{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:57:09Z","timestamp":1787021829152,"version":"build-2736575974"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013896","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000}}],"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011738","name":"Lee Kong Chian School of Medicine, Nanyang Technological University","doi-asserted-by":"publisher","award":["Ministry of Education Start-Up Grant"],"award-info":[{"award-number":["Ministry of Education Start-Up Grant"]}],"id":[{"id":"10.13039\/501100011738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001459","name":"Ministry of Education - Singapore","doi-asserted-by":"publisher","award":["RT4\/22"],"award-info":[{"award-number":["RT4\/22"]}],"id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001459","name":"Ministry of Education - Singapore","doi-asserted-by":"publisher","award":["RS04\/22"],"award-info":[{"award-number":["RS04\/22"]}],"id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001381","name":"National Research Foundation Singapore","doi-asserted-by":"publisher","award":["CISR-2023-1R-01"],"award-info":[{"award-number":["CISR-2023-1R-01"]}],"id":[{"id":"10.13039\/501100001381","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/V031112\/1"],"award-info":[{"award-number":["MR\/V031112\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Climate change is postulated to impact infectious disease transmission, yet few studies have characterised the excess risks of infectious diseases associated with extreme weather events. To address this, we conducted a study estimating and projecting the impacts of extreme heat and precipitation on the incidence of major infectious diseases in Thailand. We developed, fitted and validated an analytical framework to model province-level disease cases and their relationship with extreme weather indicators based on historical data. We used generalised additive models to delineate the relationship between monthly extreme heat days, standardised precipitation index and incidence rates of seven infectious diseases (dengue, malaria, Japanese encephalitis, melioidosis, leptospirosis, pneumonia, influenza) across Thailand\u2019s provinces. Disease-specific models were fitted to historical surveillance data and used to project future disease incidence across 4 Shared Socioeconomic Pathways (SSP) based on MIROC6 climate projections. Historically, extreme heat was associated with an increase in all infectious disease incidences except malaria and leptospirosis. We projected that dengue risk declines in most future climate change scenarios, except SSP245 where extreme heat drives a significant rise in Northern and Central Thailand from 2021\u20132060. Nationwide dengue risk is expected to decrease by 24.9% (95%CI:9.68%,40.0%) during future periods of extreme weather from 2061\u20132080 compared to historical baselines. Influenced by heat and dry weather in Northeastern and Central regions, influenza risk is expected to increase under SSP245 in 2021\u20132060, then decrease with extreme precipitation. Influenza risk in Nakhon Ratchasima is expected to increase by 36.8% (95%CI:9.83%,63.8%) in 2021\u20132040 under SSP245. Localised public health interventions are necessary to address climate change impacts.<\/jats:p>","DOI":"10.1371\/journal.pntd.0013896","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T19:26:31Z","timestamp":1767641191000},"page":"e0013896","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Projecting long-term excess risks of major infectious diseases associated with future extreme weather events in Thailand"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3165-8895","authenticated-orcid":true,"given":"Esther Li Wen","family":"Choo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo Yi","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve Hung-Lam","family":"Yim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Brady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borame Lee","family":"Dickens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-0331","authenticated-orcid":true,"given":"Jue Tao","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"pntd.0013896.ref001","author":"Intergovernmental Panel on Climate Change","year":"2020"},{"key":"pntd.0013896.ref002","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-079343","article-title":"The impact of increasing temperatures due to climate change on infectious diseases","volume":"387","author":"O Anikeeva","year":"2024","journal-title":"BMJ"},{"issue":"1","key":"pntd.0013896.ref003","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1186\/s12889-024-17961-9","article-title":"Effects of meteorological factors on influenza transmissibility by virus type\/subtype","volume":"24","author":"Z-L Yan","year":"2024","journal-title":"BMC Public Health"},{"issue":"10399","key":"pntd.0013896.ref004","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S0140-6736(23)01569-6","article-title":"Climate change and malaria: predictions becoming reality","volume":"402","author":"U