A spatial analysis of dengue fever and an analysis of dengue control strategies in Jeddah City, Saudi Arabia
Degree GrantorUniversity of Canterbury
Degree NameDoctor of Philosophy
Dengue fever poses a constant serious risk and continues to be a major public health threat in Saudi Arabia, particularly in the city of Jeddah where, since 2006, despite formally introduced Control Strategies, there has been a significant increase in the number of cases. International literature suggests that a range of variables can influence the persistence of dengue, including climatic conditions, the quality of the urban environment, socioeconomic status and control strategies.
The overall aims of this research are to understand neighbourhood influences on the pattern of dengue fever across Jeddah City and to make a preliminary determination of the enabling factors for, and barriers to, the effective implementation of the Control Strategies for dengue fever in Jeddah City.
A mixed methods research design using quantitative and qualitative data was used. Quantitative data were obtained from administrative sources for dengue fever cases and some of the spatial and temporal variables associated with them, but new variables were created for neighbourhood status and the presence of surface water. Qualitative data are drawn from key informant interviews with 15 people who were, or who had been, working on dengue fever Control Strategies. A qualitative descriptive analysis was based on pre- determined and emergent themes.
The spatial and temporal analysis of the variables related to dengue fever in Jeddah City neighbourhoods revealed that neighbourhood status has a direct relationship with dengue fever cases, which is mediated through population density and the presence of non- Saudi immigrants. While there was no relationship with the presence of swamps, seasonal variations in the incidence of dengue were most pronounced in neighbourhoods of low socioeconomic status. The qualitative review of dengue Control Strategies indicated five themes: (1) workforce characteristics and capability, (2) knowledge about dengue fever in Saudi Arabia and Jeddah City, (3) operational strategies for dengue fever control in Jeddah City, (4) the progress of implementation, and (5) overall view of the Government strategies in Jeddah City. This analysis found that the Strategies were well regarded but that aspects of implementation were not always effective. Nevertheless, both quantitative and qualitative results showed the persistence dengue fever problems in Jeddah City neighbourhoods and suggested how cases might be controlled.
The number of dengue fever cases in Jeddah City neighbourhoods could continue to rise if the direct and indirect variables affecting dengue fever at the neighbourhood level are not well controlled. Careful attention to the further monitoring of patterns of dengue and specific neighbourhood Control Strategies are recommended, and established Control Strategies need to be implemented as designed. Nonetheless, there is still a need to develop new approaches that can examine and address neighbourhood level issues of dengue fever control.