Unravelling the interplay of space, time, and weather in dengue outbreaks: An insight from Bihar, India.

Background objectives: Dengue has emerged as a major global public health threat, with a sharp rise in cases across endemic regions in recent decades. Bihar, a high-risk state in eastern India, has experienced its most severe dengue outbreaks recently, reporting 8,136 cases in 2019, 11,285 in 2022, and 19,093 in 2023. This study investigates the relationship between climate variability and dengue incidence across Bihar's 38 districts, including the capital city, Patna, over the period 2019-2023.

Methods: The analysis focuses on key meteorological factors-minimum, maximum, and mean temperatures, along with precipitation-and their time-lagged associations with weekly dengue case counts. Spatial patterns of dengue transmission are also assessed to identify regional hotspots.

Results: Results indicate that central Bihar exhibits the highest incidence of dengue during the study period. Among the examined variables, minimum temperature and rainfall show the strongest and most consistent correlations with dengue incidence, particularly with lags of 4 to 6 weeks.

Interpretation conclusion: These findings provide a foundation for developing climate-informed early warning systems and targeted vector control strategies, thereby enhancing preparedness and response to future dengue outbreaks in Bihar and similar regions.