Climate and visitors as the influencing factors of dengue fever in Badung District of Bali, Indonesia

Badung district has recorded the highest dengue fever (DF) in Bali Province. This research presents the distribution of DF in Badung district and analyses its association with climate and visitors. The monthly data of DF, climate and number of visitors during January 2013 to December 2017 were analysed using Poisson Regression. A total of 10,689 new DF cases were notified from January 2013 to December 2017. DF in 2016 was recorded as the heaviest incidence. Monthly DF cases have positive association with average temperature (0.59 (95% CI: 0.56–.62)), precipitation (5.7 x 10−4 (95% CI: 3.8 x 10−4 − 7.6 x 10−4)), humidity (.014 (95% CI: 0.003–.025)) and local visitors (7.40 x 10−6 95% CI: 5.88 x 10−6 : 8.91 x 10−6). Negative association was shown between DF cases with foreign visitors (−2.18 x 10−6 (95% CI: −2.50 x 10−6 : −1.87 x 10−6)). This study underlines the urgency to integrate climate and tourism for DF surveillance.