{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:20:00Z","timestamp":1790248800651,"version":"4.1.0"},"posted":{"date-parts":[[2026,2,17]]},"group-title":"Epidemiology","reference-count":93,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Dengue is one of the world\u2019s highest-burden arboviral diseases. Although classically considered an urban disease, many regions experience a substantial dengue burden in rural areas. The combined influence of long-term climate, short-term weather variation, local built environments, and land-use gradients on dengue dynamics in rural settings remains poorly understood, limiting our ability to predict shifting risk under global change. Here, we investigate these dynamics in Costa Rica to disentangle how these interacting socio-environmental factors shape rural dengue transmission. We first use 22 years of canton-level (admin-2) case data to establish that both dengue cases and incidence are consistently higher in rural than in urban districts. Then, using ten years of district-level (admin-3) monthly case data and a Bayesian hierarchical modeling framework, we identify the climatic and land-use features most strongly associated with dengue risk. Temperature underlies broad spatial patterns in dengue\u2019s urban\u2013rural distribution, while precipitation effects differ between coasts, reflecting intercoastal climate zone contrasts rather than interactions between urbanization and water availability. Given suitable climate, even modest levels of built infrastructure substantially increase risk, but the relationship plateaus at higher levels of building volume. Dengue risk is also elevated in areas with high agricultural crop cover at low and mid elevations but not at higher, cooler elevations. Together these results suggest that high risk of rural dengue in Costa Rica result from climate suitability aligning with baseline levels of built infrastructure, with agriculture potentially emerging as a distinct driver of rural dengue transmission.<\/jats:p>","DOI":"10.64898\/2026.02.12.26346219","type":"posted-content","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T01:15:20Z","timestamp":1771377320000},"source":"Crossref","is-referenced-by-count":2,"title":["Rural dengue dynamics: the interplay of climate, built environment, and agriculture in Costa Rica"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9839-5781","authenticated-orcid":false,"given":"Caroline","family":"Glidden","sequence":"first","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4718-5527","authenticated-orcid":false,"given":"Emma K.","family":"Southworth","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talya","family":"Shragai","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Rojas-Araya","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Vectores, Centro de Investigaci\u00f3n en Enfermedades Tropicales, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"},{"name":"Secci\u00f3n de Entomolog\u00eda M\u00e9dica, Facultad de Microbiolog\u00eda, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9513-9969","authenticated-orcid":false,"given":"Adriana","family":"Troyo","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Vectores, Centro de Investigaci\u00f3n en Enfermedades Tropicales, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"},{"name":"Secci\u00f3n de Entomolog\u00eda M\u00e9dica, Facultad de Microbiolog\u00eda, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1201-3979","authenticated-orcid":false,"given":"Luis Enrique","family":"Chaves-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Vectores, Centro de Investigaci\u00f3n en Enfermedades Tropicales, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"},{"name":"Secci\u00f3n de Entomolog\u00eda M\u00e9dica, Facultad de Microbiolog\u00eda, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"Programa Nacional Manejo Integrado de Vectores, Ministerio de Salud, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac Vargas","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Programa Nacional Manejo Integrado de Vectores, Ministerio de Salud, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Mordecai","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"issue":"2","key":"2026072009351039000_2026.02.12.26346219v2.1","first-page":"227","article-title":"Factores socioecon\u00f3micos y ambientales asociados a la incidencia de dengue: Estudio ecol\u00f3gico en Costa Rica, 2016","volume":"28","year":"2019","journal-title":"Revista Costarricense de Salud P\u00fablica"},{"key":"2026072009351039000_2026.02.12.26346219v2.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2014.10.004"},{"key":"2026072009351039000_2026.02.12.26346219v2.3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246251"},{"key":"2026072009351039000_2026.02.12.26346219v2.4","unstructured":"Arguedas, O. 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