Factors associated with dengue fever outbreak in Dire Dawa administration city, October, 2015, Ethiopia - case control study

Abstract

Background Dengue Fever (DF) is underrecognized mosquito borne viral disease prevalent in tropical and subtropical regions. In 2013, Ethiopia reported the first confirmed DF outbreak in Dire Dawa city which affected 11,409 people. During the outbreak investigation, we determined factors associated with DF and implemented control measures. Methods We conducted a 1:2 un-matched case control study from October 7–15/2015. Case was any person with fever of 2–7 days and more than two symptoms: headache, arthralgia, myalgia, rash, or bleeding from any part of the body. We recruited participants using purposive sampling from health facilities and used structured questionnaire to collect data. Multiple logistic regression analysis was conducted to control confounders and to identify factors associated with DF. Sixty-nine serum-samples were tested by Enzyme-Linked Immunosorbent Assay (ELISA). Results We enrolled 210 participants (70 cases and 140 controls) in the study. Females accounted for 51.4% of cases and 57.1% of controls. The mean age was 23.7 ± 9.5 standard deviation (SD) for cases and 31.2 ± 13 SD for controls. Close contact with DF patient (Adjusted odds ratio [AOR] =5.36, 95% confidence interval [CI]: 2.75–10.44), nonuse of bed-nets (AOR = 2.74, 95% CI: 1.06–7.08) and stagnant water around the village (AOR = 3.61, 95% CI: 1.31–9.93) were independent risk factors. From the samples tested, 42 were confirmed positive. Conclusions Individuals who live with DF patient, around stagnant water and do not use bed nets are at high risk of contracting the disease. Health education on DF prevention was given and mosquito breeding sites were drained. Strong vector prevention strategies are recommended by enhancing the existing malaria prevention and control program. Electronic supplementary material The online version of this article (10.1186/s12889-019-7015-7) contains supplementary material, which is available to authorized users.

Dengue Fever Outbreak Investigation and Response in Dire Dawa City Administration, Ethiopia, 2017

“…This study also revealed that participants not wearing long sleeved cloths (OR=19.48; 95%CI; 5.70 -66.6; P-value <0.001) had 20 times the risk of acquiring Dengue Fever infection as compared to the users. Similar study was conducted in Diredewa in 2015 was shows that there has association between the wearing type of cloth and the risk of acquiring the Dengue Fever infection 11 .…”

“…The model result shows those who have open water containers (stagnant water) around their houses were 15 times (adjusted OR = 15.2: 95% CI: 3.33 -68.8) more at risk to have the disease. In consistence with this, case control study conducted in Dire Dawa during 2015 showed that people living in the areas where open water container had high morbidity rate of dengue feve 11 . Similar study from Vietnam identified that people living near stagnant water like ponds, lakes or open sewers had higher rates of dengue fever morbidit 10 .…”

Geographical distribution of Anopheles stephensi in eastern Ethiopia

“…stephensi larvae, suggesting that these two vectors share larval habitats. Dengue is a growing public health concern in Ethiopia, particularly in eastern Ethiopia, where major outbreaks were reported in 2013 [18,19] and 2015 [20]. With the finding of Ae.…”

Anopheles stephensias an emerging malaria vector in the Horn of Africa with high susceptibility to EthiopianPlasmodium vivaxandPlasmodium falciparumisolates

“…stephensi and Aedes in the same water body [42]. Outbreaks of chikungunya [43], dengue [44], and yellow fever [45] were recently reported from Ethiopia within the same geographic setting. The WHO recommends the use of integrated vector management [46] – an adaptive and evidence-based approach to vector control which utilizes vector control interventions from within and outside the health sector that may include larval source management of both An.…”