Unveiling the Hidden Threat: Climatic, Environmental, and Socioeconomic Drivers of Dengue Transmission in the Middle East: A Systematic Review
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Abstract
Background: Dengue fever is an emerging public health concern in the Middle East, influenced by climatic, environmental, and socioeconomic factors. Traditionally linked to tropical regions, recent outbreaks in arid and semi-arid areas highlight increasing regional vulnerability. Methods: This systematic review (2000–2024) analyzed studies on climatic (temperature, humidity, rainfall), environmental (urbanization, land use), and socioeconomic (population density, household conditions) factors affecting dengue transmission. A total of seven studies were included in the final synthesis. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of included studies. Data synthesis was performed through a narrative review, categorizing findings into positive, negative, and non-significant associations with dengue incidence. Results: The findings highlight a strong correlation between climatic factors and dengue transmission, with temperature, humidity, and rainfall being the most significant predictors. While moderate rainfall provided breeding sites for Aedes mosquitoes, excessive rainfall disrupted larval development. Urbanization and poor neighborhood conditions were also positively associated with dengue incidence, particularly in high-density, lower-income communities with inadequate sanitation and water storage practices. Socioeconomic determinants such as age, gender, and occupation influenced exposure risk, with younger populations and outdoor workers being more susceptible. Methodologically, cross-sectional studies (42.8%) dominated the literature, followed by geospatial risk modeling (28.6%) and longitudinal studies (28.6%). Conclusions: The study highlights the urgent need for climate-adaptive dengue early warning systems, improved urban planning to mitigate vector breeding, and targeted interventions for high-risk populations.
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Alharbi, A. M. (2025). The increasing importance of Dengue virus infection in Saudi Arabia: A review. Virus Research. 2025 Jan 1; 351:199510. https://doi.org/10.1016/j.virusres.2024.199510
Buliva, E., Elhakim, M., Tran Minh, N. N., Elkholy, A., Mala, P., Abubakar, A., & Malik, S. M. M. R. Emerging and reemerging diseases in the World Health Organization (WHO) Eastern Mediterranean Region—progress, challenges, and WHO initiatives. Frontiers in public health. 2017 Oct 19;5:276. https://doi:10.3389/fpubh.2017.00276
Alkhaldy, I. A spatial analysis of dengue fever and an analysis of dengue control strategies in Jeddah City, Saudi Arabia; 2014.
World Health Organization (21 December 2023). Disease Outbreak News; Dengue – Global situation Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498
Reiter, P. Surveillance and control of urban dengue vectors. In Dengue and dengue hemorrhagic fever 2014 (pp. 481-518). Wallingford UK: Cabi. https://doi.org/10.1079/9781845939649.0481
Maher, O. A., Motallebi, S., Bellizzi, S., Suliman, A., & Moattari, S. Climate Change Vulnerabilities in the Eastern Mediterranean Region: Trends and Impacts on Communicable Diseases; 2024. https://doi.org/10.20944/preprints202412.0258.v1
Al-Nefaie, H., Alsultan, A., & Abusaris, R. Temporal and spatial patterns of dengue geographical distribution in Jeddah, Saudi Arabia. Journal of Infection and Public Health. 2022 Sep 1;15(9):1025-35. https://doi.org/10.1016/j.jiph.2022.08.003
Al-Sheikh, A. A. H. (2004). Studies on the ecology, vectorial role and population structure of Anopheles arabiensis in the Tihama region of Saudi Arabia and Yemen. The University of Liverpool (United Kingdom).
