{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T02:38:20Z","timestamp":1769049500218,"version":"3.49.0"},"reference-count":70,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R01EY029594"],"award-info":[{"award-number":["1R01EY029594"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Climate change and the El Ni\u00f1o Southern Oscillation (ENSO) events have been increasingly linked to infectious disease outbreaks. While growing evidence has connected climate variability with systemic illnesses, the ocular implications remain underexplored. This study aimed to assess the relationships between ENSO-driven climate events and infectious diseases with ophthalmic consequences. A narrative review of 255 articles was conducted, focusing on infectious diseases influenced by ENSO and their associated ocular findings. 39 articles met criteria for full review, covering diseases such as dengue, zika, chikungunya, malaria, leishmaniasis, leptospirosis, and Rift Valley fever. Warmer temperatures, increased rainfall, and humidity associated with ENSO events were found to enhance vector activity and disease transmission. Ocular complications included uveitis, retinopathy, and optic neuropathy, but the specific disease findings varied by infectious disease syndrome. The climactic variable changes in response to ENSO events differed across diseases and regions and were influenced by geography, local infrastructure, and socioeconomic factors. ENSO event-related climate shifts significantly impact the spread of infectious diseases with ocular symptoms. These findings highlight the need for region-specific surveillance and predictive models that may provide insight related to the risk of ophthalmic disease during ENSO events. Further research is needed to clarify long-term ENSO effects and develop integrated strategies for systemic and eye disease detection, prevention, and management.<\/jats:p>","DOI":"10.3390\/tropicalmed10100297","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:23:34Z","timestamp":1760952214000},"page":"297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of El Nino Southern Oscillation and Climate Change on Infectious Diseases with Ophthalmic Manifestations"],"prefix":"10.3390","volume":"10","author":[{"given":"Crystal","family":"Huang","sequence":"first","affiliation":[{"name":"Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE 68105, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb M.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE 68105, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Ufongene","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tolulope","family":"Fashina","sequence":"additional","affiliation":[{"name":"Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE 68105, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. V. Paul","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica G.","family":"Shantha","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, Department of Ophthalmology, University of California San Francisco, San Francisco, CA 94107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Yeh","sequence":"additional","affiliation":[{"name":"Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE 68105, USA"},{"name":"Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE 68198, USA"},{"name":"Emory Eye Center, Emory University School of Medicine, Atlanta, GA 30322, USA"},{"name":"Child Health Research Institute, University of Nebraska Medical Cetner, Omaha, NE 69198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Claude","family":"Mwanza","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of North Carolina, Chapel Hill, NC 27514, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"ref_1","unstructured":"United Nations (2025, July 18). The Paris Agreement. Available online: https:\/\/www.un.org\/en\/climatechange\/paris-agreement."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1126\/science.abo3378","article-title":"Current global efforts are insufficient to limit warming to 1.5 \u00b0C","volume":"376","author":"Matthews","year":"2022","journal-title":"Science"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100139","DOI":"10.1016\/j.crpvbd.2023.100139","article-title":"Temperature and transmission of chikungunya, dengue, and Zika viruses: A systematic review of experimental studies on Aedes aegypti and Aedes albopictus","volume":"4","author":"Delrieu","year":"2023","journal-title":"Curr. Res. Parasitol. Vector Borne Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Harris, M.J., Trok, J.T., Martel, K.S., Borbor Cordova, M.J., Diffenbaugh, N.S., Munayco, C.V., Lescano, A.G., and Mordecai, E.A. (2024). Extreme precipitation, exacerbated by anthropogenic climate change, drove Peru\u2019s record-breaking 2023 dengue outbreak. medRxiv.","DOI":"10.1101\/2024.10.23.24309838"},{"key":"ref_5","unstructured":"WHO (2025, July 18). El Ni\u00f1o Southern Oscillation (ENSO), Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/el-nino-southern-oscillation-(enso)."