A qualitative study to identify the determinants and strategies for the prevention of dengue fever in Iran

In June 2024, Iran reported a dengue fever outbreak beginning in Hormozgan province and spreading to several other provinces, raising significant public health concerns. To mitigate the disease's impact, multiple meetings were held to explore control strategies, emphasizing community participation through focus groups. This study aimed to identify the determinants, priorities, and control strategies for combating dengue fever and breeding sites of Aedes mosquitoes in Hormozgan province, Iran. This qualitative study employed purposive sampling with maximum variation to conduct 13 focus group discussions (FGDs) with 163 participants (8-13 per group) in Hormozgan Province during June-July 2024. Participants included health department officials, municipal managers, port authorities, and community leaders. Data were analyzed using thematic analysis following Braun and Clarke's six-phase approach, with trustworthiness ensured through member checking and peer debriefing. These FGDs included health department officials, governors, municipal managers, medical university representatives, Shipping offices, and influential community leaders involved in dengue prevention education. Through these discussions, seven key determinants for dengue fever control in Iran were identified. The primary factors were: (a) Environmental (b) Therapeutic and health care (c) interdisciplinary cooperation (d) Administrative, legal, and regulatory determinants (e) Financial and budgetary (f) Educational determinants and (g) Social determinants. Effective community empowerment and health program decision-making require cooperation across various organizations, enhancement of high-risk environments, and fostering a sense of responsibility and participation among community members. Given the rise of re-emerging diseases globally, identifying their determinants is crucial for quick disease control in the region and for preventing global pandemics.