Epidemiological Features of Dengue Fever in Hodeidah Governorate, Yemen: Outbreak 2019-2020

Abstract

Background: Dengue fever, a mosquito-borne viral disease caused by the dengue virus (DENV), remains a significant public health challenge, particularly in tropical regions such as Hodeidah, Yemen. The 2019 - 2020 outbreak in Hodeidah highlighted the urgent need to understand its epidemiological features to improve prevention and control strategies. Objective:  This study aimed to describe the epidemiological features of dengue fever patients in Hodeidah governorate from 2019 to 2020.  Methods: A retrospective study used data from the Center of Tropical Medicine and Infectious Diseases (CTMID) in the Authority of Public at Al Thawara Hospital, Hodeidah, Yemen, that included 3874 dengue cases recorded between November 2019 and March 2020. Blood samples were collected and analyzed for dengue infection, and concurrent conditions such as malaria and thrombocytopenia were also documented. Data were analyzed using Microsoft Excel 2019 and SPSS version 27.0. Results: The results showed that the males were 65% (n = 2529) while the females were 35% (n = 1345). This difference was statistically significant (p-value < 0.00001).  In addition, the majority of cases (47%) were observed in the 19–50 years age group, followed by the 6–18 years age group (30%).  Children aged 1–5 years accounted for 18 % of the cases, whereas individuals over 50 years represented only 5%. The age distribution of cases reveals a significant variation across (p-value = 0.00001). Also, the distribution of cases across districts shows a significantly higher concentration in urban areas more than rural that indicated statistically significant association between district and case distribution (p-value < 0.00001).  On the other hand, dengue infection was predominant, accounting for the majority of cases. Hemorrhagic dengue fever (HDF) was the most frequent diagnosis (45.64%), followed closely by dengue fever (DF) (42.90%). Dengue shock syndrome (DSS) was relatively rare, comprising only 0.46% of the total cases. Co-infections of dengue and malaria were notable, with 5.45 % of cases involving DF-malaria and 5.55 % involving HDF – malaria coinfection.  Finally, the attack rate (AR) was reported 0.11 % and the case fatality rate (CFR) was 0.57 %. Conclusion: The study concluded a significant gender disparity among reported cases, with males comprising more than females. The age associated with dengue infection where the adults and children. Dengue was the predominant infection, with hemorrhagic dengue fever (HDF) being the most common diagnosis, followed by dengue fever (DF). Co-infections with malaria were noted. The CFR was less than 1%. Integrated public health measures, including enhanced surveillance, vector control, and community education, are critical for reducing dengue transmission in high-risk areas. These insights can guide policymakers in developing targeted interventions for future outbreaks of the disease.