{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T06:17:03Z","timestamp":1782627423848,"version":"3.54.5"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012908","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nBackground\n<\/jats:title>\n<jats:p>Since 2013, dengue cases have shown a marked increase in Ethiopia. The current suspected outbreak occurring in Metahara town, Oromia Regional State, began in July 2023. This study aimed to confirm and characterize the outbreak, identify risk factors, and implement control measures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMethods\n<\/jats:title>\n<jats:p>We conducted a descriptive study and an unmatched case-control design, using a one-to-two ratio of cases to controls. We collected data on the dengue outbreak using line lists, laboratory test results, environmental observations, home visits, and entomological examinations. We selected a total of 50 cases using simple random sampling from the line list and purposively chose 100 controls from the same block. We applied community-based face-to-face interviews with 150 participants. After gathering data through Kobo Collect, we analyzed it using Statistical Package for the Social Sciences (SPSS) version 26 and summarized the findings in Microsoft Excel 2013. A binary logistic regression model was employed to identify significant variables, with p-values \u2264 0.25 in bivariate analysis considered for the final model. Crude and adjusted odds ratios (OR and AOR) were used to measure associations, with p-values \u2264 0.05 indicating significance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>The investigation confirmed 342 dengue cases, corresponding to an attack rate of 7.1 per 1,000 population and a case fatality rate of 0.88%. Significant risk factors included not using long-lasting insecticide nets during the daytime (9-fold increased likelihood) and having open water containers (5-fold increased likelihood. Respondents lacking disease awareness were 25 times more likely to be infected, while wearing long-sleeved clothing conferred a protective effect of 75% reduction in risk.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>The dengue outbreak in Metahara town was driven by epidemiological, entomological, and environmental factors, with Aedes aegypti as the primary vector. The ongoing circulation of DENV-3, coupled with insufficient vector control measures, poses a serious public health threat. Key contributing factors to the outbreak include the lack of utilization of long-lasting insecticide nets (LLINs) during the daytime, improper water storage practices, insufficient public knowledge regarding transmission and prevention strategies, and inadequate protective clothing choices that increase vulnerability to mosquito bites. Strategies including vector control, community education, promotion of protective clothing, and improved surveillance were recommended.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012908","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T17:39:48Z","timestamp":1742233188000},"page":"e0012908","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unraveling the dynamics of dengue in Metahara town, East Shewa, Oromia, Ethiopia, 2023"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1933-4238","authenticated-orcid":true,"given":"Bikila Negesa","family":"Gobena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teshome Kabeta","family":"Dadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemechu Chemeda","family":"Feyisa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birhanu","family":"Kenate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemechu","family":"Shumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fantahun","family":"Workie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haimanot","family":"Workie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebise","family":"Djirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dabesa","family":"Gobena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"pntd.0012908.ref001","author":"WHO","year":"2022"},{"key":"pntd.0012908.ref002","unstructured":"World Health Organization. Technical handbook for dengue surveillance, dengue outbreak prediction\/detection and outbreak response (model contingency plan). 2019."},{"key":"pntd.0012908.ref003","unstructured":"Sheet D, Page D, Organisation W. Dengue outbreak toolbox key reference documents: Confirmed case laboratory confirmation. 2022;2\u20134."},{"key":"pntd.0012908.ref004","unstructured":"Administration C, Biru M. Dengue fever outbreak investigation and response in Dire Dawa. 2020;63:23\u20137."