Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19

Wei Luo; Zhihao Liu; Yiding Ran; Mengqi Li; Yuxuan Zhou; Weitao Hou; Shengjie Lai; Sabrina L. Li; Ling Yin

doi:10.1371/journal.pntd.0012096

Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19

Wei Luo^* (Co-first Author)
, Zhihao Liu (Co-first Author)
, Yiding Ran
, Mengqi Li
, Yuxuan Zhou
, Weitao Hou
, Shengjie Lai
, Sabrina L. Li
, Ling Yin

^*Corresponding author for this work

Department of Architecture and Civil Engineering

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

2 Citations (Scopus)

70 Downloads (CityUHK Scholars)

Abstract

The enforcement of COVID-19 interventions by diverse governmental bodies, coupled with the indirect impact of COVID-19 on short-term environmental changes (e.g., plant shutdowns lead to lower greenhouse gas emissions), influences the Dengue Fever (DF) vector. This provides a unique opportunity to investigate the indirect impact of COVID-19 on DF transmission and generate insights for targeted prevention measures. We aim to compare DF transmission patterns and the exposure-response relationship of environmental variables and DF incidence in the pre- and during-COVID-19 to identify variations and assess the indirect impact of COVID-19 on DF transmission. We initially visualized the overall trend of DF transmission from 2017-2022, then conducted two quantitative analyses to compare DF transmission pre-COVID-19 (2017–2019) and during-COVID-19 (2020–2022). These analyses included time series analysis to assess DF seasonality, and a Distributed Lag Non-linear Model (DLNM) to quantify the exposure-response relationship between environmental variables and DF incidence. We observed a notable surge in Singapore during-COVID-19, particularly from May to August in 2020 and 2022, with cases multiplying several times compared to pre-COVID-19. All subregions in Thailand exhibited remarkable synchrony with a similar annual trend except 2021. Cyclic patterns remained generally consistent, but seasonal variability in Singapore has become increasingly pronounced. Monthly DF incidence in three countries varied significantly. Exposure-response relationships of DF and environmental variables show varying degrees of change, notably in Northern Thailand, where the peak relative risk for the maximum temperature-DF relationship rose from about 3–17, and the max RR of overall cumulative association 0–3 months of relative humidity increased from around 4–40. Our study is the first to compare DF transmission patterns and their relationship with environmental variables before and during COVID-19, demonstrating that the pandemic has affected DF transmission and altered the exposure-response relationship at both national and regional levels.

© 2025 Luo et al.

Original language	English
Article number	e0012096
Journal	PLOS Neglected Tropical Diseases
Volume	19
Issue number	4
Online published	28 Apr 2025
DOIs	https://doi.org/10.1371/journal.pntd.0012096
Publication status	Published - Apr 2025

Funding

This work was supported in part by National University of Singapore FY2020 START-UP GRANT under WBS A-0003623- 00-00 to WL, MOE Tier 1 Grant under WBS A-8002446-00-00 to WL and the National Natural Science Foundation of China (No.42271475 to LY). SL was supported by the National Institute for Health (MIDAS Mobility R01AI160780). SLL is supported by a British Academy ODA Challenge-Oriented Research Grant (IOCRG\100955). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscrip

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 13 Climate Action

Publisher's Copyright Statement

This full text is made available under CC-BY 4.0. https://creativecommons.org/licenses/by/4.0/

Access Output

10.1371/journal.pntd.0012096

305332760.pdfFinal Published version, 2.3 MBLicence: CC BY

Other Access Options

Check CityUHK Library

Permanent Link

Right click to copy link

Cite this

Luo, W., Liu, Z., Ran, Y., Li, M., Zhou, Y., Hou, W., Lai, S., Li, S. L., & Yin, L. (2025). Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19. PLOS Neglected Tropical Diseases, 19(4), Article e0012096. https://doi.org/10.1371/journal.pntd.0012096

@article{565b24f848784e24bc380306f81f504c,

title = "Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19",

abstract = "The enforcement of COVID-19 interventions by diverse governmental bodies, coupled with the indirect impact of COVID-19 on short-term environmental changes (e.g., plant shutdowns lead to lower greenhouse gas emissions), influences the Dengue Fever (DF) vector. This provides a unique opportunity to investigate the indirect impact of COVID-19 on DF transmission and generate insights for targeted prevention measures. We aim to compare DF transmission patterns and the exposure-response relationship of environmental variables and DF incidence in the pre- and during-COVID-19 to identify variations and assess the indirect impact of COVID-19 on DF transmission. We initially visualized the overall trend of DF transmission from 2017-2022, then conducted two quantitative analyses to compare DF transmission pre-COVID-19 (2017–2019) and during-COVID-19 (2020–2022). These analyses included time series analysis to assess DF seasonality, and a Distributed Lag Non-linear Model (DLNM) to quantify the exposure-response relationship between environmental variables and DF incidence. We observed a notable surge in Singapore during-COVID-19, particularly from May to August in 2020 and 2022, with cases multiplying several times compared to pre-COVID-19. All subregions in Thailand exhibited remarkable synchrony with a similar annual trend except 2021. Cyclic patterns remained generally consistent, but seasonal variability in Singapore has become increasingly pronounced. Monthly DF incidence in three countries varied significantly. Exposure-response relationships of DF and environmental variables show varying degrees of change, notably in Northern Thailand, where the peak relative risk for the maximum temperature-DF relationship rose from about 3–17, and the max RR of overall cumulative association 0–3 months of relative humidity increased from around 4–40. Our study is the first to compare DF transmission patterns and their relationship with environmental variables before and during COVID-19, demonstrating that the pandemic has affected DF transmission and altered the exposure-response relationship at both national and regional levels. {\textcopyright} 2025 Luo et al.",

author = "Wei Luo and Zhihao Liu and Yiding Ran and Mengqi Li and Yuxuan Zhou and Weitao Hou and Shengjie Lai and Li, \{Sabrina L.\} and Ling Yin",

year = "2025",

month = apr,

doi = "10.1371/journal.pntd.0012096",

language = "English",

volume = "19",

journal = "PLOS Neglected Tropical Diseases",

issn = "1935-2735",

publisher = "Public Library of Science (PLoS)",

number = "4",

}

Luo, W, Liu, Z, Ran, Y, Li, M, Zhou, Y, Hou, W, Lai, S, Li, SL & Yin, L 2025, 'Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19', PLOS Neglected Tropical Diseases, vol. 19, no. 4, e0012096. https://doi.org/10.1371/journal.pntd.0012096

Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19. / Luo, Wei (Co-first Author); Liu, Zhihao (Co-first Author); Ran, Yiding et al.
In: PLOS Neglected Tropical Diseases, Vol. 19, No. 4, e0012096, 04.2025.

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

TY - JOUR

T1 - Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19

AU - Luo, Wei

AU - Liu, Zhihao

AU - Ran, Yiding

AU - Li, Mengqi

AU - Zhou, Yuxuan

AU - Hou, Weitao

AU - Lai, Shengjie

AU - Li, Sabrina L.

AU - Yin, Ling

PY - 2025/4

Y1 - 2025/4

N2 - The enforcement of COVID-19 interventions by diverse governmental bodies, coupled with the indirect impact of COVID-19 on short-term environmental changes (e.g., plant shutdowns lead to lower greenhouse gas emissions), influences the Dengue Fever (DF) vector. This provides a unique opportunity to investigate the indirect impact of COVID-19 on DF transmission and generate insights for targeted prevention measures. We aim to compare DF transmission patterns and the exposure-response relationship of environmental variables and DF incidence in the pre- and during-COVID-19 to identify variations and assess the indirect impact of COVID-19 on DF transmission. We initially visualized the overall trend of DF transmission from 2017-2022, then conducted two quantitative analyses to compare DF transmission pre-COVID-19 (2017–2019) and during-COVID-19 (2020–2022). These analyses included time series analysis to assess DF seasonality, and a Distributed Lag Non-linear Model (DLNM) to quantify the exposure-response relationship between environmental variables and DF incidence. We observed a notable surge in Singapore during-COVID-19, particularly from May to August in 2020 and 2022, with cases multiplying several times compared to pre-COVID-19. All subregions in Thailand exhibited remarkable synchrony with a similar annual trend except 2021. Cyclic patterns remained generally consistent, but seasonal variability in Singapore has become increasingly pronounced. Monthly DF incidence in three countries varied significantly. Exposure-response relationships of DF and environmental variables show varying degrees of change, notably in Northern Thailand, where the peak relative risk for the maximum temperature-DF relationship rose from about 3–17, and the max RR of overall cumulative association 0–3 months of relative humidity increased from around 4–40. Our study is the first to compare DF transmission patterns and their relationship with environmental variables before and during COVID-19, demonstrating that the pandemic has affected DF transmission and altered the exposure-response relationship at both national and regional levels. © 2025 Luo et al.

AB - The enforcement of COVID-19 interventions by diverse governmental bodies, coupled with the indirect impact of COVID-19 on short-term environmental changes (e.g., plant shutdowns lead to lower greenhouse gas emissions), influences the Dengue Fever (DF) vector. This provides a unique opportunity to investigate the indirect impact of COVID-19 on DF transmission and generate insights for targeted prevention measures. We aim to compare DF transmission patterns and the exposure-response relationship of environmental variables and DF incidence in the pre- and during-COVID-19 to identify variations and assess the indirect impact of COVID-19 on DF transmission. We initially visualized the overall trend of DF transmission from 2017-2022, then conducted two quantitative analyses to compare DF transmission pre-COVID-19 (2017–2019) and during-COVID-19 (2020–2022). These analyses included time series analysis to assess DF seasonality, and a Distributed Lag Non-linear Model (DLNM) to quantify the exposure-response relationship between environmental variables and DF incidence. We observed a notable surge in Singapore during-COVID-19, particularly from May to August in 2020 and 2022, with cases multiplying several times compared to pre-COVID-19. All subregions in Thailand exhibited remarkable synchrony with a similar annual trend except 2021. Cyclic patterns remained generally consistent, but seasonal variability in Singapore has become increasingly pronounced. Monthly DF incidence in three countries varied significantly. Exposure-response relationships of DF and environmental variables show varying degrees of change, notably in Northern Thailand, where the peak relative risk for the maximum temperature-DF relationship rose from about 3–17, and the max RR of overall cumulative association 0–3 months of relative humidity increased from around 4–40. Our study is the first to compare DF transmission patterns and their relationship with environmental variables before and during COVID-19, demonstrating that the pandemic has affected DF transmission and altered the exposure-response relationship at both national and regional levels. © 2025 Luo et al.

UR - https://www.webofscience.com/wos/woscc/full-record/WOS:001478285800003

U2 - 10.1371/journal.pntd.0012096

DO - 10.1371/journal.pntd.0012096

M3 - RGC 21 - Publication in refereed journal

C2 - 40294120

SN - 1935-2735

VL - 19

JO - PLOS Neglected Tropical Diseases

JF - PLOS Neglected Tropical Diseases

IS - 4

M1 - e0012096

ER -

Unraveling varying spatiotemporal patterns of Dengue Fever and associated exposure-response relationships with environmental variables in three Southeast Asian countries before and during COVID-19

Abstract

Funding

UN SDGs

Publisher's Copyright Statement

Access Output

Other Access Options

Permanent Link

Other Files and Links

Fingerprint

Cite this