Elevation as a proxy for dengue disease transmission in Indonesia

Dengue is a severe health problem. In recent decades, the number of infections has increased significantly worldwide, and approximately 70% of cases were found in Asia. To predict local mosquito distribution and estimate the local risk, a combination of ecological factors has been widely used. However, it is not easy to control the dengue transmission because the transmission is influenced by several ecological factors that might have complex interactions among the factors. In addition, ecological information is commonly limited. The elevation is an important weather proxy for the Aedes Aegypti life cycle because it is correlated to a variety of vital ecological factors, especially temperature. This study evaluated the effect of the elevation and identified high-low dengue risk provinces in Indonesia using the clustering Bayesian spatial hierarchical model.  We found that the elevation's effect decreased for the provinces with an elevation higher than 289.44m.