Socioeconomic determinants of dengue incidence in Singapore.

Abstract

Community participation is critical in sustaining vector population control activities in order to preventdengue transmission. However, disease exposure in a community is often not uniform across the entirepopulation and the identification of “at-risk” groups would enable the disease prevention effort to befocused and thus cost-effective. We performed ecological data analyses to study the association betweensocioeconomic variables and dengue incidence in Singapore from 1998 to 2002. Our results indicatedthat the DF/DHF incidence was ecologically associated with some socioeconomic/demographiccharacteristics of the population. Areas with a high proportion of socioeconomically disadvantagedresidents had also a significantly higher DF/DHF incidence. The Aedes population density of larvae wasnot related to this difference in the DF/DHF incidence, indicating that additional risk factors werepresent in these population sub-groups, and that dengue control in Singapore could benefit from amore focused effort in outreach to the population of relatively lower socioeconomic levels.