Epidemiological situation of 2023 dengue fever outbreaks in ECOWAS Region: Implications for strengthening preparedness and response

Introduction: The Economic Community of West African States (ECOWAS) saw a significant rise in dengue fever (DF) outbreaks in 2023, presenting new challenges for public health systems. This paper outlines the epidemiological situation and highlights key challenges and implications for enhancing preparedness and response strategies in the region. Methods: We characterised DF outbreaks in ECOWAS from January to December 2023 using a mixed-methods approach. This included: an extensive desk review of published and grey literature; quantitative analysis of data from a self-administered questionnaire completed by key informants in Member States(MS) to assess the epidemiological situation, response, and control efforts; and a qualitative synthesis of a two-day regional stakeholder meeting. Quantitative data were analyzed using Microsoft Excel and Epi Info version 7.2 to generate descriptive statistics. Missing data and reporting limitations were explicitly documented and discussed. Results: Ten (66%) of the 15 Member States reported a total of 157,031 suspected cases, including 72,799 confirmed and probable cases and 748 deaths (overall case fatality rate [CFR]: 1.0%). Burkina Faso accounted for 98% of confirmed/probable cases (71,299) and 95% of fatalities. The highest CFR (33.3%) was reported in Benin. Among confirmed/probable cases, females (56.8%) and adults aged 20–49 years (47.5%) constituted the largest proportion. The predominant circulating viral serotypes were DENV-3 and DENV-1. Member States faced several health system, environmental, and coordination challenges Conclusion: The 2023 dengue outbreaks in ECOWAS underscore the urgent need to strengthen surveillance, improve vector control interventions, enhance laboratory diagnostic capacity, and promote regional coordination. These findings should be interpreted considering limitations in data completeness and reporting consistency across countries.