The Relationships Between the Eco-Bio-Social Determinants of Dengue Epidemiology in Latin America and the Caribbean: A Scoping Review of the Literature.

The factors influencing dengue virus (DENV) transmission by the Aedes aegypti mosquito vector in Latin America and the Caribbean (LAC) are complex and related. The use of a systems thinking, Ecohealth approach for understanding the dynamic linkages between all the ecological, biological, and social (eco-bio-social) factors associated with DENV epidemiology is imperative to better understand the DENV epidemiological system (episystem). The aim of this scoping review was to summarize the evidence for the relationships between the eco-bio-social factors influencing DENV vector dynamics, transmission, and epidemiological outcomes in LAC. The PubMed, SCOPUS, and LILACS databases were searched to collect relevant papers irrespective of design published in English, French, Portuguese, or Spanish. Full-text articles were obtained for the studies that passed the title and abstract screening process. The full-text articles were evaluated to determine if they met the eligibility criteria. Data were extracted using NVivo™ 12, and themes were compiled and communicated narratively. We included 68 studies from 13 different countries from LAC from the published literature from LAC between 2007 and 2022. Studies were classified as eco-biological (n = 24), bio-social (n = 21), eco-social (n = 14), or eco-bio-social studies (n = 9). Ten determinants emerged from the literature and were described, including: temperature; precipitation and humidity; artificial environment; vegetation and land cover; elevation and altitude; human population mobility and human activity; human population density and population demographics; chemical protective measures; seasonality and water storing practices; and urbanization and land use changes. We summarized the evidence on the eco-bio-social determinants of dengue transmission in LAC, with implications for comparable contexts in Asia and Africa. Key gaps remain regarding drivers of transmission and outcomes. Future research may benefit from using transdisciplinary research approaches to investigating Aedes-transmissible arboviruses.