INTRODUCTION

Arthropods (Phylum Arthropoda) constitute the largest and most diverse phylum in the animal kingdom, comprising more than one million described species that inhabit virtually all terrestrial and freshwater ecosystems [1]. Although the majority of arthropods provide indispensable ecological services—including pollination, decomposition, nutrient cycling, and biological control—a relatively small proportion has profound medical and public health importance because of their ability to transmit pathogens, inflict bites and stings, induce allergic reactions, contaminate food and water, or act as reservoirs and vectors of infectious diseases [2]-[4]. Medically important arthropods include mosquitoes, sand flies, houseflies, cockroaches, fleas, lice, mites, ticks, bed bugs, spiders, scorpions, and several hymenopteran species, many of which have adapted exceptionally well to human settlements and disturbed environments [5]-[7].

The ecology and distribution of these arthropods are governed by a complex interaction of climatic, environmental, ecological, and anthropogenic factors. Urban expansion, inadequate sanitation, environmental pollution, climate change, population growth, habitat modification, and poor waste management can substantially increase vector abundance and facilitate the emergence or re-emergence of arthropod-borne and arthropod-associated diseases [8]. Among these drivers, armed conflicts and humanitarian emergencies represent some of the most powerful ecological disturbances because they simultaneously damage environmental infrastructure, interrupt water and sanitation services, disrupt waste management systems, collapse healthcare services, and suspend organized vector-control programs. Such conditions create ideal breeding, resting, and feeding habitats for medically important arthropods while increasing human exposure to vectors and other arthropod pests [9]-[11].

Experiences from humanitarian crises worldwide consistently demonstrate that overcrowded displacement camps, inadequate shelter, poor personal hygiene, stagnant wastewater, accumulated refuse, decomposing organic matter, and limited access to safe water create highly favorable ecological conditions for mosquitoes, houseflies, cockroaches, fleas, lice, mites, ticks, and other arthropods of medical importance [12]-[14]. These environmental conditions not only enhance the proliferation of vectors but also facilitate the transmission of ectoparasites such as the Human Head Louse (Pediculus humanus capitis De Geer, 1778) and the Scabies Mite (Sarcoptes scabiei Linnaeus, 1758), increasing the burden of dermatological disorders, secondary bacterial infections, and other communicable diseases. Consequently, infectious diseases associated with deteriorating environmental conditions frequently become major contributors to morbidity and mortality during humanitarian emergencies, often exceeding deaths directly attributable to armed violence [14] [15].

These interactions are increasingly interpreted through the One Health framework, which recognizes the inseparable links among human, animal, and environmental health. Environmental degradation modifies arthropod habitats, alters vertebrate host communities, promotes the expansion of synanthropic species, and increases opportunities for pathogen transmission among wildlife, domestic animals, arthropod vectors, and humans [2] [16] [17]. Consequently, understanding medically important arthropods in humanitarian settings requires an integrated ecological perspective that considers environmental change, biodiversity, public health, and human behavior as interconnected components of a single system.

The Eastern Mediterranean region is particularly vulnerable to these interactions because of rapid urbanization, water scarcity, climate change, political instability, and repeated humanitarian crises [8]. Within Palestine, several medically important arthropods and arthropod-associated diseases have long been recognized, including mosquitoes, head lice, cockroaches, rodent ectoparasites, and vectors associated with cutaneous leishmaniasis and other parasitic infections [18]-[20]. Mosquito fauna in the West Bank has also received considerable attention, including the documented occurrence of the Asian Tiger Mosquito (Aedes albopictus Skuse, 1894) and ecological investigations of mosquito larvae and their breeding habitats in Salfit District [21] [22]. Previous studies in the Gaza Strip have documented mosquito breeding and proliferation in the Wadi Gaza wetlands and other lagoon habitats, widespread pediculosis among schoolchildren, public health risks associated with cockroach infestations, and ectoparasitic infestations affecting rodents and domestic animals [23]-[31]. However, these studies were conducted under relatively stable pre-war conditions and therefore cannot explain the unprecedented ecological transformations that have occurred since October 2023.

The environmental and public health situation in the Gaza Strip changed fundamentally following the outbreak of the ongoing Israeli war in October 2023. Extensive destruction of residential neighborhoods, healthcare facilities, water supply networks, wastewater treatment plants, electricity infrastructure, roads, and municipal services, together with the repeated displacement of more than 90% of the population, has produced one of the most severe humanitarian and environmental crises in recent history [16] [32]-[34]. Millions of internally displaced Palestinians have been forced to reside in overcrowded tents, schools, and temporary shelters where access to safe water, sanitation, healthcare, and basic hygiene has become critically limited.

