Global Circulation Dynamics and Its Determinants of Dengue Virus: A Network Evolution and Model Study from 1990 to 2019.

As dengue is an increasing global health threat, a better understanding of the global circulation dynamics and its determinants would be helpful for precise prevention and control of dengue. The dynamics of global circulation of the four dengue virus serotypes were explored utilizing genetic sequences through a network-based method. Four new circulation indicators, including local intensity, betweenness centrality, tip frequency, and persistence time, were defined. Three circulation roles, including source, hub, and destination, were proposed on the basis of new indicators. Spatial and temporal changes of the three circulation roles, along with the persistence time, were explored. Important determinants were also evaluated by machine learning models. Thailand, Indonesia, and Vietnam in Asia and Venezuela and Colombia in Americas were the sources for all four serotypes in different decades. Destinations were observed mostly in island regions. Over the decades, the number of regions with different circulation roles and persistence of DENV-1 increased significantly. Climate and airline factors were involved in the important determinants to circulation roles and persistence of dengue. The roles identified in the global circulation of dengue and important determinants, including climate and airline factors, provide new insights into global dynamics and are beneficial for controlling dengue.