Urban-rural disparities in self-reported dengue infection: A comprehensive analysis of the 2023 Indonesian health survey

Background

Dengue Virus (DENV) infection remains a significant public health issue in Indonesia, with incidence rates differing between urban and rural areas. This study aimed to identify individual and household factors driving self-reported dengue infections in these settings.

Methods

A secondary analysis of the 2023 Indonesian Health Survey (SKI) included 877,531 respondents from urban (n = 469,549) and rural (n = 407,982) areas. The study focused on individuals of all ages who had been diagnosed with dengue fever by a physician within the past year. Disparities in self-reported dengue infection were assessed using standardized questionnaires that covered individual factors (age, sex, education, occupation, and preventive measures) and household factors (health facility awareness, travel time, transport affordability, wealth, water source, and preventive behavior). Data collected from August to October 2023 were analyzed using weighted logistic regression models in STATA 17.0 MP to account for the complex sampling design.

Results

Self-reported dengue incidence was higher in urban areas (0.73 %) than rural areas (0.52 %). In urban settings, higher odds of dengue infection were associated with having school-aged children, living in crowded households, belonging to the wealthiest quintile, using bottled water, and neglecting regular cleaning of water storage containers. In rural areas, adults using refill water had increased odds of infection, while those working in the informal sector and practicing mosquito bite prevention showed reduced odds.

Conclusions

Our study highlights social determinants of dengue infection in Indonesia, emphasizing the need for targeted public health interventions that address educational disparities, economical access to healthcare, and effective preventive practices.