One of the most profound environmental consequences of the war has been the collapse of Water, Sanitation, and Hygiene (WASH) systems throughout the Gaza Strip. Damage to water pipelines, sewage networks, pumping stations, wastewater treatment facilities, and stormwater drainage systems has resulted in the widespread accumulation of untreated sewage, stagnant wastewater, and contaminated surface water within and around displacement camps [11] [35]-[37]. Simultaneously, the near-total disruption of municipal solid waste collection has allowed enormous quantities of household refuse, decomposing food waste, animal carcasses, medical waste, and war-generated debris to accumulate in residential and displacement areas [38] [39]. Collectively, these environmental changes have created abundant breeding and resting habitats for mosquitoes, flies, cockroaches, fleas, lice, mites, ticks, rodents, and numerous other arthropods of medical and public health importance.

The unprecedented generation of an estimated 68 million tons of war-related rubble has further transformed the urban landscape into a mosaic of artificial ecological microhabitats. Collapsed buildings, broken concrete, masonry blocks, damaged furniture, timber, and construction debris provide stable shelters for a wide range of synanthropic and medically important organisms. Besides promoting increases in vertebrate pests, including rodents and stray animals [40], these structures offer ideal refuges for venomous arthropods such as scorpions, spiders, and centipedes, thereby increasing the likelihood of human exposure, particularly within densely populated displacement camps [41]-[43].

Environmental deterioration has been compounded by severe overcrowding and the scarcity of water, soap, detergents, insecticides, fuel, and other essential hygiene resources. Under these conditions, displaced families frequently share confined shelters, bedding, clothing, and household items, greatly facilitating the transmission of ectoparasites such as the Human Head Louse (Pediculus humanus capitis De Geer, 1778) and the Scabies Mite (Sarcoptes scabiei Linnaeus, 1758) [44] [45]. At the same time, the interruption of routine environmental health services—including waste collection, drainage maintenance, vector surveillance, insecticide application, and rodent-control programs—has removed many of the barriers that normally suppress arthropod populations, allowing medically important species to proliferate largely unchecked.

Recent humanitarian and epidemiological reports have documented widespread outbreaks of communicable diseases, including scabies, pediculosis, hepatitis A, acute diarrheal diseases, and respiratory infections among displaced populations, accompanied by increasing infestations of insects and rodents within shelters and surrounding environments [46]-[49]. Nevertheless, despite growing attention to the humanitarian and public health consequences of the war, comprehensive ecological studies specifically examining the diversity of medically important arthropods inhabiting Gaza’s displacement camps, the environmental drivers underlying their proliferation, and their broader public health and humanitarian implications remain remarkably scarce.

Therefore, this study assesses the documented and potential occurrence of medically and public health–important arthropods in Gaza Strip displacement camps during the Israeli war (2023–2026), their ecological drivers, associated health risks, and humanitarian implications within a One Health framework. It integrates field observations, scientific literature, and humanitarian reports to support surveillance, integrated vector management, and public health responses in conflict-affected settings.

2. METHODOLOGY

2.1. Study Design and Study Area

This study employed a descriptive ecological design guided by the One Health framework to assess the documented and potential occurrence of medically and public health–important arthropods associated with displacement camps in the Gaza Strip during the Israeli war from October 2023 to mid-2026. Rather than conducting an experimental or quantitative entomological survey, it integrated field observations with documentary evidence to examine how war-induced environmental degradation influenced arthropod occurrence and proliferation and associated public health risks.

The study covered the Gaza Strip, Palestine (Figure 1), a densely populated coastal territory of approximately 365 km². Since October 2023, widespread destruction of residential areas, healthcare facilities, water and wastewater systems, electricity networks, and municipal services, together with the repeated displacement of more than 90% of the population, has profoundly altered environmental conditions. Displaced populations have lived in overcrowded shelters, tent camps, schools, and informal settlements characterized by inadequate sanitation, unsafe water storage, poor waste management, stagnant wastewater, and war-generated debris. These conditions created favorable habitats for the occurrence and proliferation of medically and public health–important arthropods, providing an appropriate setting for assessing the ecological and health consequences of war-related environmental degradation.

2.2. Data Collection and Information Sources

Data were collected between October 2023 and June 2026 from multiple complementary sources to support comprehensive coverage and triangulation. Field observations were conducted whenever security conditions permitted in displacement camps, temporary shelters, residential neighborhoods, healthcare surroundings, and heavily damaged urban areas. Observations focused on environmental conditions favoring arthropod occurrence and proliferation, including waste accumulation, stagnant wastewater, overcrowding, damaged sanitation infrastructure, unsafe water storage, rubble, rodent activity, and direct arthropod sightings. Photographic documentation supported these observations. Field evidence was supplemented by peer-reviewed scientific literature, reports from international and humanitarian organizations, official statements, verified news reports, and documentary photographs describing rapidly changing environmental and humanitarian conditions. Information was cross-validated across sources whenever possible to improve reliability and distinguish documented occurrence from potential occurrence or proliferation.

