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. 2025 Feb 3;19(2):e0012832.
doi: 10.1371/journal.pntd.0012832. eCollection 2025 Feb.

Temporal shifts in dengue epidemic in Guangdong Province before and during the COVID-19 pandemic: a Bayesian model study from 2012 to 2022

Jiaqing Xu  1   2   3 , Xiaohua Tan  3   4 , Yi Quan  5   6 , Dexin Gong  2 , Hui Deng  3   4 , Jianguo Zhao  2 , Xing Huang  2   7 , Yingtao Zhang  3   4 , Zhoupeng Ren  8 , Zuhua Rong  2 , Weilin Zeng  2 , Xing Li  2 , Wenyuan Zheng  2   9 , Shu Xiao  2   9 , Jianpeng Xiao  1   2   7   9 , Meng Zhang  3   4
Affiliations

Temporal shifts in dengue epidemic in Guangdong Province before and during the COVID-19 pandemic: a Bayesian model study from 2012 to 2022

Jiaqing Xu et al. PLoS Negl Trop Dis. .

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the implementation of public health intervention measures have reshaped the transmission patterns of other infectious diseases. We aimed to analyze the epidemiological characteristics of dengue in Guangdong Province, China, and to investigate the temporal shifts in dengue epidemic in Guangdong Province during the COVID-19 pandemic.

Methods: Based on the data of dengue reported cases, meteorological factors, and mosquito vector density in Guangdong Province from 2012 to 2022, wavelet analysis was applied to investigate the relationship between the dengue incidence in Southeast Asian (SEA) countries and the local dengue incidence in Guangdong Province. We constructed the dengue importation risk index to assess the monthly risk of dengue importation. Based on the counterfactual framework, we constructed the Bayesian structural time series (BSTS) model to capture the epidemic trends of dengue.

Results: Wavelet analysis showed that the local dengue incidence in Guangdong Province was in phase correlation with the dengue incidence of the prior month in relative SEA countries. The dengue importation risk index showed an increasing trend from 2012 to 2019, then decreased to a low level during the COVID-19 pandemic. From 2020 to 2022, the average annual number of reported imported cases and local cases of dengue in Guangdong Province were 26 and 2, respectively, with a decrease of 95.62% and 99.94% compared to the average during 2017-2019 (594 imported cases and 3,118 local cases). According to BSTS model estimates, 6557 local dengue cases may have been reduced in Guangdong Province from 2020 to 2022, with a relative reduction of 99.91% (95%CI: 98.85-99.99%).

Conclusion: The incidence of dengue in Guangdong notably declined from 2020 to 2022, which may be related to the co-benefits of COVID-19 intervention measures and the intensified interventions against dengue during that period. Furthermore, our findings further supported that dengue is not currently endemic in Guangdong.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The epidemic process of COVID-19 and synchronous interventions from 2020 to 2022 in Guangdong Province.
Fig 2
Fig 2. Epidemiological characteristics of dengue in Guangdong Province from 2012 to 2022.
(A) The monthly number of total local dengue cases. (B) The monthly number of total imported dengue cases. (C) Spatial distribution of local dengue cases. Based map sourced from the Resource and Environmental Science Data Platform (https://www.resdc.cn/DOI/DOI.aspx?DOIID=121) [44]. (D) Origin-destination routes of dengue importation from SEA into Guangdong.
Fig 3
Fig 3. Temporal distribution and phase relationship of monthly dengue incidence in relative SEA countries and Guangdong Province from 2012 to 2022.
(A) Monthly distribution of dengue incidence in relative SEA countries. (B) Monthly distribution of international flights from SEA countries to Guangdong Province. (C) The phase relationship between local cases and imported cases (“GDcase” represents local dengue cases in Guangdong Province). (D) The phase relationship between local cases and imported cases (“SEAimpcase” represents imported dengue cases from SEA countries to Guangdong Province).
Fig 4
Fig 4. The dengue monthly importation risks from SEA countries into Guangdong provinces from 2012 to 2022.
(A) The dengue monthly importation risk from six SEA countries. (B) The comparison between monthly predicted counterfactual (red dotted line) and reported importation risk (black solid line) of dengue in Guangdong Province.
Fig 5
Fig 5. The comparison between monthly predicted counterfactual dengue cases and observed cases from 2012 to 2022 in Guangdong Province.
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