The effects of socioecological factors on variation of communicable diseases: A multiple-disease study at the national scale of Vietnam.

OBJECTIVE:To examine the effects of socioecological factors on multiple communicable diseases across Vietnam. METHODS:We used the Moran's I tests to evaluate spatial clusters of diseases and applied multilevel negative binomial regression models using the Bayesian framework to analyse the association between socioecological factors and the diseases queried by oral, airborne, vector-borne, and animal transmission diseases. RESULTS AND SIGNIFICANCE:The study found that oral-transmission diseases were spatially distributed across the country; whereas, the airborne-transmission diseases were more clustered in the Northwest and vector-borne transmission diseases were more clustered in the South. Most of diseases were sensitive with climatic factors. For instance, a 1°C increase in average temperature is significantly associated with 0.4% (95CI, 0.3-0.5), 2.5% (95%CI, 1.4-3.6), 0.9% (95%CI, 0.6-1.4), 1.1% (95%CI), 5% (95%CI, 3-.7.4), 0.4% (95%CI, 0.2-0.7), and 2% (95%CI, 1.5-2.8) increase in risk of diarrhoea, shigellosis, mumps, influenza, dengue, malaria, and rabies respectively. The influences of socio-economic factors on risk of communicable diseases are varied by factors with the biggest influence of population density. The research findings reflect an important implication for the climate change adaptation strategies of health sectors. A development of weather-based early warning systems should be considered to strengthen communicable disease prevention in Vietnam.