2.3. Arthropod Assessment and Data Analysis

The study focused on medically and public health–important arthropods documented or potentially occurring or proliferating in displacement settings, including mosquitoes, flies, cockroaches, fleas, lice, mites, ticks, bed bugs, bees, wasps, spiders, scorpions, and centipedes. For each taxon, information was synthesized on occurrence, habitats, ecological drivers, and actual or potential health risks. Data from field observations, scientific publications, humanitarian reports, and documentary sources were integrated through qualitative ecological synthesis and triangulation. Findings were interpreted within a One Health framework linking environmental degradation, displacement conditions, arthropod ecology, vertebrate hosts, and human health.

 2.4. Ethical Considerations

The study involved no experimental manipulation of humans or animals. Field observations were conducted in publicly accessible locations when security conditions permitted, and photographs were obtained without revealing personal identities. Documentary evidence was derived from publicly available scientific and humanitarian sources, following accepted principles of research integrity and ethical conduct.

 3. RESULTS

3.1. Diversity and Taxonomic Composition of Medically and Public Health–Important Arthropods

Severe environmental degradation, infrastructure collapse, and ecological disturbance associated with displacement in the Gaza Strip during Israel’s ongoing war of genocide and ethnic cleansing (2023–2026) created favorable conditions for the occurrence and proliferation of medically and public health–important arthropods (Figure 2). Based on integrated field observations, photographic documentation, published reports, and ecological assessments, 20 arthropod taxa were either documented or identified as potentially occurring or proliferating within displacement camps. These taxa represented 3 classes, 10 orders, and 15 families, reflecting a diverse assemblage capable of exploiting war-modified environments.

Class Insecta was dominant, comprising 14 taxa (70.0%) across six orders: Diptera, Blattodea, Phthiraptera, Siphonaptera, Hemiptera, and Hymenoptera. This dominance may reflect the short developmental cycles, high reproductive potential, and broad ecological tolerance of insects, enabling them to exploit overcrowded shelters, contaminated water, accumulated organic waste, and damaged infrastructure. Class Arachnida comprised 5 taxa (25.0%), including ticks, mites, spiders, and scorpions associated with rubble, damaged buildings, poor sanitation, domestic animals, and protected microhabitats. Class Chilopoda was represented by the Mediterranean Banded Centipede (Scolopendra cingulata Latreille, 1829) (5.0%), which inhabits humid, concealed sites beneath rubble, stones, decaying materials, and structural debris.

From a public health perspective, the assessed taxa were classified into three functional groups: (i) vectors and mechanical carriers, including mosquitoes, flies, cockroaches, fleas, and ticks; (ii) ectoparasites, including lice, fleas, bed bugs, mites, and other animal-associated taxa favored by overcrowding, shared bedding, poor hygiene, and repeated displacement; and (iii) venomous and stinging arthropods, including spiders, scorpions, bees, wasps, and centipedes, which may cause envenomation, allergic reactions, and secondary infections. Overall, the documented and potential taxonomic diversity illustrates how war-related environmental degradation has created suitable conditions for arthropod occurrence, persistence, and proliferation, thereby increasing actual and potential public health risks.Top of Form

3.2. Environmental and Anthropogenic Drivers of Arthropod Proliferation

The proliferation of medically important arthropods in displacement camps throughout the Gaza Strip was driven by interacting environmental and anthropogenic pressures associated with the ongoing war. Infrastructure destruction, sanitation collapse, waste accumulation, overcrowding, interruption of vector-control services, increasing vertebrate-host availability, and favorable climatic conditions collectively increased the availability of food, moisture, hosts, and shelter required for arthropod survival and reproduction.

 3.2.1. Collapse of Water, Sanitation, and Hygiene Infrastructure

Damage to water-supply networks, sewage systems, wastewater-treatment facilities, pumping stations, and stormwater drains resulted in extensive environmental contamination and poor drainage. At the same time, intermittent water supplies forced displaced households to store water in tanks, buckets, and other containers. These conditions increased the availability of aquatic breeding opportunities for mosquitoes, while persistent leakage and elevated humidity improved conditions for cockroaches and other moisture-dependent arthropods (Figure 4).

 3.2.2. Accumulation of Solid Waste, Organic Refuse, and Animal Remains

The disruption of municipal waste collection led to the accumulation of household refuse, food residues, human and animal excreta, and decomposing animal remains within and around displacement camps. These materials provided abundant food and reproductive substrates for synanthropic flies and cockroaches. Discarded containers, bottles, cans, and used tyres also retained water, further increasing breeding opportunities for container-breeding mosquitoes (Figure 5).

