Socio-economic predictors of dengue fever at the municipality level in Mexico

Purpose: The dengue virus is an arbovirus of increasing global concern. Both the disease and its vector, Aedes mosquitos, have spread extensively over the past 30 years. This is often attributed to climate change and urbanization. However, there is evidence that socio-economic factors may also impact the risk of dengue infection. This study sought to identify socio-economic factors that contribute to the burden of dengue fever in Mexico. Methods: Monthly dengue fever reports were compiled by municipality health departments in Mexico from 2012 through 2019. These reports were then combined with census tract data containing socio-economic variables for each municipality. Negative binomial regression was carried out using SAS 9.4 to produce relative risks. Results: The percentage of households without indoor plumbing, toilets, or access to health services within each municipality were examined as covariates. Lack of indoor plumbing increased the risk of dengue 1.03 times (95% CI 1.030, 1.034). Lack of health services increased the risk for dengue 1.01 times (95% CI 1.013, 1.017). Homes without toilets increased the risk of dengue 1.04 times (95% CI 1.03, 1.04). Conclusion: Socioeconomic factors at the municipality level are significant predictors of dengue fever. Municipalities with greater percentage of access to health services, indoor plumbing and toilets had decreased risk of dengue; the burden of dengue fever in Mexico may be reduced by improving access to these key services.