Sero-catalytic and spatial modeling of dengue virus force of infection in Timor-Leste
File(s)
Accepted version
Supporting information
Author(s)
Type
Journal Article
Abstract
Dengue virus (DENV) infection causes significant morbidity and mortality across tropical and sub-tropical regions, including in Timor-Leste. In this study we present the results of a national, population-representative serological survey, used to determine the drivers of observed variations in DENV force-of-infection (FOI, i.e. the average annual per-capita risk of infection for a susceptible person) at high spatial resolution. Households were randomly selected from census data and occupants aged above one year were tested using the Panbio Indirect dengue IgG enzyme-linked immunosorbent assay between October 2021 and February 2023. Sero-catalytic models accounting for household effect were applied to estimate the DENV FOI in enumeration areas (EAs, roughly equivalent to neighbourhoods/villages). Spatial models were applied to the local FOI estimates to assess their associations with climate and environmental factors, and to predict the FOI across the rest of Timor-Leste. A total of 4780 individuals from 1755 households across 102 EAs participated. DENV seroprevalence and FOI estimates were highly spatially heterogeneous across Timor-Leste, ranging from 0.010 (95% Credible Interval (CrI): 0.005, 0.018) in EA 10104032 in Fatubossa, municipality Aileu, to 0.519 (0.295, 0.816) in EA 40403012 in Goulolo, municipality Bobonaro. Relative humidity was negatively associated with DENV FOI. The spatial models predicted highest DENV FOI along the Northern and Eastern coasts, with hotspots of transmission in Dili and Baucau cities. Findings will strengthen surveillance and guide the implementation of additional DENV control strategies such as Wolbachia-carrying mosquitoes (currently being deployed in some parts of Timor-Leste), or vaccination.
Date Acceptance
2026-08-05
Citation
Nature Communications
ISSN
2041-1723
Publisher
Nature Portfolio
Journal / Book Title
Nature Communications
Copyright Statement
© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Publication Status
Published online
Date Publish Online
2026-09-15