 

3.2.3. Hyper-overcrowding and Deterioration of Shelter Conditions

The concentration of displaced populations in tents, schools, and temporary shelters intensified close interpersonal contact and the sharing of clothing, bedding, mattresses, and personal items. Limited access to water, soap, laundry facilities, and effective treatments further facilitated the person-to-person transmission and persistence of head lice, scabies mites, and bed bugs (Figure 6).

3.2.4. War-Generated Rubble and Habitat Disturbance

The accumulation of more than 68 million tons of war-generated rubble substantially altered the urban environment. Collapsed buildings, concrete fragments, damaged furniture, timber, and other construction materials created protected spaces that reduced exposure to sunlight, temperature extremes, predators, and human disturbance. These structural changes increased the availability of refuges for scorpions, centipedes, and other shelter-seeking arthropods (Figure 7).

3.2.5. Increased Availability of Vertebrate Hosts

The deterioration of environmental management and the accumulation of food waste promoted increasing contact with commensal rodents and free-ranging domestic animals. Black rats, brown rats, and house mice provided hosts for rat fleas and lice, while stray and domestic dogs supported the persistence of the Brown Dog Tick. These vertebrate–arthropod associations strengthened potential ecological links among degraded environments, animals, and displaced communities (Figure 8).

 3.2.6. Interruption of Environmental Health and Vector-Control Services

Routine environmental health measures—including waste collection, drainage maintenance, larval mosquito control, insecticide application, rodent management, and arthropod surveillance—were severely disrupted. Shortages of fuel, pesticides, equipment, and trained personnel further reduced the capacity of local institutions to respond to infestations, allowing arthropod populations to persist with limited control.

 3.2.7. Climatic Conditions Favoring Arthropod Development

Warm temperatures from spring through early autumn accelerated arthropod development and organic matter decomposition. Humidity associated with wastewater leakage and inadequate drainage further improved survival conditions for mosquitoes, cockroaches, and mites. Climatic factors therefore intensified, rather than independently caused, the effects of environmental degradation and sanitation collapse.

 3.3. Major Breeding and Resting Habitats

The environmental drivers described above produced four principal categories of breeding, resting, and sheltering habitats within displacement camps. These habitats differed in their physical characteristics and in the arthropod groups they were likely to support: aquatic habitats, organic-waste sites, rubble complexes, and shelter interiors.

 3.3.1. Stagnant Wastewater and Stored-Water Habitats

Untreated sewage pools, poorly drained wastewater, and organically polluted standing water constituted suitable larval habitats for the Northern House Mosquito (Culex pipiens Linnaeus, 1758). By contrast, relatively clean water stored in tanks, buckets, and small artificial containers provided potential breeding sites for the Yellow Fever Mosquito (Aedes aegypti (Linnaeus, 1762)). These aquatic habitats occurred close to human shelters, increasing the likelihood of mosquito–human contact.

3.3.2. Solid-Waste and Organic-Matter Sites

Refuse piles, decomposing food, animal carcasses, excreta, and open latrines represented the principal reproductive and feeding habitats of the Housefly (Musca domestica Linnaeus, 1758) and the Oriental Latrine Fly (Chrysomya megacephala Fabricius, 1794). Damp portions of waste accumulations, kitchens, sewer openings, and food-storage areas also provided food and shelter for the American Cockroach (Periplaneta americana Linnaeus, 1758) (Figure 9) and the German Cockroach (Blattella germanica Linnaeus, 1767).

3.3.3. Structural Voids and Rubble Complexes

Cracks, cavities, shaded spaces, stone piles, timber, and the deeper layers of rubble formed stable refuges for venomous arthropods. Dry structural voids were particularly suitable for the Palestine Yellow Scorpion (Leiurus quinquestriatus Ehrenberg, 1828), Black Judaicus Scorpion (Hottentotta judaicus Simon, 1872), and Arabian Fat-tailed Scorpion (Androctonus crassicauda Olivier, 1807). Cooler and more humid spaces beneath stones, wood, and debris provided resting and foraging sites for the Mediterranean Banded Centipede (Scolopendra cingulata Latreille, 1829) (Figure 10).

 3.3.4. Domestic and Shelter Interiors

Mattress seams, stacked bedding, clothing, fabric folds, furniture, and cracks in temporary shelter structures provided protected resting and hiding places for the Common Bed Bug (Cimex lectularius Linnaeus, 1758). Human bodies, hair, clothing, and shared bedding maintained the transmission cycles of the Human Head Louse (Pediculus humanus capitis De Geer, 1778) and the Human Itch Mite (Sarcoptes scabiei Linnaeus, 1758). Indoor kitchens, leaking water points, and food-storage areas additionally supported shelter-associated cockroaches.

 3.4. Public Health Risks and Cascading Disease Dynamics

The widespread proliferation of medically important arthropods in displacement camps generated multiple, interconnected public health hazards. The combined effects of overcrowding, environmental contamination, deteriorating sanitation, and the collapse of healthcare and vector-control services increased human exposure to arthropod-associated diseases and injuries. Collectively, these risks encompassed mechanical pathogen transmission, ectoparasitic infestations, allergic reactions, venomous stings and bites, and secondary bacterial infections, placing an additional burden on an already fragile public health system.

