Dengue Fever in Al-Hodeidah Governorate, Yemen: A Seven-Year Epidemiological Analysis, 2019–2025

Background Dengue fever remains a major public health concern in Yemen, with cases reported from almost all governorates. Dengue has most severely impacted Al-Hodeidah Governorate. Ongoing conflict, population displacement, inadequate infrastructure, and a fragile health system have contributed to the persistence and spread of dengue fever in the region. Objectives To describe the epidemiological characteristics and trends of dengue fever from 2019 to 2025 Methods A retrospective descriptive analysis was conducted. The cumulative dengue fever data for the period from 2019 to 2025 were obtained from the electronic Integrated Disease Early Warning System (eIDEWS) as line-listed records. The WHO and eIDEWS case definitions were used to collect data from suspected cases. Surveillance data were reviewed and cleaned and analyzed by place, person, and time using SPSS version 27. Results A total of 115,381 suspected dengue cases were reported during the study period, of which 32,203 (27.9%) were laboratory confirmed. Males accounted for 59.0% of the cases, and the mean age of the patients was 21.6 ± 16.6 years. Most cases occurred among individuals aged 15–29 years (30.9%) and during 2020 (26.9%). The overall incidence of dengue was 302 per 10,000 population, with higher incidence among males (362 per 10,000 population) and individuals aged 15–29 years (389 per 10,000 population). Marked seasonal variation was observed, with 46.6% of cases occurring during winter. A total of 236 dengue-related deaths were reported, corresponding to a case fatality rate (CFR) of 0.2%, with the highest rates observed among females (0.22%), individuals aged ≥ 60 years (0.45%), and in 2019 (0.41%). Fever (100%), headache (99.2%), joint pain (97.3%), and muscle pain (93.0%) were the most common symptoms. Additionally, 446 cases (0.4%) displayed symptoms of dengue hemorrhagic fever. Conclusion Dengue fever remains endemic in Al-Hodeidah Governorate and continues to pose a significant public health challenge, with marked temporal, seasonal, demographic, and geographical variation. Higher case burdens in urban and conflict-affected areas emphasize the necessity of targeted interventions. Strengthening surveillance systems, enhancing community engagement and awareness, improving vector control strategies, and implementing coordinated multisectoral interventions are essential to reduce the burden of dengue and prevent future outbreaks.