Epidemiology of Dengue and its Association with Community Knowledge, Attitudes, and Practices in Jazan, Saudi Arabia, (2020–2025)

Abstract

Dengue remains a major public-health concern in southwestern Saudi Arabia, where local surveillance and community prevention are both essential. This study used the combination of retrospective surveillance and cross-sectional Knowledge, Attitude and Practices (KAP) assessment in Jazan Region. The number of laboratory confirmed dengue cases reported via the Saudi Ministry of Health HESN Plus (Health Electronic Surveillance Network) system from 2020 until 2025 was included in Component A. There were 430 adult primary healthcare (PHC) visitors who answered the structured KAP questionnaire in component B. Case counts were totaled and inter-year comparisons were made; KAP data were analyzed using descriptive statistics, nonparametric tests, Spearman correlations, reliability analysis, and multiple linear regression. Confirmed cases varied markedly across the study period: 33 in 2020, 24 in 2021, 177 in 2022, 270 in 2023, 452 in 2024, and 32 in 2025. The distribution of the number of counts across the year was not equal (χ²(5, N=988) = 902.01, p<.001), but annual population-based incidence rates were not possible as there were no denominators available. Among PHC visitors, mean standardized knowledge, attitude, practice, and total KAP scores were 83.69, 75.40, 87.55, and 82.21, respectively; 68.8%, 54.2%, 79.8%, and 79.1% met the study-defined 75% thresholds. There were important gaps of knowledge in recognition of Aedes, knowledge of the biting time and knowledge of inspecting larvae along with community participation. In adjusted models, sex and income were shown to be associated with KAP outcomes, and history of dengue was shown to be positively associated with total KAP. The results endorse continued monitoring and targeted PHC-based vector literacy and community-engagement efforts.