{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:39:24Z","timestamp":1792726764076,"version":"4.5.0"},"reference-count":79,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Introduction<\/jats:title><jats:p>Dengue fever is the most prevalent arboviral disease in the Brazilian Amazon and places a major health, social and economic burden on the region. Its association with deforestation is largely unknown, yet the clearing of tropical rainforests has been linked to the emergence of several infectious diseases, including yellow fever and malaria. This study aimed to explore potential drivers of dengue emergence in the Brazilian Amazon with a focus on deforestation.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>An ecological study design using municipality-level secondary data from the Amazonas state between 2007 and 2017 (reported rural dengue cases, incremental deforestation, socioeconomic characteristics, healthcare and climate factors) was employed. Data were transformed according to the year with the most considerable deforestation. Associations were explored using bivariate analysis and a multivariate generalised linear model.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>During the study period 2007\u20132017, both dengue incidence and deforestation increased. Bivariate analysis revealed increased incidences for some years after deforestation (e.g. mean difference between dengue incidence before and three years after deforestation was 55.47 cases per 100,000, p = 0.002), however, there was no association between the extent of deforestation and dengue incidence. Using a negative binomial regression model adjusted for socioeconomic, climate and healthcare factors, deforestation was not found to be related to dengue incidence. Access to healthcare was found to be the only significant predictor of dengue incidence.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Discussion<\/jats:title><jats:p>Previous research has shown that deforestation facilitates the emergence of vector-borne diseases. However, no significant dose-response relationships between dengue incidence and deforestation in the Brazilian Amazonas state were found in this study. The finding that access to healthcare was the only significant predictor of dengue incidence suggests that incidence may be more dependent on surveillance than transmission. Further research and public attention are needed to better understand environmental effects on human health and to preserve the world\u2019s largest rainforest.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0242685","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T22:42:05Z","timestamp":1610059325000},"page":"e0242685","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":25,"title":["Exploring the influence of deforestation on dengue fever incidence in the Brazilian Amazonas state"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7388-7074","authenticated-orcid":true,"given":"Alexandra","family":"Kalbus","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanderson","family":"de Souza Sampaio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Boenecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Reintjes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"issue":"9966","key":"pone.0242685.ref001","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0140-6736(14)60572-9","article-title":"Dengue","volume":"385","author":"MG Guzman","year":"2015","journal-title":"Lancet"},{"key":"pone.0242685.ref002","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.envres.2016.07.026","article-title":"Dengue in a changing climate","volume":"151","author":"KL Ebi","year":"2016","journal-title":"Environ Res"},{"issue":"15","key":"pone.0242685.ref003","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1056\/NEJMra1110265","article-title":"Dengue","volume":"366","author":"CP Simmons","year":"2012","journal-title":"N Engl J Med"},{"key":"pone.0242685.ref004","article-title":"Epidemiology of dengue: past, present and future prospects","volume":"299","author":"N Murray","year":"2013","journal-title":"J Clin Epidemiol"},{"issue":"1","key":"pone.0242685.ref005","first-page":"94","article-title":"The invasion of an urban forest by dengue vectors in Rio de Janeiro","volume":"29","author":"R Louren\u00e7o-de-Oliveira","year":"2004","journal-title":"J Vector Ecol"},{"issue":"6","key":"pone.0242685.ref006","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1093\/jmedent\/43.6.1112","article-title":"Movement of Dengue Vectors Between the Human Modified Environment and an Urban Forest in Rio de Janeiro","volume":"43","author":"R Maciel-de-Freitas","year":"2006","journal-title":"J Med Entomol"},{"issue":"5","key":"pone.0242685.ref007","first-page":"854","article-title":"Past and future spread of the arbovirus vectors Aedes aegypti and Aedes albopictus. 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