Sociodemographic and Structural Risk Factors for Dengue in a Rapidly Developing Indonesian District

Background: Dengue infection is an expanding public health threat in Indonesia, increasingly reported in semi-urban areas undergoing rapid demographic and environmental change, where household-level determinants remain poorly characterised. Methods: We conducted a case–control study in the Deli Serdang district, North Sumatra, evaluating sociodemographic and environmental risk factors for dengue. Patients admitted to the district referral hospital (July–September 2024) were screened via medical records. Laboratory-confirmed dengue cases were compared with non-dengue febrile controls. Housing conditions and sociodemographic characteristics were assessed using a validated electronic questionnaire with photographic documentation. Multivariable logistic regression identified independent risk factors. Results: Of 238 individuals screened, 39 dengue cases and 78 controls were enrolled. Male sex (aOR 6.7, 95% CI 1.3–33.7), student status (aOR 7.8, 95% CI 1.1–56.5), absence of window screens (aOR 12.9, 95% CI 3.1–53.8), and surrounding vegetation (aOR 7.3, 95% CI 1.7–31.9) were independently associated with dengue infection. Rural residence was overrepresented among cases, suggesting expansion beyond traditional urban boundaries. Conclusions: Dengue risk in a transitional setting is shaped by demographic exposure and modifiable structural vulnerabilities. Integrated prevention strategies, including window screening, covered water storage, environmental management, and school-based vector control, are needed in rapidly urbanising districts.