Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/82565
Title: Increasing Dengue Incidence in Singapore over the Past 40 Years: Population Growth, Climate and Mobility
Authors: Struchiner, Claudio Jose
Rocklöv, Joacim
Wilder-Smith, Annelies
Massad, Eduardo
Keywords: Singapore
Population growth
Mosquitoes
Asia
Dengue virus
Population size
Infectious disease control
Rain
Issue Date: 2015
Source: Struchiner, C. J., Rocklöv, J., Wilder-Smith, A., & Massad, E. (2015). Increasing Dengue Incidence in Singapore over the Past 40 Years: Population Growth, Climate and Mobility. PLOS ONE, 10(8), e0136286-.
Series/Report no.: PLOS ONE
Abstract: In Singapore, the frequency and magnitude of dengue epidemics have increased significantly over the past 40 years. It is important to understand the main drivers for the rapid increase in dengue incidence. We studied the relative contributions of putative drivers for the rise of dengue in Singapore: population growth, climate parameters and international air passenger arrivals from dengue endemic countries, for the time period of 1974 until 2011. We used multivariable Poisson regression models with the following predictors: Annual Population Size; Aedes Premises Index; Mean Annual Temperature; Minimum and Maximum Temperature Recorded in each year; Annual Precipitation and Annual Number of Air Passengers arriving from dengue-endemic South-East Asia to Singapore. The relative risk (RR) of the increase in dengue incidence due to population growth over the study period was 42.7, while the climate variables (mean and minimum temperature) together explained an RR of 7.1 (RR defined as risk at the end of the time period relative to the beginning and goodness of fit associated with the model leading to these estimates assessed by pseudo-R2 equal to 0.83). Estimating the extent of the contribution of these individual factors on the increasing dengue incidence, we found that population growth contributed to 86% while the residual 14% was explained by increase in temperature. We found no correlation with incoming air passenger arrivals into Singapore from dengue endemic countries. Our findings have significant implications for predicting future trends of the dengue epidemics given the rapid urbanization with population growth in many dengue endemic countries. It is time for policy-makers and the scientific community alike to pay more attention to the negative impact of urbanization and urban climate on diseases such as dengue.
URI: https://hdl.handle.net/10356/82565
http://hdl.handle.net/10220/38814
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0136286
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © 2015 Struchiner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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