Samarasekera","year":"2023","journal-title":"Lancet"},{"key":"pntd.0013896.ref005","doi-asserted-by":"crossref","first-page":"5452938","DOI":"10.1155\/2018\/5452938","article-title":"Relationship between Flooding and Out Break of Infectious Diseasesin Kenya: A Review of the Literature","volume":"2018","author":"FO Okaka","year":"2018","journal-title":"J Environ Public Health"},{"key":"pntd.0013896.ref006","doi-asserted-by":"crossref","first-page":"104582","DOI":"10.1016\/j.ebiom.2023.104582","article-title":"Effects of high temperatures and heatwaves on dengue fever: a systematic review and meta-analysis","volume":"91","author":"YT Damtew","year":"2023","journal-title":"EBioMedicine"},{"key":"pntd.0013896.ref007","doi-asserted-by":"crossref","first-page":"104593","DOI":"10.1016\/j.ebiom.2023.104593","article-title":"Viral respiratory infections in a rapidly changing climate: the need to prepare for the next pandemic","volume":"93","author":"Y He","year":"2023","journal-title":"EBioMedicine"},{"issue":"2","key":"pntd.0013896.ref008","doi-asserted-by":"crossref","DOI":"10.1016\/S2542-5196(21)00325-9","article-title":"Precipitation variability and risk of infectious disease in children under 5 years for 32 countries: a global analysis using Demographic and Health Survey data","volume":"6","author":"A Dimitrova","year":"2022","journal-title":"Lancet Planet Health"},{"key":"pntd.0013896.ref009","article-title":"A summary case report on the health impacts and response to the pakistan floods of 2010","volume":"5","author":"O Shabir","year":"2013","journal-title":"PLoS Curr"},{"issue":"1","key":"pntd.0013896.ref010","doi-asserted-by":"crossref","DOI":"10.1038\/s41612-025-00968-3","article-title":"Climate warming and influenza dynamics: the modulating effects of seasonal temperature increases on epidemic patterns","volume":"8","author":"W Ruan","year":"2025","journal-title":"NPJ Clim Atmos Sci"},{"issue":"1","key":"pntd.0013896.ref011","doi-asserted-by":"crossref","first-page":"012074","DOI":"10.1088\/1755-1315\/1089\/1\/012074","article-title":"Effect of climate change on the geographical distribution of leptospirosis risk in western Java, Indonesia","volume":"1089","author":"PW Dhewantara","year":"2022","journal-title":"IOP Conf Ser Earth Environ Sci"},{"issue":"10","key":"pntd.0013896.ref012","doi-asserted-by":"crossref","DOI":"10.1029\/2025GH001541","article-title":"Climate Change Is Expected to Expand Malaria Transmission Range and Population at Risk in Papua New Guinea","volume":"9","author":"S Karl","year":"2025","journal-title":"Geohealth"},{"issue":"1","key":"pntd.0013896.ref013","doi-asserted-by":"crossref","first-page":"5439","DOI":"10.1038\/s41467-023-41017-y","article-title":"Projecting the future incidence and burden of dengue in Southeast Asia","volume":"14","author":"FJ Col\u00f3n-Gonz\u00e1lez","year":"2023","journal-title":"Nat Commun"},{"key":"pntd.0013896.ref014","author":"Ministry of Public Health Thailamd","year":"2024"},{"issue":"2","key":"pntd.0013896.ref015","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0960-1481(01)00005-2","article-title":"Thailand climatic zones","volume":"25","author":"J Khedari","year":"2002","journal-title":"Renew Energy"},{"key":"pntd.0013896.ref016","author":"Thailand","year":"2024"},{"key":"pntd.0013896.ref017","author":"Thailand Ministry of Public Health","year":"2024"},{"issue":"4","key":"pntd.0013896.ref018","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s40475-017-0124-4","article-title":"The Role of Climate in the Epidemiology of Melioidosis","volume":"4","author":"AJ Merritt","year":"2017","journal-title":"Curr Trop Med Rep"},{"issue":"10","key":"pntd.0013896.ref019","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.trstmh.2010.07.002","article-title":"Climate change, flooding, urbanisation and leptospirosis: fuelling the fire?","volume":"104","author":"CL Lau","year":"2010","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0013896.ref020","article-title":"ERA5 hourly data on single levels from 1940 to present.","author":"C3S","year":"2018"},{"key":"pntd.0013896.ref021","author":"National Statistical Office Thailand","year":"2024"},{"key":"pntd.0013896.ref022","doi-asserted-by":"crossref","first-page":"107804","DOI":"10.1016\/j.dib.2022.107804","article-title":"High-resolution global population projections dataset developed with CMIP6 RCP and SSP scenarios for year 2010-2100","volume":"40","author":"NB Ol\u00e9n","year":"2022","journal-title":"Data Brief"},{"key":"pntd.0013896.ref023","doi-asserted-by":"crossref","first-page":"170001","DOI":"10.1038\/sdata.2017.1","article-title":"High resolution global gridded data for use in population studies","volume":"4","author":"CT Lloyd","year":"2017","journal-title":"Sci Data"},{"key":"pntd.0013896.ref024","article-title":"The relationship of drought frequency and duration to time scales","author":"T McKee","year":"1993","journal-title":"Eighth Conference on Applied Climatology"},{"key":"pntd.0013896.ref025","author":"S Beguer\u00eda","year":"2011"},{"issue":"2","key":"pntd.0013896.ref026","doi-asserted-by":"crossref","first-page":"96","DOI":"10.13031\/2013.26773","article-title":"Reference Crop Evapotranspiration from Temperature","volume":"1","author":"GH