Abstract
Dengue is an ongoing problem, especially in tropical countries. Like many other vector-borne diseases, the spread of dengue is driven by a myriad of climate and socioeconomic factors. Within developing countries, heterogeneities on socioeconomic factors are expected to create variable conditions for dengue transmission. However, the relative role of socioeconomic characteristics and their association with climate in determining dengue prevalence are poorly understood. Here we assembled essential socioeconomic factors over 5570 municipalities across Brazil and assessed their effect on dengue prevalence jointly with a previously predicted temperature suitability for transmission. Using a simultaneous autoregressive approach (SAR), we showed that the variability in the prevalence of dengue cases across Brazil is primarily explained by the combined effect of climate and socioeconomic factors. At some dengue seasons, the effect of temperature on transmission potential showed to be a more significant proxy of dengue cases. Still, socioeconomic factors explained the later increase in dengue prevalence over Brazil. In a heterogeneous country such as Brazil, recognizing the transmission drivers by vectors is a fundamental issue in effectively predicting and combating tropical diseases like dengue. Ultimately, it indicates that not considering socioeconomic factors in disease transmission predictions might compromise efficient surveillance strategies. Our study shows that sanitation, urbanization, and GDP are regional indicators that should be considered along with temperature suitability on dengue transmission, setting effective directions to mosquito-borne disease control.
Highlights
The presence and prevalence of many infectious diseases have clear geographic structures
The higher prevalence of dengue in Brazil compared to other countries has intrigued researchers for decades, revealing that distinctive factors might regulate the transmission of this arboviral disease within particular countries [30]
Broad-scale patterns of the magnitude of arboviral disease incidence fluctuate according to a myriad of exogenous factors such as climate and socioeconomic status
Summary
The presence and prevalence of many infectious diseases have clear geographic structures. These health threats vary from country to country and cause the loss of millions of lives annually [1, 2]. A multitude offactors determines infectious disease geographical distribution and potential outbreaks, spanning from socioeconomic (e.g., urbanization; population density) to Temperature, Socioeconomic Factors, and Dengue environmental (e.g., temperature; precipitation) and biotic (e.g., vectors competition) [1, 4]. Acknowledgment of the variation of these drivers over space and time may help identify regions of potential transmission once the disease dynamic is as tightly linked with exogenous factors as with endogenous mechanisms [5, 6]
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