Epidemiology of dengue fever in Ethiopia: Insights from a systematic review and meta-analysis

Abstract

Background Dengue fever is an emerging mosquito-borne viral disease with increasing reports from several regions in Ethiopia. However, national-level pooled evidence on its prevalence and determinants remains limited on dengue fever. Objectives This systematic review and meta-analysis aimed to estimate the pooled prevalence of dengue fever and identify determinants among patients in Ethiopia. Methods This systematic review followed PRISMA guidelines and registered the protocol in PROSPERO (CRD420251180312). Electronic databases and university repositories were searched. A random-effect model was used to estimate pooled prevalence and pooled odds ratios (ORs). Heterogeneity was assessed using the I 2 statistic and Cochran's Q test. Subgroup analyses were conducted based on study design and diagnostic methods. Results Thirteen studies met the inclusion criteria in this meta-analysis. Eight cross-sectional studies were included in the pooled prevalence analysis. The systematic review and meta-analysis found that the dengue fever pooled prevalence in Ethiopia was 25% (95% CI: 23–27), with no significant heterogeneity across the studies (I 2 = 0.00%), while the pooled estimate of the prevalence was statistically significant ( p < 0.001). The subgroup analysis showed a higher prevalence of dengue cases before the year 2020 (35%) compared to after 2020 (16%). Determinant analyses showed that not wearing long-sleeved clothes, not using a mosquito net, the presence of open water containers, and not spraying insecticides in the last six months were significant factors associated with dengue infection, with heterogeneity being high (I 2 > 75% of studies, p < 0.001). Conclusion Dengue fever is an important public health concern in Ethiopia, particularly in outbreak-prone and urban neighborhoods. However, pooled estimates should be interpreted cautiously due to methodological heterogeneity. The current study identified that behavioral and environmental factors significantly influence the risk of dengue fever infection. These findings demonstrate the importance of targeted public health interventions (community education on preventive practices and enhanced mosquito control strategies).