 3.4.1. Mechanical Transmission of Enteric Pathogens

Synanthropic insects, particularly the House Fly (Musca domestica Linnaeus, 1758), the Oriental Latrine Fly (Chrysomya megacephala Fabricius, 1794), the American Cockroach (Periplaneta americana Linnaeus, 1758), and the German Cockroach (Blattella germanica Linnaeus, 1767), frequently moved between sewage pools, refuse accumulation sites, open latrines, and food preparation areas. Through repeated contact with contaminated substrates, these arthropods acted as efficient mechanical carriers of enteric bacteria, protozoan cysts, helminth eggs, and other pathogenic microorganisms, facilitating food and water contamination. Their continuous movement between polluted environments and human shelters likely increased the risk of diarrheal diseases, gastroenteritis, dysentery, foodborne infections, and wound contamination among displaced populations.

 3.4.2. Ectoparasitic Infestations and Secondary Bacterial Infections

Severe overcrowding, prolonged close contact, and inadequate personal hygiene promoted widespread infestations by the Human Head Louse (Pediculus humanus capitis De Geer, 1778), the Human Itch Mite (Sarcoptes scabiei Linnaeus, 1758), the Common Bed Bug (Cimex lectularius Linnaeus, 1758), and, to a lesser extent, human fleas. Persistent pruritus caused by these ectoparasites resulted in repeated scratching, skin excoriations, and disruption of the epidermal barrier, thereby facilitating secondary bacterial infections, including impetigo and cellulitis. Chronic infestations also contributed to sleep disturbance, psychological distress, reduced quality of life, and increased susceptibility to opportunistic infections, particularly among children and other vulnerable individuals.

 3.4.3. Risks of Envenomation and Allergic Reactions

The proliferation of venomous arthropods within and around temporary shelters created a persistent risk of stings and bites among displaced populations. War-generated rubble, damaged buildings, and temporary structures provided suitable refuges for the Deathstalker (Leiurus quinquestriatus Ehrenberg, 1828), the Black Judaicus Scorpion (Hottentotta judaicus Simon, 1872), the Arabian Fat-tailed Scorpion (Androctonus crassicauda Olivier, 1807), and the Mediterranean Banded Centipede (Scolopendra cingulata Latreille, 1829). In addition, colonies of the Western Honey Bee (Apis mellifera Linnaeus, 1758) (Figure 11), Yellowjackets (Vespula spp.), and Paper Wasps (Polistes spp.) established nests within damaged structures and shelter surroundings, increasing the likelihood of stinging incidents. These encounters ranged from localized pain and inflammation to severe allergic reactions, systemic envenomation, anaphylaxis, and, in susceptible individuals, potentially life-threatening complications. The collapse of healthcare services, together with shortages of antivenoms, emergency medications, and intensive care facilities, further exacerbated these health risks.

3.4.4. Cascading Public Health Consequences

The simultaneous occurrence of mechanical pathogen transmission, ectoparasitic infestations, allergic reactions, and venomous stings and bites created a cascading burden on public health within displacement camps. Recurrent enteric infections, chronic skin infestations, secondary bacterial complications, allergic disorders, and envenomation collectively increased morbidity, impaired physical well-being, and intensified pressure on an already overwhelmed healthcare system. These interacting health hazards demonstrate how war-induced environmental degradation transformed medically important arthropods from localized nuisance organisms into significant contributors to the humanitarian and public health crisis in the Gaza Strip.

3.5. Population Groups Potentially at Increased Risk

The environmental conditions documented in this study suggest that exposure to medically important arthropods was unlikely to be uniformly distributed among displaced populations in the Gaza Strip. Individuals residing in overcrowded shelters or in close proximity to stagnant wastewater, sewage pools, refuse accumulation sites, and extensive rubble fields were likely to experience more frequent contact with mosquitoes, synanthropic flies, cockroaches, ectoparasites, and venomous arthropods. Based on the observed ecological conditions and the documented health risks associated with the recorded species (Table 1), children, older adults, pregnant women, individuals with chronic illnesses or disabilities, and personnel involved in waste collection, debris removal, sanitation, healthcare, and humanitarian activities were likely to face elevated risks of arthropod-associated infestations, mechanical pathogen exposure, allergic reactions, and envenomation. These findings highlight the importance of prioritizing vulnerable population groups when implementing integrated environmental health, vector-control, and humanitarian interventions in displacement settings.

