PONE-D-24-59480Spatial patterns and clustering of dengue incidence in Mexico: Analysis of Moran's index across 2,471 municipalities from 2022 to 2024PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: [General Comments]

This manuscript presents an important analysis of dengue transmission dynamics in Mexico, offering valuable epidemiological insights. The spatial and statistical methods applied are appropriate, and the results provide actionable information for disease control. However, certain areas require improvement in clarity, methodological transparency, and discussion depth.

[Specific Comments] – Major

Comment 1: Kindly expand the description of spatial clustering methods. The rationale for using a fixed kNN of 5 should be justified in the context of Mexico’s geographic and epidemiological diversity.

Comment 2: The authors have documented a shift in high-incidence areas from southern and central regions to the southeast and Pacific coast. I suggest you explore more potential drivers such as climate variability, vector control measures, or urbanization patterns.

Comment 3: More discussion is needed regarding how these spatial trends compare with previous dengue outbreaks in Mexico and globally.

Comment 4: The transition from DENV-2 dominance in 2022 to DENV-3 prevalence in 2023-2024 is an important finding. The authors should please discuss possible virological, ecological, or immunological factors influencing this shift.

Comment 5: Building on Comment 4, the authors should consider specific potential public health implications of serotype shifts, including changes in disease severity or vaccine effectiveness.

Comment 6: The discussion on intervention strategies remains general. The authors should kindly provide specific recommendations for vector control, early warning systems, or targeted public health campaigns in the identified high-risk regions.

[Specific Comments] – Minor

Comment 7: Clarify how missing data were handled in dengue incidence reporting.

Comment 8: Please kindly clarify whether population estimates were interpolated for 2023 and 2024 or based on projections.

Comment 9: Report confidence intervals for incidence rates where applicable.

Comment 10: Provide effect sizes alongside p-values in statistical comparisons.

Reviewer #2: A review report of the manuscript entitled “Spatial patterns and clustering of dengue incidence in Mexico: Analysis of Moran's index across 2,471 municipalities from 2022 to 2024”

- (page 9, line 2) in the beginning of the abstract part, what is known or contextual background of this study should be provided.

- (page 9, line 3) the source of the dengue case data is not mentioned. Was the data obtained from health records, a surveillance system, or another source? Please specify if the data is from a national surveillance database or other repositories.

- (page 10, introduction) although the serotype dynamics are addressed in the abstract, the introduction does not mention how the serotypes (e.g., DENV-1 to DENV-4) influence spatial and temporal patterns. Kindly explain the relevance of serotype shifts or dominance to dengue epidemiology.

- (page 10, line 27) the role of climate (e.g., temperature, rainfall) in driving dengue transmission is not mentioned. These are key factors influencing vector activity and virus replication rates and should be briefly noted. Please mention how temperature, rainfall, and vegetation influence vector ecology and dengue transmission. For instance, "Dengue transmission is influenced by climatic factors such as temperature and rainfall, which directly affect mosquito breeding, survival, and virus replication." This can be cited from a study by Dhewantara et al. entitled “Decline of notified dengue infections in Indonesia in 2017: Discussion of the possible determinants.”

- (page 11, line 47) a clear research hypothesis is missing. Please include a statement of your hypothesis in the end of your introduction.

- (page 11, line 58) the method for addressing missing or incomplete case data is not discussed. For instance, were municipalities with incomplete case or population data excluded? Was imputation performed for missing weekly case counts?

- (page 11, line 69) the GIS software or package used for mapping is not mentioned. Was mapping performed in R (e.g., using sf, tmap, or ggplot2), QGIS, or ArcGIS?

- (page 19, line 180) the discussion could benefit from comparisons with other regions where similar spatial or temporal dengue patterns have been observed. For example, how do the patterns in Mexico compare with other endemic regions like Brazil, Southeast Asia, or the Caribbean?

- (page 10, lines 26-28) this statement “This can be attributed to various factors, including human behavior, and environmental conditions (ecological, entomological, infrastructural, and social)” will be stronger if it’s supported by another relevant study. For example, a study by Musa et al. entitled “Revitalizing the state of primary healthcare towards achieving universal health coverage in conflict affected fragile northeastern Nigeria: Challenges, strategies and way forward.”

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Reviewer #1: No

Reviewer #2: No

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Spatial patterns and clustering of dengue incidence in Mexico: Analysis of Moran's index across 2,471 municipalities from 2022 to 2024

PONE-D-24-59480R1

Dear Dr. Murillo-Zamora,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Harapan Harapan, MD, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: The objective of this study was to analyze spatial and temporal patterns of dengue incidence across municipalities in Mexico from 2022 to 2024. Though I do hope further studies could explore the spatial regression, but the overall results presented are sufficient to answer the research question. I have no further concerns over the manuscript.

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If you choose “no”, your identity will remain anonymous but your review may still be made public.

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Reviewer #1: Yes:  Oluwafemi Balogun, MBBS, MPH

Reviewer #2: No

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