Dengue Fever Outbreak - Al Qahirah and Al Mudhaffar Districts, Taiz Governorate, Yemen, November 2018

  • Vector-borne
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Background:
Dengue Fever (DF) is a significant health problem in Yemen. On November 6th 2018, the surveillance officer in Taiz governorates reported an increased number of suspected DF with deaths from Taiz City. On November 7th 2018, a team from field epidemiology training program was sent to confirm the existence of outbreak, determine risk factors and recommend control measures.

Methods:
Descriptive followed by case-control study (1:2 ratio) was conducted. Case-patient defined as any person who met the definition of DF according to WHO, living in Al Qahirah or Al Mudhaffar districts during August 5th to November 13th 2018. Control is any person living in Al Qahirah or Al Mudhaffar Districts and did not suffer from DF. Data collected on individual, environmental and behavioral risk factors. Attack rate, odds ratios (OR) and 95% confidence intervals (95%CI) were calculated. p value < 0.05 was considered as the cut point for significant. Nineteen blood samples were collected for lab confirmation. Epi info version 7.2 was used.

Results:
Fifty patients were found. 52% were males. 76% were <30 years old of age. Overall attack rate was 1/10,000 of population. Case fatality rate was 4%. There were significant associations between DF and illiterate-secondary education (OR=5.2, 95%CI:2.2–12.8), not working (OR=9.6, 95%CI:4.3–21.4), uncovering water container (OR=2.8, 95%CI:1.3– 6.1), not using mosquito repellent (OR=4, 95%CI:1.3–12.3), not using mosquito nets (OR=15.5, 95%CI:2-118), wearing short clothes (OR=15.8, 95%CI:5.3-47.5), bad around the house (OR=3.3, 95%CI:1.6–6.7), bad sanitation (OR=4.4, 95%CI:2.1–9.0), outdoor trees (OR=2.4, 95%CI:1.2–5.1) and not screening windows (OR=10.6, 95%CI:4.8-23.5). Out of 19 blood samples,11 (58%) were positive for DF IgM.

Conclusion:
DF outbreak was laboratory confirmed. The identified risk factors have been proven to contribute in DF infection. Implementation of control and prevention measures to alter the related factors (e.g. covering water containers, elimination the breeding sites of vector and use individual protective measures). Raising community awareness regarding transmission and preventive measures. Strengthening surveillance system sensitivity is perquisite.

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