Compound climate extremes, socioeconomic conditions and human mobility influence dengue dynamics heterogeneously across Vietnam

Dengue represents a significant public health challenge in Vietnam, driven by biological, behavioral, and environmental factors. The research examined the effects of compound climate extremes, socioeconomic conditions, and human mobility on dengue relative risk across 670 districts in Vietnam over 20 years, stratified into eight subregions. Dengue risk was greatest following dry conditions followed by wet conditions in seven subregions. Higher temperatures increased risk in North and Central Vietnam but had limited effect in the South. Mobility associations followed an urban-rural gradient, with higher risk in highly rural districts where residents traveled more frequently to fewer destinations, and in urban districts with more visitors. Stratifying climatic and socioeconomic effects by subregion improved predictive skill at lead times of 1 to 6 months compared to unstratified models. Accounting for compound extremes across distinct spatial contexts could strengthen disease early warning systems in Vietnam and beyond.