Socioeconomic and environmental determinants of dengue transmission in an urban setting: An ecological study in Nouméa, New Caledonia.

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Raphaël M Zellweger, Jorge Cano, Morgan Mangeas, François Taglioni, Alizé Mercier, Marc Despinoy, Christophe E Menkès, Myrielle Dupont-Rouzeyrol, Birgit Nikolay, Magali Teurlai
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2017
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Pacific; Climate change
• Online Access: https://doi.org/10.1371/journal.pntd.0005471; https://doaj.org/article/89c4aeb98487400890044628398bb1a7

BACKGROUND:Dengue is a mosquito-borne virus that causes extensive morbidity and economic loss in many tropical and subtropical regions of the world. Often present in cities, dengue virus is rapidly spreading due to urbanization, climate change and increased human movements. Dengue cases are often heterogeneously distributed throughout cities, suggesting that small-scale determinants influence dengue urban transmission. A better understanding of these determinants is crucial to efficiently target prevention measures such as vector control and education. The aim of this study was to determine which socioeconomic and environmental determinants were associated with dengue incidence in an urban setting in the Pacific. METHODOLOGY:An ecological study was performed using data summarized by neighborhood (i.e. the neighborhood is the unit of analysis) from two dengue epidemics (2008-2009 and 2012-2013) in the city of Nouméa, the capital of New Caledonia. Spatial patterns and hotspots of dengue transmission were assessed using global and local Moran's I statistics. Multivariable negative binomial regression models were used to investigate the association between dengue incidence and various socioeconomic and environmental factors throughout the city. PRINCIPAL FINDINGS:The 2008-2009 epidemic was spatially structured, with clusters of high and low incidence neighborhoods. In 2012-2013, dengue incidence rates were more homogeneous throughout the city. In all models tested, higher dengue incidence rates were consistently associated with lower socioeconomic status (higher unemployment, lower revenue or higher percentage of population born in the Pacific, which are interrelated). A higher percentage of apartments was associated with lower dengue incidence rates during both epidemics in all models but one. A link between vegetation coverage and dengue incidence rates was also detected, but the link varied depending on the model used. CONCLUSIONS:This study demonstrates a robust spatial association between dengue incidence rates ...