3.6. Relative Public Health Importance of Medically Important Arthropods

The ecological assessment indicated substantial variation in the relative public health importance of medically important arthropods documented or considered likely to proliferate in Gaza displacement camps. This qualitative classification was based on ecological adaptability, likely frequency of human exposure, persistence under camp conditions, and the severity and breadth of associated health effects (Table 2). Synanthropic flies, cockroaches, mosquitoes, and human-associated ectoparasites represented the greatest cumulative public health burden because of their close association with sewage, accumulated waste, overcrowded shelters, shared bedding, and inadequate hygiene. Fleas, ticks, and rodent-associated lice presented additional but more localized risks linked to increasing populations of rodents and stray animals. Venomous and stinging arthropods, particularly scorpions, centipedes, bees, and wasps, were generally associated with less frequent human encounters but potentially severe outcomes, including systemic envenomation, anaphylaxis, and life-threatening complications. Accordingly, public health importance was determined not solely by the severity of individual bites or stings, but by the combined effects of ecological persistence, probable exposure frequency, population vulnerability, and limited access to preventive and emergency healthcare services.

3.7. One Health Implications of Arthropod Proliferation in Displacement Camps

The findings of this study demonstrate that the proliferation of medically important arthropods in Gaza displacement camps represents a clear manifestation of the interconnected relationships among environmental degradation, animal ecology, and human health within the One Health framework. The widespread destruction of water and sanitation infrastructure, accumulation of war-generated rubble, collapse of waste management systems, and deterioration of living conditions fundamentally altered ecological processes, creating favorable habitats for medically important arthropods and their vertebrate hosts.

The environmental changes associated with the ongoing war promoted the expansion of commensal rodents, including the Black Rat (Rattus rattus Linnaeus, 1758), the Brown Rat (Rattus norvegicus Berkenhout, 1769), and the House Mouse (Mus musculus Linnaeus, 1758), together with increasing numbers of stray dogs and cats around refuse accumulation sites and temporary shelters. These vertebrates served as important reservoir hosts for several ectoparasites, particularly the Oriental Rat Flea (Xenopsylla cheopis Rothschild, 1903), the Spiny Rat Louse (Polyplax spinulosa Burmeister, 1839), ticks, and mites, thereby strengthening ecological links between vertebrate hosts, arthropod populations, and displaced human communities.

Simultaneously, the proliferation of mosquitoes, synanthropic flies, cockroaches, fleas, lice, mites, ticks, and venomous arthropods increased opportunities for pathogen transmission, ectoparasitic infestations, allergic reactions, and envenomation. These health risks were further amplified by severe overcrowding, inadequate sanitation, food insecurity, malnutrition, and the collapse of environmental health and healthcare services, creating conditions that favored sustained human exposure and increased vulnerability to arthropod-associated diseases and injuries.

Overall, the results indicate that the public health impacts of medically important arthropods cannot be separated from the broader environmental and humanitarian consequences of war. The observed interactions among degraded ecosystems, vertebrate hosts, arthropod populations, and displaced human communities highlight the need for integrated One Health interventions that simultaneously address environmental rehabilitation, restoration of water, sanitation, and hygiene (WASH) services, solid waste and rubble management, vector and rodent control, disease surveillance, and healthcare recovery to reduce arthropod-associated health risks in displacement settings.

4. DISCUSSION

This study identified 20 medically important arthropod taxa representing 3 classes, 10 orders, and 15 families in Gaza displacement camps. Palestinian and regional studies likewise demonstrate diverse invertebrate and medically important arthropod assemblages, although their ecological settings differ from displacement camps [50]-[53]. Regional evidence also highlights arthropod-borne diseases and the potential effects of climate change and human migration on biting-arthropod exposure and associated allergic and infectious risks [54] [55]. Insects predominated (70%), reflecting the high reproductive capacity, short life cycles, and ecological adaptability of synanthropic flies, cockroaches, mosquitoes, ectoparasites, and stinging Hymenoptera [4] [56]. Arachnids (25%) and the single chilopod taxon (5%) were less diverse but remained important as persistent ectoparasites or sources of severe envenomation [42] [57] [58]. Overall, public health importance depended more on exposure frequency, ecological persistence, population vulnerability, and clinical severity than on taxonomic diversity alone; consequently, ubiquitous synanthropic insects and human-associated ectoparasites imposed a greater cumulative burden than less frequently encountered venomous taxa.

The findings support a war-ecology interpretation in which infrastructure destruction generates interconnected exposure pathways. Satellite assessments and recent investigations documented extensive damage to Gaza’s WASH infrastructure and the collapse of sanitation, disease surveillance, and environmental-health capacities [35]-[37] [59]. This deterioration weakened infection prevention and clinical care, increased MDRO-related risks, and restricted access to clean water, sterile equipment, medical supplies, and functioning healthcare services [60]-[62], contributing to interrelated physical, infectious, nutritional, and psychological harms [63]. Official reports similarly documented worsening WASH services, living conditions, and healthcare capacity during 2025 [64] [65]. Damaged sewage and drainage systems produced polluted standing water, water shortages encouraged household storage, refuse supplied food and oviposition substrates, and rubble created protected refuges. Consequently, arthropod breeding and resting sites became concentrated near overcrowded shelters, increasing contact among arthropods, contaminated substrates, vertebrate hosts, and displaced people [11] [16].

