Background: Malaria is a significant public health concern in the Kingdom of Saudi Arabia (KSA). This study aimed to investigate the spatiotemporal distribution of malaria in the KSA between 2017 and 2021. Methods: A spatial analysis was conducted using data for malaria cases stratified by Plasmodium species reported by the Ministry of Health for the period 2017–2021. Covariate data such as environmental, socioeconomic, and demographic factors were assembled from different publicly available sources. Results: A total of 13,852 cases were reported from 20 regions in the KSA during the study period. The study indicated a decline in the overall number of reported cases from 2715 in 2017 to 2616 in 2021, primarily driven by a decrease in Plasmodium falciparum infections. However, the number of Plasmodium vivax cases increased in 2021. Southern regions of the KSA remained at higher risk due to imported cases from neighboring Yemen. Socioeconomic and demographic factors, such as access to healthcare and education, were found to affect malaria transmission. Environmental factors, such as temperature and rainfall, were also identified as determinants of malaria risk. Conclusions: This study showed significant spatial variation in malaria cases in the KSA that was related to underlying socioeconomic status and environmental factors. The findings of this study highlight the need for continued efforts to control and eliminate malaria in the KSA, particularly in regions with higher risk of malaria.

The conventional morphological characterization of mosquito species remains heavily used for species identification in Jazan, Saudi Arabia. It requires substantial expertise and time, as well as having difficulty in confirming identity of morphologically similar species. Therefore, to establish a reliable and accurate identification system that can be applied to understanding spatial distribution of local mosquito species from the Jazan region, DNA barcoding was explored as an integrated tool for mosquito species identification. In this study, 44 adult mosquito specimens were analyzed, which contain 16 species belong to three genera of potential mosquito disease vectors (Aedes, Anopheles, and Culex). The specimens were collected from the Jazan region located in southwest Saudi Arabia. These included old and preserved mosquito voucher specimens. In addition, we assessed the genetic distance based on the generated mitochondrial partial COI DNA barcodes to detect cryptic diversity across these taxa. Nine mosquito species belonging to three genera were successfully barcoded and submitted to GenBank, namely: Aedes aegypti, Aedes caspius, Aedes vexans, Aedes vittatus, Anopheles arabiensis, Culex pipiens, Culex quinquefasciatus, Culex sitiens, and Culex tritaeniorhynchus. Of these nine species, Aedes vexans, Aedes vittatus, Culex sitiens, and Culex tritaeniorhynchus were registered in GenBank for the first time from Saudi Arabia. The DNA barcodes generated a 100% match to known barcodes of these mosquito species, that also matched with the morphological identification. Ae. vexans was found to be either a case of cryptic species (subspecies) or a new species from the region. However, more research has to be conducted to prove the latter. This study directly contributes to the development of a molecular reference library of mosquito species from the Jazan region and Saudi Arabia. The library is essential for confirmation of species in support of existing mosquito surveillance and control programmes.

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The present study provided information on the susceptibility status of the adult and larvae of Aedes aegypti mosquitoes in Jazan region of Saudi Arabia. Bioassay tests were performed on adults and larvae by using WHO recommended concentrations and test kits. Adults of Ae. aegypti mosquitoes were exposed to test papers impregnated with Lambda-cyhalothrin (0.05%), Cyfluthrin (0.15%), Deltamethrin (0.05%), Permethrin (0.75%), Fenitrothion (1%), Bendiocarb (0.1%) and DDT (4%) insecticides. Ae. aegypti mosquitoes were found to be susceptible only to Cyfluthrin; (mortality rate was 100%), whereas variable resistances were observed from the rest of the other insecticides tested (mortality rates ranged between 93.6 and 17%). Larvae were subjected to different concentrations of Diflubenzuron, Methoprene (IGRs) and Temephos (Organophosphate). Adult emergence inhibition (IE₅₀ & IE₉₅) values for the IGRs and the (LC₅₀ & LC₉₅) for Temephos were determined by log-probit regression analysis. Ae. aegypti larvae were resistant to Temephos (LC₅₀ 61.8-LC₉₅ 35600.1 mg/l) and showed high susceptibility to Methoprene than Diflubenzuron (IE₅₀ 0.49-IE₉₅ 10.9 mg/l) and (IE₅₀ 0.86 and IE₉₅ 93.8 mg/l), respectively. Larvae were more susceptible to Methoprene than Diflubenzuron by 1.8 folds.

Morphological characteristics have been the gold standard method to identify mosquito species. However, morphological identification has many limitations including lack of expertise and damaging of external characters due to improper specimen handling. Therefore, we used the polymerase chain reaction technique (PCR) as an integrated tool to identify Culex mosquito species to establish a more precise and reliable identification system related to their spatial distribution in Jazan region. We identified Culex mosquito species and subspecies using taxonomic keys, and then we used the polymerase chain reaction technique (PCR) as an integrated tool to confirm and refine the list of Culex mosquito species in the region. Phylogenetic trees were constructed for the identified species, and their distinctive clustering was compared with their references species in the GenBank. We identified 7026 adult Culex mosquitoes belonging to 4 species. Culex tritaeniorhynchus was the predominant species (45), followed by Cx. quinquefasciatus (32), then Culex sitiens (20), and Cx. pipiens (3). The most infested areas by Culex in the region were Gizan and Sabya. The PCR achieved 100 success in identifying the four Culex mosquito species. We also report the molecular identification of Cx. quinquefasciatus and Cx. pipiens species for the first time in Jazan region while the molecular identification of Cx. tritaeniorhynchus and Cx. sitiens was reported for the first time in Jazan region and the whole Saudi Arabia. This study utilized for the first time PCR to identify Culex mosquito species in Jazan region. The PCR is a complementary and integrated taxonomy-based identification tool for mosquito species. This integration has the capacity to promote and enhance vector surveillance and control programs, as well as defining the genetic diversity of species in the region.

Dengue fever (DF) is the most rapidly spreading mosquito-borne viral disease worldwide. Several confirmed dengue cases occurred in Jazan region in the last decade. Current study aims to assess the knowledge, attitudes and preventive practices of dengue fever among students of secondary schools in Jazan, Kingdom of Saudi Arabia. A cross-sectional study was conducted among students of six secondary schools in Jazan. Multistage stratified random sample method was used and seven hundred forty two (742) were taken as respondents in study. We collected information on the socio-demographic characteristics of the respondents about their knowledge, attitude and practice towards DF using a prestructured and self administered questionnaire. findings illustrate a poor DF knowledge among the secondary school students in Jazan. As to attitudes towards DF prevention and control, the majority of the respondents were having good attitudes and believed that DF could be controlled and prevented (93.2%), DF control is the responsibility of government and community (83.1%) and they themselves have an important role to play in DF prevention (78.5%).The most common practice to prevent mosquito breeding were found to be the disposing of water from breeding containers (85.5%) and covering of water containers (68.6%). A significant association between the practice of DF preventive and control measures and the gender of the respondents was found (P<0.005).The top two common sources of DF knowledge were identified as primary health care centers and television (48.1% and 44.5%, respectively) Low prevalence of sufficient knowledge was evident among secondary school students in Jazan. Government authorities should strengthen its programs on massive educational campaigns to increase awareness and knowledge regarding dengue and preventive measures to reduce mosquito and prevent dengue. Knowledge of dengue epidemiology may be incorporated into the school curriculum.