Dengue Incidence and Sociodemographic Conditions in Pucallpa, Peruvian Amazon: What Role for Modification of the Dengue–Temperature Relationship?

Margot Charette Department of Geography, McGill University, Montreal, Canada;

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Lea Berrang-Ford Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom;

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Oliver Coomes Department of Geography, McGill University, Montreal, Canada;

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Elmer Alejandro Llanos-Cuentas School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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César Cárcamo School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Manisha Kulkarni School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada;

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Sherilee L. Harper School of Public Health, University of Alberta, Edmonton, Canada

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Dengue is a climate-sensitive disease with an increasing global burden. Although the relationship between meteorological conditions and dengue incidence is well established, less is known about the modifying nature of sociodemographic variables on that relationship. We assess the strength and direction of sociodemographic effect modification of the temperature–dengue relationship in the second largest city of the Peruvian Amazon to identify populations that may have heightened vulnerability to dengue under varying climate conditions. We used weekly dengue counts and averaged meteorological variables to evaluate the association between disease incidence, meteorological exposures, and sociodemographic effect modifiers (gender, age, and district) in negative binomial regression models. District was included to consider geographical effect modification. We found that being a young child or elderly, being female, and living in the district of Manantay increased dengue’s incidence rate ratio (IRR) as a result of 1°C increase in weekly mean temperature (IRR = 2.99, 95% CI: 1.99–4.50 for women less than 5 years old and IRR = 2.86, 95% CI: = 1.93–4.22 for women older than 65 years, both estimates valid for the rainy season). The effect of temperature on dengue depended on season, with stronger effects during rainy seasons. Sociodemographic variables can provide options for intervention to mitigate health impacts with a changing climate. Our results indicate that patterns of baseline risk between regions and sociodemographic conditions can differ substantially from trends in climate sensitivity. These results challenge the assumption that the distribution of climate change impacts will be patterned similarly to existing social gradients in health.

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Author Notes

Address correspondence to Margot Charette, Department of Geography, McGill University, 7207 Ave. de Chateaubriand, Montreal H2R 2L4, Canada. E-mail: margot.charette@mail.mcgill.ca

Authors’ addresses: Margot Charette and Oliver Coomes, Department of Geography, McGill University, Montreal, Canada, E-mails: margot.charette@mail.mcgill.ca and oliver.coomes@mcgill.ca. Lea Berrang-Ford, Priestley International Center for Climate, University of Leeds, Leeds, United Kingdom, E-mail: l.berrangford@leeds.ac.uk. Elmer Alejandro Llanos-Cuentas and César Cárcamo, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: alejandro.llanos.c@upch.pe and carcamo@u.washington.edu. Manisha Kulkarni, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada, E-mail: manisha.kulkarni@uottawa.ca. Sherilee L. Harper, School of Public Health, University of Alberta, Edmonton, Canada, sherilee.harper@ualberta.ca.

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