BibTex format
@article{Djaafara:2026:10.1371/journal.pntd.0014135,
author = {Djaafara, BA and Elyazar, IRF and Silalahi, FSM and Surya, A and Handito, A and Thohir, B and Aryani, D and Kamal, M and Ramadona, AL and Gunawan, D and Hipokrates and Khoirun, Nisa A and Prianto, E and Samad, I and Sugiarto, A and Fornace, K and Clapham, HE and Faria, NR and Mishra, S},
doi = {10.1371/journal.pntd.0014135},
journal = {PLoS Negl Trop Dis},
title = {Dengue transmission heterogeneity across Indonesia's archipelago: Climate-driven spatiotemporal patterns and policy implications.},
url = {http://dx.doi.org/10.1371/journal.pntd.0014135},
volume = {20},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Indonesia has the highest dengue burden in Southeast Asia, with 488 of 514 districts reporting cases annually across its 17,000-island archipelago. Despite this substantial burden, spatiotemporal transmission patterns remain poorly characterised. We analysed province-level dengue surveillance data (2010-2024) from Indonesia's Ministry of Health alongside local and regional climate variables to characterise heterogeneity in dengue periodicity and identify provinces where climate-based early warning may be feasible. Using wavelet phase analysis, dynamic time warping clustering, and distributed lag non-linear models, we examined relationships between climate and dengue incidence across 34 provinces. A systematic west-to-east gradient in dengue wave timing was identified, with Northern Sumatran provinces peaking earlier than other provinces, aligning with Australian-Asian monsoon progression. This gradient was robust in western Indonesia (Spearman ρ = 0.7 between longitude and phase lag) but weakened in eastern provinces. Multi-annual outbreak peaks (2015-2016, 2023-2024) coincided with strong El Niño events, with mean incidence during strong El Niño years was 96% higher than other years. The Indian Ocean Dipole showed no significant association. Phase coherence analysis identified 18 provinces where precipitation-dengue timing was sufficiently consistent (coherence ≥0.85) for potential early warning applications and DLNM confirmed significant dose-response associations in 11 of these. Indonesia's dengue-climate relationships exhibit structured heterogeneity that precludes uniform national prediction approaches but may enable province-specific early warning in high-coherence areas. A two-tier system combining ENSO monitoring for strategic preparedness with local climate monitoring for tactical intervention timing could improve outbreak response across Indonesia's diverse epidemiological landscapes.
AU - Djaafara,BA
AU - Elyazar,IRF
AU - Silalahi,FSM
AU - Surya,A
AU - Handito,A
AU - Thohir,B
AU - Aryani,D
AU - Kamal,M
AU - Ramadona,AL
AU - Gunawan,D
AU - Hipokrates
AU - Khoirun,Nisa A
AU - Prianto,E
AU - Samad,I
AU - Sugiarto,A
AU - Fornace,K
AU - Clapham,HE
AU - Faria,NR
AU - Mishra,S
DO - 10.1371/journal.pntd.0014135
PY - 2026///
TI - Dengue transmission heterogeneity across Indonesia's archipelago: Climate-driven spatiotemporal patterns and policy implications.
T2 - PLoS Negl Trop Dis
UR - http://dx.doi.org/10.1371/journal.pntd.0014135
UR - https://www.ncbi.nlm.nih.gov/pubmed/41843618
VL - 20
ER -