Dengue fever is an increasing public health concern in urban India due to rapid urbanization, inadequate vector control, and underreporting of cases. Surat, a densely populated city in Gujarat, has remained a recurrent dengue hotspot, yet detailed spatiotemporal patterns and entomological determinants of transmission remain insufficiently explored. This study aimed to assess spatiotemporal patterns of dengue transmission in Surat and identify entomological and demographic predictors of elevated vector density to guide targeted urban interventions. A retrospective longitudinal analysis was conducted using five years of dengue surveillance data (January 2016–December 2020). A total of 1,658 laboratory-confirmed dengue cases reported to the sentinel surveillance system of the Surat Municipal Corporation were included. Monthly entomological surveillance assessed vector indices—House Index (HI), Container Index (CI), and Breteau Index (BI)—across administrative zones. Associations were examined using chi-square analysis, and binomial logistic regression identified predictors of moderate-to-high vector density (HI ≥ 1%) considering temporal, spatial, and demographic variables. Model performance was evaluated using receiver operating characteristic analysis. During the study period, reported dengue incidence declined from 11.1 to 2.2 cases per 100,000 population; however, elevated vector indices persisted, particularly in the South and South-East zones. Approximately 36% of cases occurred in households located in areas with HI ≥ 1%. Adolescents and young adults (median age 21.7 years) were disproportionately affected. Public sector facilities reported 2.6 times more cases than private providers (p < 0.001), suggesting substantial underreporting. Logistic regression identified year, month, zone, and age as significant predictors of elevated vector density (p < 0.001). The model showed moderate discrimination (AUC = 0.688), high specificity (87.3%), and low sensitivity (35.9%). Despite declining reported incidence, persistently high larval indices and post-monsoon peaks indicate ongoing transmission risk, emphasizing the need for zone-specific vector control and strengthened surveillance systems.
Gohil et al. (Thu,) studied this question.
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