Abstract
Examining the effect of environmental and social factors on populations exposed to vector-borne diseases is critical to prepare for future outbreaks. While extensive studies have been conducted on the epidemiology of the dengue virus, research on the human-environmental aspects of the disease is sparse. A multivariate analysis using constrained ordination is carried out to evaluate the spatial and temporal variations of the dengue virus in Sri Lanka. The constrained factor scores are mapped using geographic information systems software to identify clusters of high and low incidences of dengue. The results reveal distinct patterns of the virus in urban, peri-urban and rural districts. Mobility had a significant effect on populations exposed to the virus in both urban and peri-urban areas. The age cohort variables of percent population under the age of 5 and aged 5 to 19 had a negative impact on dengue rates in urban areas and a marginal impact in rural precincts. Precipitation, poverty, and literacy had a marginal to moderate impact on the prevalence of dengue at the district level. Three distinct clusters emerged from the resulting factor scores: an urban high cluster concentrated in the western region, a peri-urban/rural high cluster in the interior and northeastern region, and a rural low cluster in the dry zone. The size of the clusters varied during epidemic and non-epidemic years, but remained fairly consistent when the western districts were omitted. The district level assessment forms the basis for future evaluation of social-environmental factors related to dengue at the local level.
Published Version
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