},{"key":"pntd.0012908.ref005","first-page":"129","article-title":"Serological evidence of dengue fever and its associated factors in health facilities in the Borena Zone, South Ethiopia","volume":"10","author":"EN Geleta","year":"2019","journal-title":"Res Rep Trop Med"},{"issue":"5","key":"pntd.0012908.ref006","doi-asserted-by":"crossref","first-page":"e0006430","DOI":"10.1371\/journal.pntd.0006430","article-title":"A serologic study of dengue in northwest Ethiopia: Suggesting preventive and control measures","volume":"12","author":"G Ferede","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0012908.ref007","doi-asserted-by":"crossref","first-page":"e0008992","DOI":"10.1371\/journal.pntd.0008992","article-title":"Another dengue fever outbreak in Eastern Ethiopia\u2014An emerging public health threat","volume":"15","author":"MA Gutu","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"pntd.0012908.ref008","doi-asserted-by":"crossref","DOI":"10.3390\/insects13111066","article-title":"Epidemiological, entomological, and climatological investigation of the 2019 dengue fever outbreak in Gewane District, Afar Region, North-East Ethiopia","volume":"13","author":"W Mekuriaw","year":"2022","journal-title":"Insects"},{"key":"pntd.0012908.ref009","doi-asserted-by":"crossref","DOI":"10.1155\/2023\/4349078","article-title":"A community-level knowledge, attitude, and practice about dengue fever and the identification of mosquito breeding containers in Dire Dawa City of Ethiopia: A cross-sectional study","volume":"2023","author":"T Kebede","year":"2023","journal-title":"Canadian Journal of Infectious Diseases and Medical Microbiology"},{"issue":"1","key":"pntd.0012908.ref010","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1365-3156.2007.01966.x","article-title":"Insecticide-treated bednets to control dengue vectors: preliminary evidence from a controlled trial in Haiti","volume":"13","author":"A Lenhart","year":"2008","journal-title":"Trop Med Int Health"},{"issue":"1","key":"pntd.0012908.ref011","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1186\/s12936-021-03811-1","article-title":"Challenges and opportunities for use of long-lasting insecticidal nets to prevent malaria during overnight travel in Uganda: a qualitative study","volume":"20","author":"D Ekusai-Sebatta","year":"2021","journal-title":"Malar J"},{"key":"pntd.0012908.ref012","article-title":"Dengue y dengue grave","author":"WHO","year":"2023"},{"key":"pntd.0012908.ref013","author":"Centers for Disease Control and Prevention. Index @ Www.Cdc.Gov [Internet]. 2022 West Nile virus update","year":"2022"},{"issue":"3","key":"pntd.0012908.ref014","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1177\/1461444810365020","article-title":"Review article","volume":"11","author":"P Kilmer","year":"2010","journal-title":"Journalism"},{"issue":"6","key":"pntd.0012908.ref015","doi-asserted-by":"crossref","first-page":"924","DOI":"10.3201\/eid1306.070008","article-title":"Age and clinical dengue illness","volume":"13","author":"JR Egger","year":"2007","journal-title":"Emerg Infect Dis"},{"key":"pntd.0012908.ref016","first-page":"17589","article-title":"Integrated vector management","author":"MM Cameron","year":"2013","journal-title":"Biol Environ Control Dis Vectors"},{"issue":"2","key":"pntd.0012908.ref017","doi-asserted-by":"crossref","first-page":"e0245457","DOI":"10.1371\/journal.pone.0245457","article-title":"Systematic review of Integrated Disease Surveillance and Response (IDSR) implementation in the African region","volume":"16","author":"CM Wolfe","year":"2021","journal-title":"PLoS One"},{"key":"pntd.0012908.ref018","author":"World Health Organization (WHO). health-topics-ethiopia @ www.afro.who.int [Internet]","year":"n.d"},{"key":"pntd.0012908.ref019","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.2147\/JMDH.S411191","article-title":"Integrated Disease Surveillance Response Practice and Associated Factors Among Health Professionals Working in Public Hospitals in West Hararghe Zone, Eastern Oromia, Ethiopia: Multi-Center Cross-Sectional Study","volume":"16","author":"A Yusuf","year":"2023","journal-title":"J Multidiscip Healthc"},{"key":"pntd.0012908.ref020","first-page":"1","article-title":"Guideline","author":"A Bedasso","year":"2022"},{"key":"pntd.0012908.ref021","unstructured":"Griffiths CL. Dengvaxia: the world\u2019s first vaccine for prevention of secondary dengue. 2021.1\u20138."},{"key":"pntd.0012908.ref022","unstructured":"Chen W. Updates on Dengue Vaccines. 2023."},{"issue":"2","key":"pntd.0012908.ref023","doi-asserted-by":"crossref","first-page":"92","DOI":"10.15406\/jdvar.2023.12.00330","article-title":"Partipatory disease surveilance in Fentale & Adama Districts of East Shewa Zone, Oromia Regional State","volume":"12","author":"A Lemma","year":"2023","journal-title":"JDVAR"},{"key":"pntd.0012908.ref024","article-title":"Encyclopedia F. Metehara.","year":"2023"},{"key":"pntd.0012908.ref025","doi-asserted-by":"crossref","unstructured":"Degife LH, Worku Y, Belay D, Bekele A, Hailemariam Z. 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