The epidemiology of Dengue fever in Saudi Arabia: A systematic review

Abstract

Dengue fever (DF) is the most serious mosquito-borne viral disease worldwide. DF is an acute febrile illness caused by Aedes aegypti and Aedes albopictus, which are endemic in certain cities of Saudi Arabia, such as Jeddah and Makkah (Mecca). An online literature search was conducted using relevant keywords to retrieve DF studies conducted in Saudi Arabia. Forty-five articles were identified initially. After screening for exclusion and retrieving full texts, a total of 10 articles were used for this review. Four studies were cross-sectional, and three observed a seroprevalence ranging from 31.7% to 56.9%, either among clinically suspected cases or among patients visiting the hospital for other reasons. Evidence extracted from risk factors and distribution studies indicated that young males are commonly affected. Fever, vomiting, thrombocytopenia and leukopoenia were the common features of the three studies related to clinical presentation of DF. One cross-sectional study concerning an educational program for DF demonstrated that a positive family history of DF, literate mothers, and age over 17 years were the predictors of a high DF knowledge score. However, the paucity of large epidemiological studies limits the generalizability of such evidence. Future studies in Saudi Arabia should focus upon the expansion of DF to other cities in the Kingdom. Larger epidemiological studies are needed for estimating the true burden and incidence of DF in the Saudi population, as they are limited to seroprevalence among clinically suspected cases and hospital-based patients.

Circulation of Dengue Virus Serotypes in the City of Makkah, Saudi Arabia, as Determined by Reverse Transcription Polymerase Chain Reaction

“…Most of these cases were recorded during the months from May through July, whereas in our study we analyzed the samples collected in the months other than the above. Overall, the prevalence of DENV in Saudi Arabia, as reported in different studies, ranged from 31.7% to 56.9% [13]. The other reason for such low prevalence of DENV infection in the present study might be the stage of disease or the day of sample collection after onset of the illness.…”

“…The subsequent outbreaks occurred in different cities of the Western and Southwestern regions of Saudi Arabia, that is, Jeddah, Makkah, Aseer, and Jizan, in the years 1994 through 2010. By then the Western and Southwestern regions of Saudi Arabia were declared as the dengue endemic areas [8–13]. …”

The prevalence of dengue virus serotypes in asymptomatic blood donors reveals the emergence of serotype 4 in Saudi Arabia

“…The virus has later spread to other nearby cities, including Makkah, and the Western region has been declared dengue endemic following several outbreaks throughout the last decade [5, 6]. Additionally, the virus and/or its vector have been found in other new geographical areas of the kingdom as shown by several recent epidemiological reports [7–9].…”

Indian Medical Mission at Hajj-2016: Mass-Gathering Medicine Perspectives, Challenges, and Opportunities in a Mission Posture

“…2 Nevertheless, clinical suspicion increases the burden of laboratory testing, and institutionalization furthers healthcare-associated transmission. 21,31,32 With the Middle East catering to 10 million annual pilgrims and otherwise being a global transport hub, travel-related infections and public health emergencies need to be assessed, detected, and answered with robust health systems under a One-Health approach in consonance with international health regulations. 3,5,13,33,34 Quarantine, syndromic surveillance, and cluster investigation for endemic infectious diseases including dengue and Rift Valley fever can be feasible primary tools for mass gatherings during Hajj.…”

“…41 Clientele assessments and engagement can be fostered by new-age, technology-driven Delphi techniques through smartphone platforms for early reporting and passive surveillance. 31,32 Health system interventions such as evidence-based surveillance systems including real-time and post-event surveillance, disaster decision support-systems, crossplatform wireless records systems, political patronage, legislative drug dispensing by local pharmacies, and capability assurance towards mass gathering medicine and travel medicine can facilitate the operational fecundity of various stakeholders. 13,14,21,29 The magnitude of the Hajj medical operations calls for a permanent Indian civil hospital sited near the Indian Hajj pilgrim office, directed by a medical specialist to oversee planning, operations, and coordination throughout the Hajj paradigm and be suspended in the lean period.…”