The very high ranking of the Housefly (Musca domestica Linnaeus, 1758) and Oriental Latrine Fly (Chrysomya megacephala Fabricius, 1794) reflects their rapid development in excreta, decomposing organic matter, and refuse, followed by movement to food, utensils, wounds, and water. Regional evidence of heat adaptation supports Housefly persistence during Gaza’s warm seasons [66], while its established mechanical transfer of enteric organisms, including agents associated with shigellosis, reinforces this concern [67] [68]. Gaza-focused analyses likewise indicate that synanthropic flies may contribute to parasitic and other infections during sanitation collapse [69] [70]. Nevertheless, their coexistence with enteric disease does not confirm causation because contaminated water, inadequate sanitation, crowding, and food insecurity operate simultaneously [46] [47] [49]. Intestinal parasitic infections among Gaza sanitation workers further demonstrate risks associated with sewage and refuse exposure [71]. These flies should therefore be interpreted as potential amplifiers of an already intense fecal–oral exposure system.

The American Cockroach (Periplaneta americana Linnaeus, 1758) and German Cockroach (Blattella germanica Linnaeus, 1767) received very high rankings because they persist in sewers, damp rubble, crowded kitchens, and shared food-storage areas, repeatedly contacting contaminated and domestic surfaces. Similar infestations associated with poor sanitation have been documented elsewhere [72]. Their carriage of human parasites and pathogenic or multidrug-resistant bacteria supports their roles as mechanical disseminators and indicators of environmental hygiene failure [73]-[77]. Cockroach allergens additionally contribute to asthma, rhinitis, dermatitis, and allergic sensitization, particularly where ventilation and treatment are inadequate [56] [68]. Their prioritization therefore reflects widespread exposure and combined infectious and allergic significance, not evidence that every cockroach carries or transmits pathogens.

Mosquitoes followed two habitat pathways: the Northern House Mosquito (Culex pipiens Linnaeus, 1758) was associated with stagnant, organically polluted water, whereas the Yellow Fever or Dengue Mosquito (Aedes aegypti Linnaeus, 1762) could exploit artificial containers created by water insecurity and prolonged storage. Mosquito abundance is strongly associated with inadequate sanitation [78], and pre-war studies identified mosquito breeding and control as environmental concerns in Gaza [27] [79] [80]. War-related WASH disruption likely expanded larval habitats, while warm conditions may accelerate development [8] [81]. Regional experience shows that changing ecological conditions can transform neglected arthropod-borne diseases into emerging threats [82]. However, habitat suitability and vector presence do not confirm active West Nile, dengue, or other arboviral transmission; pathogen detection, clinical surveillance, and local vector-competence evidence remain necessary [59] [83].

The Human Head Louse (Pediculus humanus capitis De Geer, 1778), Human Itch or Scabies Mite (Sarcoptes scabiei Linnaeus, 1758), and Common Bed Bug (Cimex lectularius Linnaeus, 1758) depend primarily on close contact, shared bedding and clothing, inadequate laundering, delayed diagnosis, and incomplete treatment of contacts. Head-louse infestations were documented in Gaza before the war, providing a pre-existing basis for intensified transmission [25] [28] [84]. Studies among schoolchildren and displaced or crowded populations consistently associate pediculosis with close contact and adverse socioeconomic and hygienic conditions [85]-[89]. Recent Gaza evidence indicates that extreme crowding and hygiene deprivation have transformed manageable lice and scabies infestations into camp-wide problems [44] [70], causing itching, sleep disruption, stigma, excoriation, and secondary infection, especially among children and immunologically or nutritionally vulnerable people [45].The Human or House Flea (Pulex irritans Linnaeus, 1758), Oriental Rat Flea (Xenopsylla cheopis Rothschild, 1903), Spiny Rat Louse (Polyplax spinulosa Burmeister, 1839), and Brown Dog Tick (Rhipicephalus sanguineus Latreille, 1806) demonstrate the need to integrate arthropod and vertebrate-host management. The occurrence of the Human Flea in livestock and residential environments illustrates its ability to connect animal hosts with human dwellings [90]. Refuse, rubble, abandoned structures, and food residues favor rodents, while disrupted veterinary services increase contact with free-ranging dogs and cats. Gaza studies documented rodent ectoparasites, stray-cat parasites, and intestinal parasites in the House Mouse (Mus musculus Linnaeus, 1758), consistent with the regional diversity of rodent-associated ectoparasites [29] [30] [91]. Palestinian evidence of Bartonella in ixodid ticks and domestic animals and the proposed involvement of ticks in Madurella mycetomatis transmission elsewhere illustrate broader animal–tick–pathogen networks [92] [93]. However, vector presence does not confirm local pathogen circulation; targeted collection and molecular testing remain essential.