},{"key":"ref_6","first-page":"100601","article-title":"El Ni\u00f1o-Southern Oscillation: A call to action for public health emergency preparedness and response","volume":"27","author":"Bambaren","year":"2023","journal-title":"Lancet Reg. Health Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1093\/milmed\/usx183","article-title":"Ocular Manifestations of Mosquito-Transmitted Diseases","volume":"183","author":"Karesh","year":"2018","journal-title":"Mil. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1016\/j.jfo.2018.05.002","article-title":"Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever","volume":"41","author":"Merle","year":"2018","journal-title":"J. Fr. D\u2019Ophtalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"taz077","DOI":"10.1093\/jtm\/taz077","article-title":"Dengue, Zika and chikungunya during pregnancy: Pre- and post-travel advice and clinical management","volume":"26","author":"Vouga","year":"2019","journal-title":"J. Travel Med."},{"key":"ref_10","unstructured":"WHO (2025, October 01). Vector-Borne Diseases, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/vector-borne-diseases."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s40985-016-0035-2","article-title":"Climate change and infectious diseases","volume":"37","author":"Flahault","year":"2016","journal-title":"Public Health Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"96476","DOI":"10.5501\/wjv.v13.i4.96476","article-title":"Climate change and the emergence and exacerbation of infectious diseases: A review","volume":"13","author":"Ali","year":"2024","journal-title":"World J. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0035-9203(03)90097-6","article-title":"Common themes in changing vector-borne disease scenarios","volume":"97","author":"Molyneux","year":"2003","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"669","DOI":"10.4103\/ijmr.IJMR_1219_18","article-title":"Concurrent dengue infections: Epidemiology & clinical implications","volume":"154","author":"Sirisena","year":"2021","journal-title":"Indian J. Med. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3126\/nepjoph.v11i2.27814","article-title":"Dengue-associated Eye Disease","volume":"11","author":"Latif","year":"2019","journal-title":"Nepal. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.ajo.2025.08.021","article-title":"Ocular manifestations in Dengue Fever: A Systematic Review and Meta-Analysis","volume":"280","author":"Haslam","year":"2025","journal-title":"Am. J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"540","DOI":"10.4103\/tjo.TJO-D-23-00106","article-title":"An update on the ocular manifestations of dengue","volume":"14","author":"Wang","year":"2024","journal-title":"Taiwan. J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119830","DOI":"10.1016\/j.envres.2024.119830","article-title":"Global risk of dengue outbreaks and the impact of El Ni\u00f1o events","volume":"262","author":"Mokhtar","year":"2024","journal-title":"Env. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1017\/S095026881100183X","article-title":"Meteorological factors and El Ni\u00f1o Southern Oscillation are independently associated with dengue infections","volume":"140","author":"Earnest","year":"2012","journal-title":"Epidemiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"141","DOI":"10.4081\/gh.2014.12","article-title":"Geographical distribution of the association between El Ni\u00f1o South Oscillation and dengue fever in the Americas: A continental analysis using geographical information system-based techniques","volume":"9","author":"Ferreira","year":"2014","journal-title":"Geospat. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"971","DOI":"10.4269\/ajtmh.12-0478","article-title":"Climate and Non-Climate Drivers of Dengue Epidemics in Southern Coastal Ecuador","volume":"88","author":"Lowe","year":"2013","journal-title":"Am. Soc. Trop. Med. Hyg."