Examine public awareness and preventive actions for dengue fever in Sudan amidst the ongoing crises

BACKGROUND: Dengue Fever (DF) is one of the mosquito-transmitted viral diseases with the highest morbidity and mortality, affecting millions worldwide. In Sudan, which is presently embroiled in conflict and has a failing medical system, the number of DF cases continues to grow. This study was designed to evaluate public knowledge and preventive health behaviors regarding DF during a crisis. METHODS: A cross-sectional online survey was distributed via social media across Sudan; the questionnaire included four sections on sociodemographic data, dengue knowledge, prevention practices, and the impact of the ongoing conflict on healthcare access. It consisted of both multiple-choice and open-ended questions assessing awareness, behaviors, and barriers. A total of 164 participants responded. Data were collected using a self-administered questionnaire and analyzed with SPSS, using descriptive and inferential statistics. Ethical approval was obtained. RESULTS: Out of 164 respondents (65.9% female, average age 31.9), 60% were displaced. Generally, knowledge of DF symptoms and prevention was adequate, particularly among the educated segment; however, only 36.9% had high actual knowledge scores. Women were more likely to have moderate knowledge, while men were slightly more likely to be in the good knowledge category (Fisher's Exact Test, p = 0.045), with a moderate effect size (V = 0.16). Preventive behaviors were moderate, with 61.7% using a mosquito net; however, knowledge was not significantly associated with behavior implementation (p = 0.147). Regarding gender, there was a significant difference in health-seeking behavior: 70.4% of females reported always seeking care, compared with 48.2% of males (Fisher's Exact Test, p = 0.039). Access barriers were significantly associated with location (Chi-square, p = 0.001) and displacement status. There was a statistically significant association between displacement and dengue diagnosis; 35.6% and 9.5% of displaced versus non-displaced individuals had previously reported infection (Fisher's Exact Test, p = 0 0.001). Barriers to preventive measures and care included cost, resource constraints, and insecurity, with the greatest disparity observed in Khartoum (Fisher's Exact Test, p = 0.031). CONCLUSION: Overall knowledge of dengue symptoms and prevention is relatively high in Sudan; however, structural barriers (displacement, poverty, and the collapse of health care systems) hinder effective implementation of prevention measures. Community-based strategies and improved access to health care and preventive tools are urgently needed during crises.