Primary Drivers of Dengue Spatial Heterogeneity in Northeastern Thailand’s Border Provinces (2014–2023)

Dengue fever remains a significant public health concern with over 100 million cases globally each year. Thailand is a hotspot experiencing dengue outbreaks in all regions, especially northeastern Thailand. Within this hyperendemic region, five border provinces, Ubon Ratchathani, Sisaket, Yasothon, Amnat Charoen, and Mukdahan, serve as critical dengue hotspots with historically high incidence and national surveillance alerts, underscoring their importance in regional disease control. This study analyzed 53,241 dengue cases across five border provinces from 2014 to 2023. Ubon Ratchathani province reported the highest caseload, while Khong Chiam district had the highest incidence rate. Children and adolescents were disproportionately affected, with a concerning rise in severe disease among older children. Occupational and demographic factors influenced disease burden, with students, males, and infants at increased risk. Localized outbreaks and varying disease patterns highlight the complexity of dengue in this region. Amnat Charoen province saw a significant increase in dengue hemorrhagic fever (DHF) cases, from 25.78% in 2015 to 97.77% in 2023. Crucially, the extreme vulnerability of newborns was starkly evident, with a total of 15 newborn dengue cases (DF and DHF combined) identified in this study across the entire 10‐year period. A substantial 12 cases (7 DF and 5 DHF) were reported in Mukdahan province’s border district, all occurring in 2023 alone. Notably, all five newborn DHF cases identified throughout the entire study period were concentrated in this single district in 2023. This highly localized clustering of severe dengue in the most vulnerable age group highlights a significant, acute outbreak in that area, potentially linked to vertical transmission, and underscores the urgent need for targeted maternal–child health interventions. This study underscores the substantial dengue burden in northeastern Thailand’s border provinces. To effectively mitigate dengue’s impact and inform robust prevention and control strategies, further research is imperative to elucidate the underlying factors driving these trends. The study was conducted without external funding.