Dengue Elimination Challenges in Bali: A One Health Perspective

Abstract

Dengue virus infection (IVD) has resulted in significant mortality and morbidity in the past decade in Bali, Indonesia. IVD case reports in 57 subdistricts in the period January–December 2022 reached 7,582 cases (distribution of cases between subdistricts in Figure 1), an incidence rate (IR) of 162/100,000 population (Figure 1), and mortality of 15 people (case fatality rate [CFR] of 0.2%). Cases were declared to have tripled from the previous year, and IR did not meet the national target (> 49/100,000 population). The urgency of dengue eradication in Bali aims to reduce morbidity and mortality due to DHF. We highlight the challenges and obstacles that make IVD cases in Bali increasingly concerning. Based on our review, climate variability is essential in increasing vector populations in the environment. However, a comprehensive study that studies the interrelationships of all climate elements, including temperature, air humidity, wind speed, air pressure, precipitation, rainy days, rain properties, the standardized precipitation index (SPI), and the length of solar irradiation in increasing abundance, population, and vector activity with increasing cases of IVD, has not been studied comprehensively.