Forecasting the incidence of dengue fever in Fujian province under varying climate change and demographic scenarios.

To project the future disease burden of dengue fever in Fujian Province by accounting for anticipated changes in climate and population, and to inform the development of targeted and effective dengue prevention and control strategies as well as public health interventions;

METHODS

We applied a distributed lag nonlinear model (DLNM) calibrated using locally acquired dengue cases from 2015 to 2019 and linked it to future temperature projections from four global climate models under three Shared Socioeconomic Pathways (SSP1-2.6, SSP2-4.5, and SSP5-8.5). These projections were integrated with population scenarios to estimate the temperature-attributable dengue burden through 2099;

RESULTS

Dengue risk increased across all scenarios. By 2090-2099, heat exposure (referenced to 18 °C) was associated with a 1.68-fold higher excess risk of dengue fever (95% CI: 1.01-1.89) under SSP1-2.6, 1.50-fold higher (1.38-1.64) under SSP2-4.5, and 1.74-fold higher (1.59-1.88) under SSP5-8.5. Notably, the moderate-emission scenario (SSP2-4.5) yielded a lower risk than both low- and high-emission pathways, reflecting the nonlinear temperature-dengue relationship in this transitional transmission region;

CONCLUSIONS

The burden of dengue fever in Fujian Province is projected to increase under all climate change scenarios examined. These findings underscore the need of proactive and climate-informed public health planning to mitigate the growing dengue risk associated with global warming.