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Banu, S., Guo, Y., Hu, W., Dale, P., Mackenzie, J.S., Mengersen, K., and Tong, S. (2015). Impacts of El Ni\u00f1o Southern Oscillation and Indian Ocean Dipole on dengue incidence in Bangladesh. Sci. Rep., 5.","DOI":"10.1038\/srep16105"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"106136","DOI":"10.1016\/j.actatropica.2021.106136","article-title":"Spatiotemporal dynamics of dengue in Colombia in relation to the combined effects of local climate and ENSO","volume":"224","author":"Poveda","year":"2021","journal-title":"Acta Trop."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dostal, T., Meisner, J., Munayco, C., Garc\u00eda, P.J., C\u00e1rcamo, C., P\u00e9rez Lu, J.E., Morin, C., Frisbie, L., and Rabinowitz, P.M. (2022). The effect of weather and climate on dengue outbreak risk in Peru, 2000\u20132018: A time-series analysis. PLoS Neglected Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010479"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Vincenti-Gonzalez, M.F., Tami, A., Lizarazo, E.F., and Grillet, M.E. (2018). ENSO-driven climate variability promotes periodic major outbreaks of dengue in Venezuela. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-24003-z"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Pramanik, M., Singh, P., Kumar, G., Ojha, V.P., and Dhiman, R.C. (2020). El Ni\u00f1o Southern Oscillation as an early warning tool for dengue outbreak in India. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09609-1"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.virol.2020.01.015","article-title":"Zika virus-spread, epidemiology, genome, transmission cycle, clinical manifestation, associated challenges, vaccine and antiviral drug development","volume":"543","author":"Pielnaa","year":"2020","journal-title":"Virology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.preteyeres.2018.04.004","article-title":"Zika and the Eye: Pieces of a Puzzle","volume":"66","author":"Ventura","year":"2018","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_29","first-page":"s13742-016","article-title":"Analyzing climate variations at multiple timescales can guide Zika virus response measures","volume":"5","author":"Thomson","year":"2016","journal-title":"Gigascience"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1073\/pnas.1614303114","article-title":"Global risk model for vector-borne transmission of Zika virus reveals the role of El Ni\u00f1o 2015","volume":"114","author":"Caminade","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Anyamba, A., Chretien, J.P., Britch, S.C., Soebiyanto, R.P., Small, J.L., Jepsen, R., Forshey, B.M., Sanchez, J.L., Smith, R.D., and Harris, R. (2019). Global Disease Outbreaks Associated with the 2015\u20132016 El Ni\u00f1o Event. Sci. Rep., 9.","DOI":"10.1038\/s41598-018-38034-z"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.idc.2019.08.006","article-title":"Chikungunya","volume":"33","author":"Vairo","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"da Silva, L.C.M., da Silva Platner, F., da Silva Fonseca, L., Rossato, V.F., de Andrade, D.C.P., de Sousa Valente, J., Brain, S.D., and Fernandes, E.S. (2022). Ocular Manifestations of Chikungunya Infection: A Systematic Review. Pathogens, 11.","DOI":"10.3390\/pathogens11040412"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40942-016-0057-4","article-title":"Arboviruses and the eye","volume":"3","author":"Ventura","year":"2017","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Harapan, H., Michie, A., Yufika, A., Anwar, S., Te, H., Hasyim, H., Nusa, R., Dhewantara, P.W., Mudatsir, M., and Imrie, A. (2020). Effects of El Ni\u00f1o Southern Oscillation and Dipole Mode Index on Chikungunya Infection in Indonesia. Trop. Med. Infect. Dis., 5.","DOI":"10.3390\/tropicalmed5030119"},{"key":"ref_36","unstructured":"Pan American Health Organization (PAHO) (2025, July 18). With Rising Cases, Experts Discuss Chikungunya Spread in the Americas. Available online: https:\/\/www.paho.org\/en\/news\/4-5-2023-rising-cases-experts-discuss-chikungunya-spread-americas."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e1831","DOI":"10.1002\/hsr2.1831","article-title":"Global health concern on the rising dengue and chikungunya cases in the American regions: Countermeasures and preparedness","volume":"7","author":"Mohapatra","year":"2024","journal-title":"Health Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Huang, X., Hu, W., Yakob, L., Devine, G.J., McGraw, E.A., Jansen, C.C., Faddy, H.M., and Frentiu, F.D. (2019). El Ni\u00f1o Southern Oscillation, overseas arrivals and imported chikungunya cases in Australia: A time series analysis. PLoS Neglected Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007376"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Oyas, H., Holmstrom, L., Kemunto, N.P., Muturi, M., Mwatondo, A., Osoro, E., Bitek, A., Bett, B., Githinji, J.W., and Thumbi, S.M. (2018). Enhanced surveillance for Rift Valley Fever in livestock during El Ni\u00f1o rains and threat of RVF outbreak, Kenya, 2015\u20132016. PLoS Neglected Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006353"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.cll.2017.01.004","article-title":"Rift Valley Fever","volume":"37","author":"Hartman","year":"2017","journal-title":"Clin. Lab. Med."