Dengue is the world's most important and fastest spreading viral vector-borne disease. Due to
international trade and travel, demographic and climate changes, the global incidence of dengue
increased 30-fold during last 50 years and it is now estimated that 50-250 million cases occur each
year. Only a small percentage of cases are symptomatic and reported. Two fifths of the human
population live in area at risk of dengue transmission. About 500 000 annual dengue infections are
cases of potentially fatal severe dengue disease. The social and economic burden of dengue is very
high, although poorly understood.
The aim of this study is to examine demographic and socio-economic changes in Thailand from
1982 to 2012 and to compare them with the evolution of dengue epidemiology in Thailand. Some
160 dengue epidemiology-related articles, reports and guidelines have been revised to investigate
the potential impact of socio-economic and demographic factors on dengue. Socio-economic and
demographic changes in Thailand 1982-2012 were analysed. A comprehensive database was created
and the data collected for each indicator was interpreted in the context of dengue epidemiology.
An improvement in many relevant indicators, such as the access to health security, units and
services, or decreasing poverty, was found. Despite that, the incidence of dengue was found to
remain high. It was hypothesised that high morbidity might be related to the increase of
international air traffic, cross-border and internal migration, trade in vehicles, tyres and natural
rubber, expanding paddy crop plantations, disparities in learning rates, and health care and services
distribution among regions and between urban and rural zones, low housing, social security, and
health services standards among illegal and low-skilled working immigrants. Disparity in the access
to health and social services might have also provoked errors in dengue reporting. The demographic
transition towards an ageing-society in Thailand was found to challenge dengue epidemiology. This
calls for establishing new symptoms, control, and treatment guidelines. Dengue epidemiology
management was found to be challenged by the economic burden of dengue, parallel to significant
poverty rates, low dengue-related knowledge, inappropriate attitudes and practice in execution of
daily-life and traditional practices.
The study supports dengue epidemiology control and management as it identifies and analyzes
demographic and socio-economic factors which 1) determine the scale of dengue incidence, 2)
contribute to dengue reporting and surveillance system improvement, 3) challenge dengue
epidemiology mangement and 4) contribute to determining dengue economic and disease burden.
The data collected can be incorporated into dengue prediction models to help capture the impact of
socio-economic and demographic factors on dengue risk.