Dengue is one of the world’s most neglected tropical diseases (NTD). It is endemic to many countries in America, Africa, Europe, the East Mediterranean, Southeast Asia and the Western Pacific (Gwee et al., 2021, Ratnam et al., 2013, Redondo-Bravo et al., 2019, WHO, 2021). NTDs also include Chagas disease, chikungunya, schistosomiasis, leishmaniasis, ectoparasitosis and other diseases (WHO, 2021).

The main vector of the dengue virus is the mosquito Aedes aegypti, which also transmits other viruses, such as yellow fever, Zika, and chikungunya (Leta et al., 2018). The WHO has proposed a global strategic plan to address the need to improve dengue prevention and control actions. The overall objective of an emergency plan is to reduce the risk of dengue transmission and to strengthen and maintain control measures. Monitoring and evaluation should be planned and implemented to assess the impact of all interventions (Organization et al., 2012).

The Brazilian National Dengue Control Program was established in 2002 when a proposal for this Contingency Plan was implemented by all state and municipal health departments for dengue care entities (FUNASA, 2017). Despite national efforts to prevent dengue, total eradication has not been achieved, partly due to decentralization to municipalities (Roque et al. 2017). This challenge is not unique to Brazil. For instance, in 2023, Europe also experienced a rise in dengue cases, particularly in Italy and Spain, due to climate-related factors such as rising temperatures and increased rainfall (Brem et al., 2024).

This is due mainly to the influence of climate change, as rising temperatures and heightened rainfall facilitate the spread of dengue. Existing public health strategies may prove inadequate against this escalating threat. Urgent action is warranted, including stricter adherence to individual preventative measures, heightened public awareness, and the implementation of coordinated European programs aimed at addressing dengue comprehensively (Brem et al., 2024).

Evidence (Vazquez-Prokopec et al., 2010, Bowman et al., 2016) suggests that the main shortcomings of strategic plans aimed at preventing bites from Aedes aegypti mosquitoes are the analysis of symptomatic cases in the neighborhood where the initial cases occurred and the limited scope of vector control. Furthermore, it is essential to highlight the importance of continuous surveillance of mosquito breeding sites throughout all the year and the consistent application of focal control measures. This is crucial because mosquito populations can quickly rebound if control efforts are relaxed (Nathan, 2012).

Furthermore, human mobility through global travel is considered one critical path for the rapid spread of emerging infectious diseases (Prothero, 1977, Yuan et al., 2021). International travel promotes the spread of dengue infections to other regions, and it may also import cases to non-endemic regions (Gwee et al., 2021, Lana et al., 2017, Matusali et al., 2020). The occurrence of dengue outbreaks in non-endemic regions is typically initiated by imported cases. In the 2016 outbreak in Buenos Aires, the majority of imported dengue cases originated from Paraguay and the adjacent northeastern region of Argentina. Gurevitz et al. (2021) suggest that dengue outbreaks in Paraguay pose a significant risk for the occurrence of dengue in Buenos Aires because of various factors. These factors include increased border crossing during the summer when the dengue virus (DENV) thrives in Paraguay and favorable transmission conditions are present in Buenos Aires (Gurevitz et al., 2021).

Findlater et al. (2019) reported that the amount of air travel from dengue-endemic countries to China on an annual basis can be a valuable predictor for assessing the risk of identifying imported cases of dengue. This finding introduces a new risk factor that, with additional refinement, has the potential to enhance forecasting models and provides valuable insights into disease surveillance. Another study conducted in Brazil (Nunes et al., 2014) reported that air traffic between different regions in the country has a moderate but statistically significant effect on the spread of dengue fever. The research has revealed a positive correlation, indicating that higher air traffic fluxes are associated with increased dispersal of the dengue virus (Nunes et al., 2014).

Like air travel, intermunicipal journey has an impact on the transmission of dengue. Saba et al. (2018) presented that transportation plays a significant role in the spread of epidemics, including dengue. It influences the occurrence of reported dengue cases between different municipalities and affects self-organized criticality variables related to the disease dynamics. Using complex network analysis, Saba et al. (2014) discovered a correlation between dengue cases and the inter-municipal road transport network in Bahia.

A thorough comprehension of the trend and potential geographic sources of imported dengue is crucial in informing policy, risk assessment, and intervention decision-making processes aimed at preventing and delaying dengue outbreaks, given the disease’s emerging global impact (Gwee et al., 2021).

Most studies are based on the number of tourists entering and leaving the region and the incidence of dengue. However, few articles mathematically demonstrate models to analyze the spatiotemporal spread of dengue in these results (Lana et al., 2017, Quam and Wilder-Smith, 2015, Stoddard et al., 2013). Additional parameters such as the incubation period, sting rate, and vector lifetime may be considered. However, these parameters are difficult to estimate because of to the lack of available information (Aguiar et al., 2022).

Pantanal represents the largest wetland in the world, covering the states of Mato Grosso do Sul and Mato Grosso. The Pantanal of Mato Grosso do Sul is a significant tourist hub in Brazil (Mittermeier et al., 1990). Tourist data reveal that 50% of tourists who visit the state of Mato Grosso do Sul choose to explore the Bonito and Pantanal regions, spending an average of one week in each of these tourist destinations. Moreover, the primary means of entry for tourists into Mato Grosso do Sul are by land and air routes (SEMAGRO, 2020). Specifically, in the border region between Brazil and Bolivia, the flow of visits processed by the Federal Police Migration Post under the category of “Tourism for Classification” has averaged 54,522 visas over the last five years. The majority of these come from Bolivia (86.6%), followed by Peru (3.1%), and Paraguay (1.5%) (SEMAGRO, 2020).

The main goal of this study is to evaluate the spatiotemporal cross-correlation between dengue in the Pantanal of the State of Mato Grosso do Sul and different states and countries bordering the State of Mato Grosso do Sul to provide new insights into dengue spread and the protocols to combat dengue in the region. The time-lagged Detrended Cross-Correlation Analysis Coefficient (DCCAC) method was applied in this study, which consists of identifying nonlinear and non-stationary correlations, a behavior found in incidences of infectious diseases sensitive to climate (Ehelepola et al., 2021).