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Kuthyar, S., Anthony, C.L., Fashina, T., Yeh, S., and Shantha, J.G. (2021). World Health Organization High Priority Pathogens: Ophthalmic Disease Findings and Vision Health Perspectives. Pathogens, 10.","DOI":"10.3390\/pathogens10040442"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ehelepola, N.D.B., Ariyaratne, K., and Dissanayake, D.S. (2021). The interrelationship between meteorological parameters and leptospirosis incidence in Hambantota district, Sri Lanka 2008\u20132017 and practical implications. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245366"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Weinberger, D., Baroux, N., Grangeon, J.-P., Ko, A.I., and Goarant, C. (2014). El Ni\u00f1o Southern Oscillation and Leptospirosis Outbreaks in New Caledonia. PLoS Neglected Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0002798"},{"key":"ref_44","first-page":"282","article-title":"Ocular leptospirosis: A review of current state of art of a neglected disease","volume":"66","year":"2022","journal-title":"Rom. J. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1093\/trstmh\/try032","article-title":"Spatiotemporal dynamics of human leptospirosis and its relationship with rainfall anomalies in Colombia","volume":"112","year":"2018","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.3855\/jidc.11702","article-title":"Impact of El Ni\u00f1o-Southern oscillation on human leptospirosis in Colombia at different spatial scales","volume":"13","year":"2019","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_47","first-page":"785","article-title":"Climatic Variability and Human Leptospirosis Cases in Cartagena, Colombia: A 10-Year Ecological Study","volume":"106","author":"Loyola","year":"2021","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Rees, E.M., Lotto Batista, M., Kama, M., Kucharski, A.J., Lau, C.L., and Lowe, R. (2023). Quantifying the relationship between climatic indicators and leptospirosis incidence in Fiji: A modelling study. PLoS Glob. Public Health, 3.","DOI":"10.1371\/journal.pgph.0002400"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e214","DOI":"10.1016\/S2666-5247(24)00016-8","article-title":"The 2023 WHO World malaria report","volume":"5","author":"Venkatesan","year":"2024","journal-title":"Lancet Microbe"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/nyas.12690","article-title":"The pathogenesis of pediatric cerebral malaria: Eye exams, autopsies, and neuroimaging","volume":"1342","author":"Taylor","year":"2015","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4081\/gh.2012.122","article-title":"Analysis of the El Ni\u00f1o\/La Ni\u00f1a-Southern Oscillation variability and malaria in the Estado Sucre, Venezuela","volume":"6","author":"Camardiel","year":"2012","journal-title":"Geospat. Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/1475-2875-10-100","article-title":"The role of El Ni\u00f1o southern oscillation (ENSO) on variations of monthly Plasmodium falciparum malaria cases at the cayenne general hospital, 1996\u20132009, French Guiana","volume":"10","author":"Hanf","year":"2011","journal-title":"Malar. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1186\/1475-2875-10-246","article-title":"Environmental, entomological, socioeconomic and behavioural risk factors for malaria attacks in Amerindian children of Camopi, French Guiana","volume":"10","author":"Stefani","year":"2011","journal-title":"Malar. J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s12936-017-1779-y","article-title":"El Ni\u00f1o Southern Oscillation as an early warning tool for malaria outbreaks in India","volume":"16","author":"Dhiman","year":"2017","journal-title":"Malar. J."