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Epidemiology of dengue and the effect of seasonal climate variation on its dynamics: a spatio-temporal descriptive analysis in the Chao-Shan area on China’s southeastern coast
  1. Qin Zhang1,
  2. Yuliang Chen2,
  3. Yu Fu3,
  4. Tao Liu4,
  5. Qingying Zhang2,
  6. Pi Guo2,
  7. Wenjun Ma4
  1. 1 Good Clinical Practice Office, Cancer Hospital of Shantou University Medical College, Shantou, China
  2. 2 Department of Preventive Medicine, Shantou University Medical College, Shantou, China
  3. 3 Department of Finance, Zhongnan University of Economics and Law, Wuhan, China
  4. 4 Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
  1. Correspondence to Dr. Qingying Zhang; qyzhang{at} and Dr Pi Guo; pguo{at}


Objective Dengue is a mosquito-transmitted virus infection that remains rampant across the tropical and subtropical areas worldwide. However, the spatial and temporal dynamics of dengue transmission are poorly understood in Chao-Shan area, one of the most densely populated regions on China’s southeastern coast, limiting disease control efforts. We aimed to characterise the epidemiology of dengue and assessed the effect of seasonal climate variation on its dynamics in the area.

Design A spatio-temporal descriptive analysis was performed in three cities including Shantou, Chaozhou and Jieyang in Chao-Shan area during the period of 2014–2017.

Setting Data of dengue cases of three cities including Shantou, Chaozhou and Jieyang in Chao-Shan area during 2014–2017 were extracted. Data for climatic variables including mean temperature, relative humidity and rainfall were also compiled.

Methodology The epidemiology and dynamics of dengue were initially depicted, and then the temporal dynamics related to climatic drivers was assessed by a wavelet analysis method. Furthermore, a generalised additive model for location, scale and shape model was performed to study the relationship between seasonal dynamics of dengue and climatic drivers.

Results Among the cities, the number of notified dengue cases in Chaozhou was greatest, accounting for 78.3%. The median age for the notified cases was 43 years (IQR: 27.0–58.0 years). Two main regions located in Xixin and Chengxi streets of Chaozhou with a high risk of infection were observed, indicating that there was substantial spatial heterogeneity in intensity. We found an annual peak incidence occurred in autumn across the region, most markedly in 2015. This study reveals that periods of elevated temperatures can drive the occurrence of dengue epidemics across the region, and the risk of transmission is highest when the temperature is between 25°C and 28°C.

Conclusion Our study contributes to a better understanding of dengue dynamics in Chao-Shan area.

  • China
  • climate
  • dengue
  • seasonal variation
  • spatial
  • wavelet analysis

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  • Contributors QinZ, PG and WM conceived the study, undertook statistical analysis and drafted the manuscript. YC, YF, TL and QingZ collected the data and assisted in the statistical analysis. QinZ, PG, TL, QingZ and WM interpreted the results. QinZ, PG and TL wrote and revised the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the National Key R&D Project of China (2018YFB0505500,2018YFB0505503), the National Natural Science Foundation of China (No. 81703323and 81773497), and the Top-tier University Construction Project under Departmentof Education of Guangdong Government (No. 2015022 and 2015023).

  • Disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are not publicly available because of personal privacy preservation. The dengue surveillance data are available from the corresponding authors on request. Requests for materials should be addressed to PG (email: or TL (email:

  • Patient consent for publication Not required.

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