Attribution of Dengue Outbreak Risk to Climate Change-Driven Changes in Extreme Events in Colombia

Dengue transmission is highly sensitive to climate variability, with increasing evidence that cascading and compound extreme events increase outbreak risk. In Brazil and Barbados, drought conditions at long temporal lags (4–6 months) followed by extreme wet conditions at short lags (1–3 months) have been associated with increased dengue risk, particularly when combined with elevated temperatures (Fletcher et al. 2025; Lowe et al. 2021). In Colombia, dengue incidence has similarly been linked to El Niño–Southern Oscillation (ENSO)–driven increases in temperature and reductions in precipitation (Muñoz et al. 2021), as well as to long-lag drought effects that vary across altitudinal and urbanization gradients (Kache et al. 2024; Lowe et al. 2021). Despite this growing body of evidence, the extent to which anthropogenic climate change has altered dengue risk through changes in extreme event patterns remains largely unquantified. 

Here, we develop a predictive modelling framework that integrates the interacting effects of multiple climate extremes (drought, extreme rainfall, heatwaves) at short and long temporal lags to estimate dengue case incidence in Colombia under current climate conditions and under counterfactual pre-industrial climate conditions, thereby quantifying changes in dengue outbreak probability attributable to anthropogenic climate change. Multiple realizations of climate models simulating precipitation and temperature extremes under current and pre-industrial climate conditions will be used as inputs to the dengue risk model, allowing estimation of dengue outbreak probability attributable to climate change while explicitly characterizing uncertainty arising from both climate and epidemiological model components. This attribution framework will provide a transferable approach for quantifying climate-sensitive infectious disease outbreak risk attributable to anthropogenic climate change.