Publisher DOI: 10.1371/journal.pone.0242685
Title: Exploring the influence of deforestation on dengue fever incidence in the Brazilian Amazonas state
Language: English
Authors: Kalbus, Alexandra 
de Souza Sampaio, Vanderson 
Boenecke, Juliane 
Reintjes, Ralf 
Editor: Becker, Daniel 
Issue Date: 7-Jan-2021
Publisher: PLOS
Journal or Series Name: PLOS ONE 
Volume: 16
Issue: 1
Abstract: 
Introduction Dengue fever is the most prevalent arboviral disease in the Brazilian Amazon and places a major health, social and economic burden on the region. Its association with deforestation is largely unknown, yet the clearing of tropical rainforests has been linked to the emergence of several infectious diseases, including yellow fever and malaria. This study aimed to explore potential drivers of dengue emergence in the Brazilian Amazon with a focus on deforestation. Methods An ecological study design using municipality-level secondary data from the Amazonas state between 2007 and 2017 (reported rural dengue cases, incremental deforestation, socioeconomic characteristics, healthcare and climate factors) was employed. Data were transformed according to the year with the most considerable deforestation. Associations were explored using bivariate analysis and a multivariate generalised linear model. Results During the study period 2007–2017, both dengue incidence and deforestation increased. Bivariate analysis revealed increased incidences for some years after deforestation (e.g. mean difference between dengue incidence before and three years after deforestation was 55.47 cases per 100,000, p = 0.002), however, there was no association between the extent of deforestation and dengue incidence. Using a negative binomial regression model adjusted for socioeconomic, climate and healthcare factors, deforestation was not found to be related to dengue incidence. Access to healthcare was found to be the only significant predictor of dengue incidence. Discussion Previous research has shown that deforestation facilitates the emergence of vector-borne diseases. However, no significant dose-response relationships between dengue incidence and deforestation in the Brazilian Amazonas state were found in this study. The finding that access to healthcare was the only significant predictor of dengue incidence suggests that incidence may be more dependent on surveillance than transmission. Further research and public attention are needed to better understand environmental effects on human health and to preserve the world’s largest rainforest.
URI: https://hdl.handle.net/20.500.12738/17147
ISSN: 1932-6203
Review status: This version was peer reviewed (peer review)
Institute: Department Gesundheitswissenschaften 
Fakultät Life Sciences 
Type: Article
Additional note: article number: e0242685
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