Abstract
BACKGROUND: Although the contribution of greenspace to dengue transmission has been reported, the complex role of greenspace morphology remains unclear. We aimed to investigate the relationship between greenspace morphology and dengue in China and to explore the interaction with urbanization and built environment characteristics. METHODS: Dengue data at the township level were collected from five provinces in southern China during 2017-2020. Metrics of greenspace morphology, including percentage, mean area, fragmentation, shape, aggregation, and connectedness, were calculated to quantify its structural characteristics. A negative binomial regression model combined with principal component analysis was conducted to assess the relationship between greenspace morphology and dengue. The modification effects of urbanization and built environment characteristics were evaluated using an interaction term in the model. RESULTS: Per-interquartile range increase in total percentage, mean area, area-weighted mean shape index, and aggregation index of greenspace were associated with 1.78 (95% confidence interval [CI] 1.57-2.01), 1.14 (1.10-1.20), 1.17 (1.06-1.29), and 1.18 (1.11-1.26) incidence rate ratios of dengue, respectively, while edge density was negatively related to the risk of dengue. In areas with high gross domestic product per capita and population size, the impact of greenspace morphology on the incidence of dengue was more pronounced. By contrast, the influence of greenspace morphology on dengue risk was diminished in regions characterized by higher urban isolation and fragmentation. CONCLUSIONS: Greenspace morphology had a bidirectional impact on the risk of dengue, with urbanization and built environment characteristics exerting diverse modification effects. Our study highlights the importance of a rational greenspace layout to prevent the spread of dengue.