dengue, Zika and chikungunya cases in Rio de Janeiro, during the first triple epidemic.

The influence of climate on mosquito-borne diseases like dengue and chikungunya is well-established, but comprehensively tracking long-term spatial and temporal trends across large areas has been hindered by fragmented data and limited analysis tools. This study presents an unprecedented analysis, in terms of breadth, estimating the SIR transmission parameters from incidence data in all 5,570 municipalities in Brazil over 14 years (2010-2023) for both dengue and chikungunya. We describe the Episcanner computational pipeline, developed to estimate these parameters, producing a reusable dataset describing all dengue and chikungunya epidemics that have taken place in this period, in Brazil. The analysis reveals new insights into the climate-epidemic nexus: We identify distinct geographical and temporal patterns of arbovirus disease incidence across Brazil, highlighting how climatic factors like temperature and precipitation influence the timing and intensity of dengue and chikungunya epidemics. The innovative Episcanner tool empowers researchers and public health officials to explore these patterns in detail, facilitating targeted interventions and risk assessments. This research offers a new perspective on the long-term dynamics of climate-driven mosquito-borne diseases and their geographical specificities linked to the effects of global temperature fluctuations such as those captured by the ENSO index., Comment: Submitted for peer review

In disease mapping, the relative risk of a disease is commonly estimated across different areas within a region of interest. The number of cases in an area is often assumed to follow a Poisson distribution whose mean is decomposed as the product between an offset and the logarithm of the disease's relative risk. The log risk may be written as the sum of fixed effects and latent random effects. The BYM2 model decomposes each latent effect into a weighted sum of independent and spatial effects. We build on the BYM2 model to allow for heavy-tailed latent effects and accommodate potentially outlying risks, after accounting for the fixed effects. We assume a scale mixture structure wherein the variance of the latent process changes across areas and allows for outlier identification. We propose two prior specifications for this scale mixture parameter. These are compared through simulation studies and in the analysis of Zika cases from the first (2015-2016) epidemic in Rio de Janeiro city, Brazil. The simulation studies show that, in terms of the model assessment criterion WAIC and outlier detection, the two proposed parametrisations perform better than the model proposed by Congdon (2017) to capture outliers. In particular, the proposed parametrisations are more efficient, in terms of outlier detection, than Congdon's when outliers are neighbours. Our analysis of Zika cases finds 19 out of 160 districts of Rio as potential outliers, after accounting for the socio-development index. Our proposed model may help prioritise interventions and identify potential issues in the recording of cases., Comment: 50 pages, 33 figures, 7 tables