Effects of socio-economic and environmental factors on the spatial heterogeneity of dengue fever investigated at a fine scale

The spatial pattern of dengue fever cases is the result of complex interactions between the virus, the host and the vector, which may be affected by environmental conditions. The largest outbreak of dengue fever in Guangzhou city, China occurred in 2014 with case numbers 2.7 times the number of cumulative cases since 1978 and a significantly non-random spatial distribution. Selecting Guangzhou City as the study area, we used scan statistics to analyze the spatial heterogeneity of dengue fever and a generalized additive model to evaluate and examine the effects of socio-economic and environmental factors on spatial heterogeneity at a fine scale. The study found that the spatial distribution of dengue fever is highly heterogeneous and various factors differ in relative importance. The junction of the central districts of Guangzhou is a high-risk area with the urban village and urban-rural fringe zone formed by urbanization as important regional factors. The low gross domestic product per capita, the high population density, the high road density were perceived as risk factors. The Asian subtropical coastal area together with the socioeconomic and environmental factors were found to be the key drivers at the fine scale explaining the high spatial heterogeneity of dengue fever in Guangzhou City.