Hargreaves","year":"1985","journal-title":"Appl Eng Agric"},{"key":"pntd.0013896.ref027","author":"NASA Global Modelling and Association Office","year":"2011"},{"key":"pntd.0013896.ref028","article-title":"IPSL IPSL-CM6A-LR model output prepared for CMIP6 CMIP","author":"O Boucher","year":"2018"},{"key":"pntd.0013896.ref029","article-title":"CMCC CMCC-ESM2 model output prepared for CMIP6 LS3MIP","author":"D Peano","year":"2020"},{"key":"pntd.0013896.ref030","article-title":"MIROC MIROC6 model output prepared for CMIP6 ScenarioMIP","author":"H Shiogama","year":"2019"},{"issue":"5","key":"pntd.0013896.ref031","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.envsoft.2008.10.008","article-title":"Using MODAWEC to generate daily weather data for the EPIC model","volume":"24","author":"J Liu","year":"2009","journal-title":"Environ Model Softw"},{"key":"pntd.0013896.ref032","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.gloenvcha.2016.05.009","article-title":"The Shared Socioeconomic Pathways and their energy, land use, and greenhouse gas emissions implications: An overview","volume":"42","author":"K Riahi","year":"2017","journal-title":"Glob Environ Change"},{"issue":"3","key":"pntd.0013896.ref033","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/0304-4076(90)90014-K","article-title":"Regression-based tests for overdispersion in the Poisson model","volume":"46","author":"AC Cameron","year":"1990","journal-title":"J Econ"},{"issue":"11","key":"pntd.0013896.ref034","article-title":"The effects of weather and climate change on dengue","volume":"7","author":"FJ Col\u00f3n-Gonz\u00e1lez","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"issue":"5","key":"pntd.0013896.ref035","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S1473-3099(22)00025-1","article-title":"Measuring the effects of COVID-19-related disruption on dengue transmission in southeast Asia and Latin America: a statistical modelling study","volume":"22","author":"Y Chen","year":"2022","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"pntd.0013896.ref036","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011763","article-title":"Non-linear associations between meteorological factors, ambient air pollutants and major mosquito-borne diseases in Thailand","volume":"17","author":"P Tewari","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013896.ref037","doi-asserted-by":"crossref","DOI":"10.1201\/9781315370279","author":"SN Wood","year":"2017","journal-title":"Generalized Additive Models: An Introduction with R"},{"key":"pntd.0013896.ref038","doi-asserted-by":"crossref","first-page":"103478","DOI":"10.1016\/j.ijdrr.2022.103478","article-title":"The non-linear and interactive effects of meteorological factors on the transmission of COVID-19: A panel smooth transition regression model for cities across the globe","volume":"84","author":"G Zhai","year":"2023","journal-title":"Int J Disaster Risk Reduct"},{"issue":"1","key":"pntd.0013896.ref039","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/1467-9868.00374","article-title":"Thin Plate Regression Splines","volume":"65","author":"SN Wood","year":"2003","journal-title":"J R Stat Soc Ser B Stat Methodol"},{"issue":"1","key":"pntd.0013896.ref040","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1467-9868.2010.00749.x","article-title":"Fast Stable Restricted Maximum Likelihood and Marginal Likelihood Estimation of Semiparametric Generalized Linear Models","volume":"73","author":"SN Wood","year":"2010","journal-title":"J R Stat Soc Ser B Stat Methodol"},{"issue":"11","key":"pntd.0013896.ref041","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0050972","article-title":"The incubation periods of Dengue viruses","volume":"7","author":"M Chan","year":"2012","journal-title":"PLoS One"},{"key":"pntd.0013896.ref042","doi-asserted-by":"crossref","first-page":"100382","DOI":"10.1016\/j.epidem.2019.100382","article-title":"Temperature-dependent variation in the extrinsic incubation period elevates the risk of vector-borne disease emergence","volume":"30","author":"T Kamiya","year":"2020","journal-title":"Epidemics"},{"key":"pntd.0013896.ref043","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.12688\/f1000research.125294.2","article-title":"The relationship between climate change and malaria in South-East Asia: A systematic review of the evidence","volume":"11","author":"AA Rahmani","year":"2023","journal-title":"F1000Res"},{"issue":"3","key":"pntd.0013896.ref044","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3390\/tropicalmed8030179","article-title":"Environmental Factors Linked to Reporting of Active Malaria Foci in Thailand","volume":"8","author":"P Prempree","year":"2023","journal-title":"Trop Med Infect Dis"},{"issue":"8","key":"pntd.0013896.ref045","doi-asserted-by":"crossref","first-page":"3118","DOI":"10.1073\/pnas.1815029116","article-title":"High ambient temperature dampens adaptive immune responses to influenza A virus infection","volume":"116","author":"M Moriyama","year":"2019","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"1","key":"pntd.0013896.ref046","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1038\/s41598-020-79546-x","article-title":"The