Prevalence and factors associated with dengue fever serotypes in Eastern Sudan: a hospital-based cross-sectional study
5 affiliations
- 1Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of Kassala
- 2Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Bakht Alruda
- 3Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Kassala
- 4Department of Internal Medicine, Kassala Teaching Hospital, Ministry of Health Kassala State
- 5King Saud University Celiac Disease Research Chair, Department of Pediatric, College of Medicine, King Saud University
Abstract
Background Dengue is a critical public health threat in Sudan, exacerbated by rapid urbanization and climatic factors. The 2024 outbreak in Kassala State occurred amidst a violent internal conflict and massive population displacement, synergistically accelerating transmission and complicating clinical management. This study aimed to determine the prevalence of dengue virus (DENV) serotypes and identify sociodemographic and clinical factors associated with specific serotypes among residents and internally displaced persons (IDPs) in Kassala during the 2024 epidemic. Methods A hospital-based cross-sectional study was conducted at Kassala Teaching Hospital (October–December 2024). Serum samples from 227 confirmed dengue patients (RDT-positive for NS1, IgM, or both) were analyzed using one-step Real-Time PCR for serotyping. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the most prevalent serotypes. Results Among the confirmed 227 dengue fever, DENV-2 was the dominant serotype (59.9%), followed by DENV-3 (35.2%) and DENV-1 (4.8%). Notably, 52% of patients were IDPs, and 30.4% presented with severe forms (DHF/DSS). The overall mortality rate was 6.6%, with 13 out of the 15 recorded deaths occurring among the displaced population. While a high fatality rate was noted among the small subset of DENV-1 patients (4 out of 11), this finding must be interpreted with extreme caution due to the limited sample size. Multivariate analysis revealed that the non-use of mosquito nets was the only independent factor associated with DENV-2 infection (adjusted odds ratio, AOR = 2.20; 95% CI: 1.23–3.90; P = 0.007). No significant differences were found between serotypes regarding age, gender, or displacement status. Conclusion The 2024 dengue outbreak marked a significant shift from DENV-3 to DENV-2 dominance, with a high mortality burden clustering heavily within vulnerable IDPs due to systemic displacement factors rather than strain dominance. The strong association between net non-use and DENV-2 highlights the urgent need for targeted long-lasting insecticidal nets (LLINs) distribution and vector control in displacement camps. Additionally, the high fatality rate in the small DENV-1 subset underscores the necessity of strengthened molecular surveillance to monitor virulent strains in conflict zones.
Related
- Prevalence of pulmonary tuberculosis and associated factors among suspected tuberculosis patients attending Halaba Kulito General Hospital, Ethiopia: cross-sectional study.
- Prevalence of rifampicin-resistant tuberculosis and its associated factors among patients with tuberculosis at Galkayo General Hospital, Puntland, Somalia: a facility-based cross-sectional study.
- Prevalence and associated factors of chronic kidney disease among hypertensive patients attending cardiac clinic at a tertiary hospital in Tanzania: a hospital-based cross-sectional study
- Prevalence and factors associated with iron deficiency among regular blood donors in Regional Hospital, Southern Thailand: a cross-sectional study
- Prevalence and associated factors of delayed diagnosis of type 2 diabetes mellitus among adults attending a comprehensive specialized hospital in Central Ethiopia: A facility-based cross-sectional study
BibTeX
@article{musa2026prevalence,
title = {{Prevalence and factors associated with dengue fever serotypes in Eastern Sudan: a hospital-based cross-sectional study}},
author = {Abdualmoniem O. Musa and Abdel Rhman S. Hajnour and Asma Mohammed Almuatasim and Elddai H. Elnaem and Amal Huseen Karar and Ahmed A. Hassan and Tajeldin M. Abdallah},
journal = {BMC Infectious Diseases},
year = {2026},
month = jul,
doi = {10.1186/s12879-026-14117-5},
url = {https://doi.org/10.1186/s12879-026-14117-5},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prevalence and factors associated with dengue fever serotypes in Eastern Sudan: a hospital-based cross-sectional study
AU - Abdualmoniem O. Musa
AU - Abdel Rhman S. Hajnour
AU - Asma Mohammed Almuatasim
AU - Elddai H. Elnaem
AU - Amal Huseen Karar
AU - Ahmed A. Hassan
AU - Tajeldin M. Abdallah
PY - 2026
DA - 2026/07/01
JO - BMC Infectious Diseases
DO - 10.1186/s12879-026-14117-5
UR - https://doi.org/10.1186/s12879-026-14117-5
AB - Background Dengue is a critical public health threat in Sudan, exacerbated by rapid urbanization and climatic factors. The 2024 outbreak in Kassala State occurred amidst a violent internal conflict and massive population displacement, synergistically accelerating transmission and complicating clinical management. This study aimed to determine the prevalence of dengue virus (DENV) serotypes and identify sociodemographic and clinical factors associated with specific serotypes among residents and internally displaced persons (IDPs) in Kassala during the 2024 epidemic. Methods A hospital-based cross-sectional study was conducted at Kassala Teaching Hospital (October–December 2024). Serum samples from 227 confirmed dengue patients (RDT-positive for NS1, IgM, or both) were analyzed using one-step Real-Time PCR for serotyping. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the most prevalent serotypes. Results Among the confirmed 227 dengue fever, DENV-2 was the dominant serotype (59.9%), followed by DENV-3 (35.2%) and DENV-1 (4.8%). Notably, 52% of patients were IDPs, and 30.4% presented with severe forms (DHF/DSS). The overall mortality rate was 6.6%, with 13 out of the 15 recorded deaths occurring among the displaced population. While a high fatality rate was noted among the small subset of DENV-1 patients (4 out of 11), this finding must be interpreted with extreme caution due to the limited sample size. Multivariate analysis revealed that the non-use of mosquito nets was the only independent factor associated with DENV-2 infection (adjusted odds ratio, AOR = 2.20; 95% CI: 1.23–3.90; P = 0.007). No significant differences were found between serotypes regarding age, gender, or displacement status. Conclusion The 2024 dengue outbreak marked a significant shift from DENV-3 to DENV-2 dominance, with a high mortality burden clustering heavily within vulnerable IDPs due to systemic displacement factors rather than strain dominance. The strong association between net non-use and DENV-2 highlights the urgent need for targeted long-lasting insecticidal nets (LLINs) distribution and vector control in displacement camps. Additionally, the high fatality rate in the small DENV-1 subset underscores the necessity of strengthened molecular surveillance to monitor virulent strains in conflict zones.
SN - 1471-2334
ER -