Urbanization, infrastructure, and mosquito thermal suitability shape the causal effects of extreme weather on dengue transmission

Danyang Wang; Xiaoxu Wu; Jin Chen; Lu Zhao

doi:10.59717/j.xinn-med.2026.100188

The Innovation Medicine > 2026 Vol. 4 > No. 1 > 100188

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Urbanization, infrastructure, and mosquito thermal suitability shape the causal effects of extreme weather on dengue transmission

1.
State Key Laboratory of Remote Sensing and Digital Earth, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
2.
School of Geospatial Engineering and Science, Sun Yat-sen University, Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, China
3.
State Key Laboratory of Earth Surface Processes and Disaster Risk Reduction, Innovation Research Center of Satellite Application (IRCSA), Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China

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Corresponding author: wuxx85@mail.sysu.edu.cn
Received Date: July 04, 2025

Accepted Date: January 06, 2026

Published Online: January 07, 2026

The Innovation Medicine 4(1), https://doi.org/10.59717/j.xinn-med.2026.100188 | Cite this article

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PUBLIC SUMMARY

PUBLIC SUMMARY
1. Among extreme weather, heatwaves present the highest risk, followed by drought and wet events.
  
  Compound drought–heatwave events pose a lower dengue risk than individual events.
  
  Extreme weather increases dengue risk in rural areas compared with urban areas.
  
  Drought drives dengue in urban areas with better facilities and high mosquito thermal suitability.

ABSTRACT

ABSTRACT

Dengue is a widespread arboviral disease and poses a persistent global health threat, particularly in Southeast Asia, a region characterized by frequent dengue and extreme weather. Urbanization, infrastructure, and mosquito thermal suitability are pivotal factors in shaping dengue dynamics. However, their roles in modulating the causal effects of extreme weather on dengue transmission remain unclear. Here, we compile monthly dengue data during 2000-2019 covering Singapore and 162 first–level administrative units in six Southeast Asian countries. A spatiotemporal Bayesian framework is developed to explicitly capture the interactions of extreme weather with urbanization and with infrastructure. We also apply convergent cross mapping (CCM) to identify causal associations between extreme weather and dengue, incorporating vector thermal suitability, urban development, and access to improved water and sanitation. Among extreme weather, heatwaves pose the highest relative risk (RR) [max RR 5.5, 95% CI: 3.27–9.25], followed by drought [max RR 5.21, 95% CI: 3.31–8.21], wet conditions [max RR 2.76, 95% CI: 1.79–4.26], and compound drought–heatwave events [max RR 2.55, 95% CI: 1.3–5.01]. Causal analysis indicates divergent pathways: in urban settings with improved infrastructure and high mosquito thermal suitability, drought and compound drought–heatwave events emerge as key drivers; in rural settings with poor infrastructure and low mosquito thermal suitability, their effects are not significant. This study reveals that extreme weather–driven dengue is modulated by social vulnerability and mosquito thermal suitability, and provides practical insights for integrating extreme weather into adaptation strategies for dengue control.

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Wang D., Wu X., Chen J., et al. (2026). Urbanization, infrastructure, and mosquito thermal suitability shape the causal effects of extreme weather on dengue transmission. The Innovation Medicine 4:100188. https://doi.org/10.59717/j.xinn-med.2026.100188

Wang D., Wu X., Chen J., et al. (2026). Urbanization, infrastructure, and mosquito thermal suitability shape the causal effects of extreme weather on dengue transmission. The Innovation Medicine 4:100188. https://doi.org/10.59717/j.xinn-med.2026.100188

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Urbanization, infrastructure, and mosquito thermal suitability shape the causal effects of extreme weather on dengue transmission

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Urbanization, infrastructure, and mosquito thermal suitability shape the causal effects of extreme weather on dengue transmission

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