Increasing transmission of dengue virus across ecologically diverse regions of Ecuador and associated risk factors.

presence and arbovirus disease risk, with population size, precipitation, elevation, sewage connection, trash removal, and access to water as strong predictors. Our investigation reveals changes driving the expansion of dengue and other arboviruses globally and provides an approach for identifying areas at early stages of establishing endemic transmission that should be targeted for intense preventative efforts to avert future epidemics.