Altassan, K. K. Environmental and Population Factors Influencing Dengue Fever Emergence and Spread in Saudi Arabia. University of Washington; 2020.
da Silva, A. C., & Scalize, P. S. Environmental Variables Related to Aedes aegypti Breeding Spots and the Occurrence of Arbovirus Diseases. Sustainability. 2023 May 17;15(10):8148. https://doi.org/10.3390/su15108148
Faraj, T. K. Influence of climate variables upon selected infectious diseases in Asir Region, Saudi Arabia (Doctoral dissertation, University of East Anglia); 2011. https://ueaeprints.uea.ac.uk/id/eprint/52528
Alkhaldy, I., & Barnett, P. Evaluation of neighborhood socio-economic status, as measured by the Delphi Method, on dengue fever distribution in Jeddah City, Saudi Arabia. International Journal of Environmental Research and Public Health. 2021 Jun 13;18(12):6407. https://doi.org/10.3390/ijerph18126407
Soghaier, M. A., Mahmood, S. F., Pasha, O., Azam, S. I., Karsani, M. M., Elmangory, M. M., ... & Eltigai, E. Dengue fever in a border state between Sudan and Republic of South Sudan: Epidemiological perspectives. J. Public Health Epidemiol. 2013 Aug 31;5(8):319-24. https://doi.org/10.5897/JPHE2013.0533
Suaya, J., Shepard, D. S., & Beatty, M. E. Dengue: burden of disease and costs of illness. In Report of the Scientific Working Group meeting on Dengue, Geneva, 1− 5 October 2006 (pp. 35-49). World Health Organization on behalf of the Special Programme for Research and Training in Tropical Diseases; 2007. Available at: https://scholarworks.brandeis.edu/esploro/outputs/9924137222401921
Islam, J., Asif, M. H., Rahman, S., & Hasan, M. Exploring Mosquito Hazards in Bangladesh: Challenges and Sustainable Solutions. IUBAT Review. 2024 Dec 31;7(2):1-29. https://doi.org/10.3329/iubatr.v7i2.78792
Wielgosz, B., Mangheni, M., Tsegai, D. W., & Ringler, C. Malaria and agriculture: A global review of the literature with a focus on the application of integrated pest and vector management in East Africa and Uganda; 2012. Available at SSRN: https://ssrn.com/abstract=2197504 or http://dx.doi.org/10.2139/ssrn.2197504
Pascoe, L., Clemen, T., Bradshaw, K., & Nyambo, D. Review of importance of weather and environmental variables in agent-based arbovirus models. International journal of environmental research and public health. 2022 Nov 24;19(23):15578. https://doi.org/10.3390/ijerph192315578
Ebi, K. L., & Nealon, J. Dengue in a changing climate. Environmental research. 2016 Nov 1;151:115-23. https://doi.org/10.1016/j.envres.2016.07.026
Simoy, M. I., Simoy, M. V., & Canziani, G. A. The effect of temperature on the population dynamics of Aedes aegypti. Ecological modelling. 2015 Oct 24;314:100-10. https://doi.org/10.1016/j.ecolmodel.2015.07.007
Brown, L., Medlock, J., & Murray, V. (2014). Impact of drought on vector-borne diseases–how does one manage the risk?. Public health. 2014 Jan 1;128(1):29-37. https://doi.org/10.1016/j.puhe.2013.09.006
Ebi, K. L., & Nealon, J. (2016). Dengue in a changing climate. Environmental research, 151, 115-123. https://doi.org/10.1016/j.envres.2016.07.026
Maher, O. A., Motallebi, S., Bellizzi, S., Suliman, A., & Moattari, S. (2024). Climate Change Vulnerabilities in the Eastern Mediterranean Region: Trends and Impacts on Communicable Diseases. https://doi.org/10.20944/preprints202412.0258.v1
Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., ... & Stewart, L. A. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. Bmj. 2015 Jan 2;349. https://doi.org/10.1136/bmj.g7647
Luchini, C., Stubbs, B., Solmi, M., & Veronese, N. Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale. World Journal of Meta-Analysis. 2017 Aug 26;5(4):80-4. http://dx.doi.org/10.13105/wjma.v5.i4.80
Khormi, H., Kumar, L., & Elzahrany, R. Modelling of dengue fever and its vector risks based on the impacts of socioeconomic, meteorological and environmental factors: a Geographic Information System-based case study of Jeddah, Saudi Arabia; 2013. Avaliable at: https://hdl.handle.net/1959.11/13613
Ahmed, R. M., Hassan, S. M., & Elrahman, A. H. Climatic Factors Affecting Density of Aedes aegypti (Diptera: Culicidae) in Kassala City, Sudan 2014/2015. Asploro Journal of Biomedical and Clinical Case Reports. 2019;2019(2):58 https://doi.org/10.36502/2019/ASJBCCR.6161
Alkhaldy I, Basu A. A cross-tabulated analysis for the influence of climate conditions on the incidence of dengue fever in Jeddah City, Saudi Arabia during 2006-2009. Int J Health Sci (Qassim). 2022 Nov-Dec;16(6):3-10. PMID: 36475033; PMCID: PMC9682878.
