# Comparative Analysis of Dengue versus Chikungunya Outbreaks in Costa Rica

## TL;DR

This study compares dengue and chikungunya outbreaks in Costa Rica, highlighting misdiagnosis issues and using a deterministic model with genetic algorithms to estimate key epidemiological parameters.

## Contribution

It introduces a combined modeling and optimization approach to quantify misdiagnosis between dengue and chikungunya during outbreaks.

## Key findings

- Chikungunya cases are likely underreported.
- Dengue cases are likely overreported.
- The model effectively estimates epidemic parameters and misdiagnosis rates.

## Abstract

For decades, dengue virus has been a cause of major public health concern in Costa Rica, due to its landscape and climatic conditions that favor the circumstances in which the vector, Aedes aegypti, thrives. The emergence and introduction throughout tropical and subtropical countries of the chikungunya virus, as of 2014, challenged Costa Rican health authorities to provide a correct diagnosis since it is also transmitted by the same vector and infected hosts may share similar symptoms. We study the 2015-2016 dengue and chikungunya outbreaks in Costa Rica while establishing how point estimates of epidemic parameters for both diseases compare to one another. Longitudinal weekly incidence reports of these outbreaks signal likely misdiagnosis of infected individuals: underreporting of chikungunya cases, while overreporting cases of dengue. Our comparative analysis is formulated with a single-outbreak deterministic model that features an undiagnosed class. Additionally, we also used a genetic algorithm in the context of weighted least squares to calculate point estimates of key model parameters and initial conditions, while formally quantifying misdiagnosis.