Impacts of El Niño Southern Oscillation on the dengue transmission dynamics in the Metropolitan Region of Recife, Brazil.

Background: This research addresses two questions: (1) how El Niño Southern Oscillation (ENSO) affects climate variability and how it influences dengue transmission in the Metropolitan Region of Recife (MRR), and (2) whether the epidemic in MRR municipalities has any connection and synchronicity.

Methods: Wavelet analysis and cross-correlation were applied to characterize seasonality, multiyear cycles, and relative delays between the series. This study was developed into two distinct periods.