},{"key":"ref_55","unstructured":"World Health Organization (2025, July 18). Leishmaniasis, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/leishmaniasis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.4103\/ijo.IJO_2232_20","article-title":"Ocular Leishmaniasis\u2014A systematic review","volume":"69","author":"Mignot","year":"2021","journal-title":"Indian J. Ophthalmol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Ferreira De Souza, R.A., Andreoli, R.V., Toshie Kayano, M., and Lima Carvalho, A. (2015). American cutaneous leishmaniasis cases in the metropolitan region of Manaus, Brazil: Association with climate variables over time. Geospat. Health, 10.","DOI":"10.4081\/gh.2015.314"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e190298","DOI":"10.1590\/0074-02760190298","article-title":"Effects of El Ni\u00f1o-Southern Oscillation on human visceral leishmaniasis in the Brazilian State of Mato Grosso do Sul","volume":"115","author":"Oliveira","year":"2020","journal-title":"Mem\u00f3rias Do Inst. Oswaldo Cruz"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"107131","DOI":"10.1016\/j.actatropica.2024.107131","article-title":"Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia","volume":"252","author":"Martins","year":"2024","journal-title":"Acta Trop."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"106032","DOI":"10.1016\/j.actatropica.2021.106032","article-title":"Impact of El Ni\u00f1o on the dynamics of American cutaneous leishmaniasis in a municipality in the western Amazon","volume":"222","author":"Andreoli","year":"2021","journal-title":"Acta Trop."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Holmes, C.J., and Benoit, J.B. (2019). Biological Adaptations Associated with Dehydration in Mosquitoes. Insects, 10.","DOI":"10.3390\/insects10110375"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s10661-019-7583-0","article-title":"Non-parametric tests and multivariate analysis applied to reported dengue cases in Brazil","volume":"191","author":"Gois","year":"2019","journal-title":"Environ. Monit. Assess."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"144439","DOI":"10.1016\/j.scitotenv.2020.144439","article-title":"Flood risk influenced by the compound effect of storm surge and rainfall under climate change for low-lying coastal areas","volume":"764","author":"Hsiao","year":"2021","journal-title":"Sci. Total Environ."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Sterzel, T., L\u00fcdeke, M.K.B., Walther, C., Kok, M.T., Sietz, D., and Lucas, P.L. (2020). Typology of coastal urban vulnerability under rapid urbanization. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0220936"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12936-017-1694-2","article-title":"The impact of urbanization and population density on childhood Plasmodium falciparum parasite prevalence rates in Africa","volume":"16","author":"Kabaria","year":"2017","journal-title":"Malar. J."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Romeo-Aznar, V., Paul, R., Telle, O., and Pascual, M. (2018). Mosquito-borne transmission in urban landscapes: The missing link between vector abundance and human density. Proc. Biol. Sci., 285.","DOI":"10.1098\/rspb.2018.0826"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"101865","DOI":"10.1016\/j.clae.2023.101865","article-title":"Symptoms of dry eye related to the relative humidity of living places","volume":"46","author":"Martin","year":"2023","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1038\/s41377-023-01207-1","article-title":"Impacts of air pollution and meteorological conditions on dry eye disease among residents in a northeastern Chinese metropolis: A six-year crossover study in a cold region","volume":"12","author":"Lu","year":"2023","journal-title":"Light. Sci. Appl."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s40123-025-01185-0","article-title":"Climate Change and the Impact on Ocular Infectious Diseases: A Narrative Review","volume":"14","author":"Agrawal","year":"2025","journal-title":"Ophthalmol. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"908","DOI":"10.4269\/ajtmh.25-0053","article-title":"Weather, Air Pollution, and Seasonality: Predictors of Pathogen-Associated Conjunctivitis Outbreaks in Kathmandu Valley, Nepal","volume":"113","author":"Chaudhary","year":"2025","journal-title":"Am. J. Trop. Med. Hyg."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/10\/297\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T04:28:19Z","timestamp":1761020899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/10\/297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,18]]},"references-count":70,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["tropicalmed10100297"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10100297","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,18]]}}}