Epidemiological characterisation of dengue fever across Saudi Arabia.

Abstract

Background: Dengue fever is an emerging public health threat in Saudi Arabia. To guide evidence-based vector control, this study aimed to characterise the epidemiological and clinical patterns of infections across key regions in the Kingdom between 2022 and 2024.

Methods: A total of 2850 serum samples from suspected dengue patients were collected from hospitals in seven regions in Saudi Arabia. RNA extraction and dengue virus detection were conducted using standardised reverse transcription polymerase chain reaction (RT-PCR) protocols. Statistical analysis was applied to identify the sociodemographic predictors of PCR-confirmed dengue.

Results: Among the 2850 individuals tested, 1447 (50.8%) were PCR positive. Most cases (n=1269) occurred in 2023, with Makkah alone recording 801 cases. Males represented 73.5% of PCR-positive cases, while non-Saudi nationals accounted for 47.7%. Multivariable regression showed significantly lower odds of positivity among females (odds ratio [OR] 0.65 [95% confidence interval {CI} 0.55 to 0.76], p<0.001) and higher odds among non-Saudi nationals (OR 1.17 [95% CI 1.00 to 1.38], p=0.050). Despite the relatively low caseloads, Jazan and Asir had higher adjusted odds compared with Madinah.

Conclusions: Dengue transmission shows strong geographic, demographic and seasonal variation, with evidence of epidemic activity in 2023. These findings underscore the need for targeted vector control and enhanced surveillance in high-risk regions.