Environmental health factors influencing dengue: a systematic review with thematic categorization

Environmental conditions significantly influence dengue fever transmission by affecting Aedes mosquito breeding. This systematic review aimed to identify and synthesize environmental health factors associated with dengue risk. A comprehensive search across multiple databases yielded 64 studies conducted in urban, peri-urban, and rural settings. Data were extracted and categorized thematically, and risk of bias was assessed using the JBI Checklists, Newcastle-Ottawa Scale, and ROBINS-I tool, depending on study design. Eight key environmental health factors were identified: water storage practices, solid waste disposal, housing characteristics, drainage and standing water, vegetation and shaded areas, urbanization and population density, climate and seasonal variation, and water supply reliability. Improper water storage and unmanaged waste were consistently linked to higher mosquito entomological indices. Poor housing conditions and densely populated urban areas also correlated with increased dengue risk. Seasonal rainfall and unreliable water infrastructure intensified vulnerability, particularly in resource-limited contexts. Findings emphasize that environmental health conditions are central to dengue prevention. Effective control requires multi-sectoral strategies that integrate infrastructure upgrades, environmental management, and behavioural change. Future research should prioritize evaluating environmental interventions and developing predictive models incorporating climate, infrastructure, and human behaviour to guide public health responses.环境条件通过影响伊蚊（Aedes mosquito）的滋生，显著影响登革热的传播。本系统综述（systematic review）旨在识别并综合与登革热风险相关的环境健康因素。研究团队对多个数据库开展全面检索，最终纳入64项在城市、城郊及农村地区开展的研究。采用主题法对提取的数据进行分类，并根据研究设计类型，分别使用乔布里研究所检查表（JBI Checklists）、纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）及非随机干预研究偏倚风险评估工具（ROBINS-I tool）评估偏倚风险。最终确定8类关键环境健康因素：储水习惯、固体废物处置、住房特征、排水系统与积水、植被与荫蔽区域、城市化与人口密度、气候与季节变化及供水可靠性。不当储水与废弃物未管控行为始终与更高的蚊虫昆虫学指数（mosquito entomological indices）相关。恶劣的住房条件与人口稠密的城区同样与登革热风险升高存在关联。季节性降雨与不可靠的供水基础设施会加剧易感风险，在资源受限地区尤为显著。本研究结果强调，环境健康状况是登革热预防的核心要素。有效的防控需采用多部门策略，整合基础设施升级、环境管理与行为改变举措。未来研究应优先评估环境干预措施，并开发融入气候、基础设施与人类行为因素的预测模型，以指导公共卫生应对工作。