Evaluation of Neighborhood Socio-Economic Status, as Measured by the Delphi Method, on Dengue Fever Distribution in Jeddah City, Saudi Arabia

Dengue fever, a mosquito-transmitted viral disease, is present in many neighborhoods in Jeddah City, Saudi Arabia. One factor likely to affect its distribution is the socio-economic status of local neighborhoods; however, the absence of socio-economic census data in Saudi Arabia has precluded detailed investigation. This study aims to develop a proxy measure of socio-economic status in Jeddah City in order to assess its relationship with the occurrence of dengue fever. The Delphi method was used to assess the socio-economic status (high, medium or low) of local neighborhoods in Jeddah City. A Geographic Information System (GIS) was applied to understand the distribution of dengue fever according to the socio-economic status of Jeddah City neighborhoods. Low-socio-economic status neighborhoods in south Jeddah City, with poor environmental conditions and high levels of poverty and population density, reported most cases of dengue fever. Nevertheless, dengue continues to increase in high socio-economic status neighborhoods in the northern part of the city, possibly due to ideal breeding conditions caused by the presence of standing water associated with high levels of construction. Moreover, the low-socioeconomic-status neighborhoods had the highest average number of cases, being 3.95 times that of high-status neighborhoods for the period 2006–2009. The Delphi approach can produce a useful and robust measure of socio-economic status for use in the analysis of patterns of dengue fever. Results suggest that there are nuances in the relationship between socio-economic status and dengue that indicate that higher status areas are also at risk. A useful additional tool for researchers in Saudi Arabia would be the development of census data or other systematic measures that allow socio-economic status to be included in spatial analyses of dengue fever and other diseases.