Dengue is a continuous health burden in Laos and Thailand. We assessed and mapped dengue vulnerability in selected provinces of Laos and Thailand using multi-criteria decision approaches. An ecohealth framework was used to develop dengue vulnerability indices (DVIs) that explain links between population, social and physical environments, and health to identify exposure, susceptibility, and adaptive capacity indicators. Three DVIs were constructed using two objective approaches, Shannon’s Entropy (SE) and the Water-Associated Disease Index (WADI), and one subjective approach, the Best-Worst Method (BWM). Each DVI was validated by correlating the index score with dengue incidence for each spatial unit (district and subdistrict) over time. A Pearson’s correlation coefficient (r) larger than 0.5 and a
p-value less than 0.05 implied a good spatial and temporal performance. Spatially, DVI
WADI was significantly correlated on average in 19% (4–40%) of districts in Laos (mean
r = 0.5) and 27% (15–53%) of subdistricts in Thailand (mean
r = 0.85). The DVI
SE was validated in 22% (12–40%) of districts in Laos and in 13% (3–38%) of subdistricts in Thailand. The DVI
BWM was only developed for Laos because of lack of data in Thailand and was significantly associated with dengue incidence on average in 14% (0–28%) of Lao districts. The DVI
WADI indicated high vulnerability in urban centers and in areas with plantations and forests. In 2019, high DVI
WADI values were observed in sparsely populated areas due to elevated exposure, possibly from changes in climate and land cover, including urbanization, plantations, and dam construction. Of the three indices, DVI
WADI was the most suitable vulnerability index for the study area. The DVI
WADI can also be applied to other water-associated diseases, such as Zika and chikungunya, to highlight priority areas for further investigation and as a tool for prevention and interventions.
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