Department of Hygiene, Hokkaido University, Sapporo, Hokkaido Japan.
School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
PLoS Negl Trop Dis. 2023 Oct 23;17(10):e0011700. doi: 10.1371/journal.pntd.0011700. eCollection 2023 Oct.
Temperature has a significant impact on dengue incidence, however, changes on the temperature-dengue relationship across axes of socio-economic vulnerability is not well described. This study sought to determine the association between dengue and temperature in multiple locations in the Philippines and explore the effect modification by socio-economic factors.
Nationwide dengue cases per province from 2010 to 2019 and data on temperature were obtained from the Philippines' Department of Health-Epidemiological Bureau and ERA5-land, respectively. A generalized additive mixed model (GAMM) with a distributed lag non-linear model was utilized to examine the association between temperature and dengue incidence. We further implemented an interaction analysis in determining how socio-economic factors modify the association. All analyses were implemented using R programming.
Nationwide temperature-dengue risk function was noted to depict an inverted U-shaped pattern. Dengue risk increased linearly alongside increasing mean temperature from 15.8 degrees Celsius and peaking at 27.5 degrees Celsius before declining. However, province-specific analyses revealed significant heterogeneity. Socio-economic factors had varying impact on the temperature-dengue association. Provinces with high population density, less people in urban areas with larger household size, high poverty incidence, higher health spending per capita, and in lower latitudes were noted to exhibit statistically higher dengue risk compared to their counterparts at the upper temperature range.
This observational study found that temperature was associated with dengue incidence, and that this association is more apparent in locations with high population density, less people in urban areas with larger household size, high poverty incidence, higher health spending per capita, and in lower latitudes. Differences with socio-economic conditions is linked with dengue risk. This highlights the need to develop interventions tailor-fit to local conditions.
温度对登革热发病率有重大影响，然而，社会经济脆弱性轴上温度与登革热关系的变化尚不清楚。本研究旨在确定菲律宾多个地区登革热与温度之间的关联，并探讨社会经济因素的影响修饰作用。
从 2010 年至 2019 年，从菲律宾卫生部流行病学局和 ERA5-land 分别获得全国各省的登革热病例数和温度数据。使用广义加性混合模型（GAMM）和分布式滞后非线性模型来检验温度与登革热发病率之间的关联。我们进一步实施了交互分析，以确定社会经济因素如何修饰这种关联。所有分析均使用 R 编程语言执行。
全国范围内的温度-登革热风险函数被描绘为倒 U 形模式。随着平均温度从 15.8 摄氏度线性增加，登革热风险增加，并在 27.5 摄氏度达到峰值，然后下降。然而，省际分析显示出显著的异质性。社会经济因素对温度-登革热关联有不同的影响。人口密度高、城市地区人口少、家庭规模大、贫困发生率高、人均卫生支出高以及纬度较低的省份，与高温地区相比，登革热风险明显更高。
这项观察性研究发现，温度与登革热发病率有关，而这种关联在人口密度高、城市地区人口少、家庭规模大、贫困发生率高、人均卫生支出高以及纬度较低的地区更为明显。与社会经济条件的差异与登革热风险有关。这突显出需要根据当地情况制定有针对性的干预措施。
