Unravelling the dengue surge in South Asia during 2000-2023: pattern, trend, genomics, and key determinants

This study aimed to analyse the patterns, trends, genomic characteristics, and key determinants of dengue virus (DENV) infections and associated deaths in South Asia over 2000-23. We collected data from the WHO dengue surveillance dashboard and the health ministries of respective countries and publicly available data from eight South Asian (SA) countries. Descriptive measures, data visualisation techniques, and time series analysis were used to identify the pattern and trend. A time-scaled phylogenetic analysis was carried out to explore the genomic epidemiology and evolution of dengue viruses. Furthermore, a generalised linear model was fitted to identify climatic, demographic, and socioeconomic factors. Between 2000 and 2023, SA countries showed a sharp increase in dengue cases and deaths in the region, contributing to 6.50% of cases and 11.07% of deaths caused by DENV during 2020-23 globally. The total cases in the region are projected to grow approximately 40% and total deaths by 62% by 2033. Overall, the predominant genotypes in the region were DENV2/II, DENV3/I, and DENV3/III. Generalised linear model underscores climatic, demographic, and socioeconomic factors. The findings urge intensified public health measures and emphasise the need for comprehensive interventions, including vector control, climate adaptation, and strengthened healthcare systems to de-escalate the situation.