02148nas a2200217   4500000000100000008004100001653000900042653001700051653001100068653001700079653001600096653001800112100001500130700001200145245018500157856005900342300000800401490000900409520149800418022001401916       2017                            d10aNTDs10adeterminants10aDengue10aTransmission10aPuerto Rico10aZika response1 aMatysiak A1 aRoess A00aInterrelationship between climatic, ecologic, social, and cultural determinants affecting dengue emergence and transmission in Puerto Rico and their implications for Zika response.  uhttps://www.hindawi.com/journals/jtm/2017/8947067/cta/  a14p0 v20173 a<p><em>Objective</em>.The global resurgence of dengue has been attributed to rapid population growth, urban expansion, increased air travel, globalization, and climate change. Dengue is now endemic in Puerto Rico. Puerto Rico is at risk for Zika, another emerging arbovirus. The interrelationship between climatic, ecological, social, and cultural factors that affect dengue and other arboviruses’ transmission is understudied. <em>Design</em>.The objective of this systematic review is to examine the interrelationship between climatic, ecological, social, and cultural factors on dengue transmission in Puerto Rico and to draw lessons for Zika response. <em>Results</em>. A comprehensive search of peer-reviewed journal articles was performed, producing 562 articles; 26 were selected for this review. Findings indicate that human activities and behaviors (urbanization, migration, and consumption) as well as climate have a significant impact on the abundance and the transmission potential of <em>Ae. aegypti</em>, the vector for dengue, Zika, and other viruses. <em>Conclusion</em>. Despite the public health burden of dengue limited investments have been made in research and surveillance. Future research is needed to developmodels that integrate themultivariate effects of climatic, ecological, social, and cultural factors, which for Puerto Rico have mostly been examined independently. Such models have the potential to inform response to dengue, Zika, and other arboviruses.</p>
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