Abstract
The rapid growth and development of cities is a contributing factor to the rise and persistence of dengue fever (DF) in many areas around the world. Many studies have examined how neighbourhood environmental conditions contribute to dengue fever and its spread, but have not paid enough attention to links between socio-economic conditions and other factors, including population composition, population density, the presence of migrant groups, and neighbourhood environmental conditions. This study examines DF and its distribution across 56 neighbourhoods of Jeddah City, Saudi Arabia, where the incidence of dengue remains high. Using stepwise multiple regression analysis it focuses on the key ecological correlates of DF from 2006-2009, the years of the initial outbreak. Neighbourhood variations in average case rates per 10,000 population (2006–2009) were largely predicted by the Saudi gender ratio and socio-economic status (SES), the respective beta coefficients being 0.56 and 0.32 (p < 0.001). Overall, 77.1% of cases occurred in the poorest neighbourhoods. SES effects, however, are complex and were partly mediated by neighbourhood population density and the presence of migrant groups. SES effects persisted after controls for both factors, suggesting the effect of other structural factors and reflecting a lack of DF awareness and the lack of vector control strategies in poorer neighbourhoods. Neighbourhood environmental conditions, as measured by the presence of surface water, were not significant. It is suggested that future research pay more attention to the different pathways that link neighbourhood social status to dengue and wider health outcomes.
Highlights
Since the 1980s the prevalence of dengue fever (DF) has increased rapidly and become problematic globally, but especially in low-and middle-income countries [1]
We wished to establish the degree to which the correlation between neighbourhood socioeconomic status and DF case rates remained, after controlling for these possible intervening factors. These analyses aimed to explore the different ways in which socio-economic status (SES) is connected to the DF case rates in Jeddah City neighbourhoods
Most (77.1%) dengue fever cases occurring in Jeddah City between 2006–2009 could be found in low SES communities
Summary
Since the 1980s the prevalence of dengue fever (DF) has increased rapidly and become problematic globally, but especially in low-and middle-income countries [1]. Like various strains of COVID, the spread of dengue has been associated with an increased globalisation of travel for work and leisure and increased urbanisation, which has created new environments of risk. Rapid urbanisation creates environmental conditions such as substandard housing, high population densities, poor sewer or waste management services and increased water insecurity, all factors which help create hospitable habitats for the Aedes mosquito. The combination of these factors creates optimal conditions for dengue transmission, and a considerable literature has evolved detailing the impact of different physical, demographic, and socio-economic environmental conditions associated with DF and its spread.
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