Yasin, Y. J. GIS Application and Environmental Factors for Mosquito Control in Eastern Province, Saudi Arabia (Master's thesis, King Fahd University of Petroleum and Minerals (Saudi Arabia); 2015. 10689264.
Kholedi, A. A. N., Balubaid, O., Milaat, W., Kabbash, I. A., & Ibrahim, A. Factors associated with the spread of dengue fever in Jeddah Governorate, Saudi Arabia. EMHJ-Eastern Mediterranean Health Journal. 2012 Jan 1;18(1). Available at: https://iris.who.int/handle/10665/118238
Seidahmed, O. M., Hassan, S. A., Soghaier, M. A., Siam, H. A., Ahmed, F. T., Elkarsany, M. M., & Sulaiman, S. M. Spatial and temporal patterns of dengue transmission along a Red Sea coastline: a longitudinal entomological and serological survey in Port Sudan city; 2012. https://doi.org/10.1371/journal.pntd.0001821
Ifedayo, I. O. Evaluation of the Correlation Between Climate Change and Emerging and Re-Emerging Diseases in Selected South-Western States (Ekiti, Osun and Ondo), Nigeria (Master's thesis, Kwara State University (Nigeria); 2022. 30640726.
Lamy, K., Tran, A., Portafaix, T., Leroux, M. D., & Baldet, T. (2023). Impact of regional climate change on the mosquito vector Aedes albopictus in a tropical island environment: La Réunion. Science of the Total Environment. 2023 Jun 1;875:162484. https://doi.org/10.1016/j.scitotenv.2023.162484
Campbell-Lendrum, D., Molyneux, D., Amerasinghe, F., Davies, C., Fletcher, E., Schofield, C., ... & Epstein, P. (2005). Ecosystems and vector-borne disease control. Ecosystems and human well-being: policy responses. 2005;3:353-72.
Ngugi, H. N. Ecology of Immature Stages of the Dengue Fever Vector Aedes Aegypti (L.)(Diptera: Culicidae) in Rural and Urban Sites of the Southern Coast of Kenya (Doctoral dissertation, University of Nairobi); 2023. Available at: http://erepository.uonbi.ac.ke/handle/11295/164298
Bond, P. (1999). Basic infrastructure for socio-economic development, environmental protection and geographical desegregation: South Africa's unmet challenge. Geoforum. 1999 Feb 1;30(1):43-59. https://doi.org/10.1016/S0016-7185(98)00031-1
Chandra, G., & Mukherjee, D. Effect of climate change on mosquito population and changing pattern of some diseases transmitted by them. In Advances in Animal Experimentation and Modeling 2022 Jan 1 (pp. 455-460). Academic Press. https://doi.org/10.1016/B978-0-323-90583-1.00030-1
Udayanga, L., Gunathilaka, N., Iqbal, M. C. M., Lakmal, K., Amarasinghe, U. S., & Abeyewickreme, W. Comprehensive evaluation of demographic, socio-economic and other associated risk factors affecting the occurrence of dengue incidence among Colombo and Kandy Districts of Sri Lanka: a cross-sectional study. Parasites & vectors. 2018 Dec;11:1-8. https://doi.org/10.1186/s13071-018-3060-9
Romeo-Aznar, V., Paul, R., Telle, O., & Pascual, M. Mosquito-borne transmission in urban landscapes: the missing link between vector abundance and human density. Proceedings of the Royal Society B. 2018 Aug 15;285(1884):20180826. https://doi.org/10.1098/rspb.2018.0826