Assessing the impact of flood duration on dengue burden across 108 countries

Dengue burden is exacerbated by climate change and environmental disasters such as floods. To quantify this association, we modeled age-standardized dengue incidence rates across 108 countries from 2000 to 2021 using quasi-Poisson regression, adjusting for socioeconomic, health system, and meteorological covariates. Over this period, the global age-standardized incidence rate of dengue increased significantly to 752.04 per 100,000 population. We found that each additional day in mean flood duration was associated with a 0.37% increase in dengue incidence. Stronger associations occurred in the Region of the Americas, high-middle sociodemographic index regions, and among older adults. These findings highlight the importance of incorporating flood risk into dengue early warning systems, disaster preparedness, and vector control strategies to mitigate the public health impacts of climate-related disasters.