effects of flooding and weather conditions on leptospirosis transmission in Thailand","volume":"11","author":"S Chadsuthi","year":"2021","journal-title":"Sci Rep"},{"key":"pntd.0013896.ref047","doi-asserted-by":"crossref","first-page":"105731","DOI":"10.1016\/j.ebiom.2025.105731","article-title":"COPD risk due to extreme temperature exposure: combining epidemiological evidence with pathophysiological mechanisms","volume":"116","author":"J Xu","year":"2025","journal-title":"EBioMedicine"},{"issue":"1","key":"pntd.0013896.ref048","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1038\/s41467-022-35748-7","article-title":"Interaction between dry and hot extremes at a global scale using a cascade modeling framework","volume":"14","author":"S Mukherjee","year":"2023","journal-title":"Nat Commun"},{"key":"pntd.0013896.ref049","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.gloenvcha.2016.06.004","article-title":"The marker quantification of the Shared Socioeconomic Pathway 2: A middle-of-the-road scenario for the 21st century","volume":"42","author":"O Fricko","year":"2017","journal-title":"Global Environmental Change"},{"issue":"1","key":"pntd.0013896.ref050","doi-asserted-by":"crossref","DOI":"10.1186\/s40249-019-0565-1","article-title":"Impact of past and on-going changes on climate and weather on vector-borne diseases transmission: a look at the evidence","volume":"8","author":"F Fouque","year":"2019","journal-title":"Infect Dis Poverty"},{"issue":"12","key":"pntd.0013896.ref051","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.3390\/pathogens10121534","article-title":"The Ecology and Evolution of Japanese Encephalitis Virus","volume":"10","author":"P Mulvey","year":"2021","journal-title":"Pathogens"},{"issue":"4","key":"pntd.0013896.ref052","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0000188","article-title":"Influence of climate variables on dengue fever occurrence in the southern region of Thailand","volume":"2","author":"FI Abdulsalam","year":"2022","journal-title":"PLOS Glob Public Health"},{"issue":"3","key":"pntd.0013896.ref053","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0009182","article-title":"Impact of recent climate extremes on mosquito-borne disease transmission in Kenya","volume":"15","author":"C Nosrat","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013896.ref054","first-page":"4123543","article-title":"Breeding Habitat Preference of the Dengue Vector Mosquitoes Aedes aegypti and Aedes albopictus from Urban, Semiurban, and Rural Areas in Kurunegala District, Sri Lanka","volume":"2024","author":"JMMK Herath","year":"2024","journal-title":"J Trop Med"},{"issue":"12","key":"pntd.0013896.ref055","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0006935","article-title":"Statistical modeling of the effect of rainfall flushing on dengue transmission in Singapore","volume":"12","author":"CM Benedum","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013896.ref056","article-title":"Analysis of temperature and humidity on dengue hemorrhagic fever in Manado Municipality","author":"TCN Monintja","year":"2021","journal-title":"Gac Sanit"},{"key":"pntd.0013896.ref057","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1186\/1756-3305-7-447","article-title":"Bionomic response of Aedes aegypti to two future climate change scenarios in far north Queensland, Australia: implications for dengue outbreaks","volume":"7","author":"CR Williams","year":"2014","journal-title":"Parasit Vectors"},{"issue":"10301","key":"pntd.0013896.ref058","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S0140-6736(21)01208-3","article-title":"Hot weather and heat extremes: health risks","volume":"398","author":"KL Ebi","year":"2021","journal-title":"Lancet"},{"issue":"9","key":"pntd.0013896.ref059","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0239729","article-title":"Climate factors influence seasonal influenza activity in Bangkok, Thailand","volume":"15","author":"N Suntronwong","year":"2020","journal-title":"PLoS One"},{"key":"pntd.0013896.ref060","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1186\/s40064-015-1149-6","article-title":"Influenza activity in Thailand and occurrence in different climates","volume":"4","author":"S Prachayangprecha","year":"2015","journal-title":"Springerplus"},{"issue":"3","key":"pntd.0013896.ref061","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1003194","article-title":"Environmental predictors of seasonal influenza epidemics across temperate and tropical climates","volume":"9","author":"JD Tamerius","year":"2013","journal-title":"PLoS Pathog"},{"key":"pntd.0013896.ref062","author":"National Institute of Environmenta Health","year":"2024"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013896","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:43:07Z","timestamp":1767897787000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013896"}},"subtitle":[],"editor":[{"given":"Qu","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":62,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013896","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]}}}