War-generated rubble created a direct-injury pathway by providing cracks, stone piles, timber, and shaded cavities for the Palestine Yellow Scorpion or Deathstalker (Leiurus quinquestriatus Ehrenberg, 1828), Black Judaicus Scorpion (Hottentotta judaicus Simon, 1872), Arabian Fat-tailed Scorpion (Androctonus crassicauda Olivier, 1807), and Mediterranean Banded Centipede (Scolopendra cingulata Latreille, 1829). Reports from Gaza camps documented increased scorpion sightings during hot weather, particularly around rubble refuges [94]. Palestinian faunal, epidemiological, and clinical evidence confirms the occurrence and medical importance of these arthropods and identifies continuing surveillance and reporting limitations [57] [95]-[98]. The potentially severe systemic effects of the Deathstalker and other buthid scorpions are especially concerning among children [99] [100]. Regional studies further demonstrate the varied manifestations and continuing burden of scorpion stings [101] [102]. Risks are greatest among people sleeping at ground level, returning to damaged homes, or handling debris and are intensified by limited transport, emergency care, and antivenom availability [42]. Arthropod precautions should therefore be incorporated into rubble removal, shelter placement, community education, and emergency referral planning.

Although considerable spider diversity has been documented in Jordan and neighboring areas [103] [104], spiders were excluded from the 20 assessed taxa because field and photographic evidence did not adequately confirm medically important species in the surveyed Gaza camps. This exclusion does not imply regional absence; targeted arachnological surveys are needed before spiders can be reliably incorporated into future public health assessments.

Ants (family Formicidae) are highly diverse in morphology, ecology, behavior, and medical importance [56] [105]. Although ant diversity and invasive species, particularly the Little Fire Ant (Wasmannia auropunctata Roger, 1863), have been studied in neighboring areas, no published investigation specifically addressing ant prevalence, species composition, or public health importance in Gaza was identified [105]-[107]. Nevertheless, field observations and residents’ accounts indicate widespread camp infestations involving painful bites or stings and substantial nuisance. Targeted surveys are therefore needed to identify species, assess associated risks, and determine the environmental drivers of their proliferation.

The inclusion of the Western Honey Bee (Apis mellifera Linnaeus, 1758), Yellowjackets (genus Vespula Thomson, 1869), and Paper Wasps (genus Polistes Latreille, 1802) extends the assessment beyond disease vectors. Disturbed nests in rubble and abandoned structures, together with exposed food waste, may increase human contact. In May 2024, the accidental disturbance of a Yellowjacket nest (genus Vespula Thomson, 1869) by an Israeli tank in Rafah, southern Gaza Strip, triggered a swarm attack that resulted in multiple stings and the envenomation of 12 Israeli soldiers, illustrating the risks associated with nest disturbance [108] [109] (see Figure 12). Hymenoptera venom can induce severe systemic allergy, while repeated stings may cause substantial venom exposure [110] [111]. The German Wasp (Vespula germanica Fabricius, 1793) also forages actively under Mediterranean conditions and exploits human-associated food resources [112] [113]. Although ranked below ubiquitous flies and ectoparasites, these taxa can cause life-threatening anaphylaxis or mass envenomation.

The principal ecological drivers were mutually reinforcing. War-related displacement disrupts animal-health services and intensifies human–animal–environment interactions, increasing zoonotic risks [114]. WASH failure creates aquatic habitats and contamination; waste supports synanthropic insects and vertebrate hosts; overcrowding facilitates ectoparasite transmission; rubble shelters venomous taxa; and collapsed surveillance and healthcare delay detection and treatment. These interactions require a coordinated One Health response rather than isolated insecticide campaigns [2] [17] [40]. Priorities include source reduction, safe water storage, refuse removal, sanitation restoration, rodent and stray-animal management, improved bedding and clothing hygiene, access to pediculicides and scabicides, and clinical preparedness for bites, stings, and anaphylaxis. This approach is supported by evidence linking insect and rodent infestations to public health risks in Gaza camps and by broader conflict-associated infectious-disease evidence [49] [59] [70].

The qualitative assessment provides operational priorities. The Housefly (Musca domestica Linnaeus, 1758), Oriental Latrine Fly (Chrysomya megacephala Fabricius, 1794), American Cockroach (Periplaneta americana Linnaeus, 1758), German Cockroach (Blattella germanica Linnaeus, 1767), Human Head Louse (Pediculus humanus capitis De Geer, 1778), and Human Itch or Scabies Mite (Sarcoptes scabiei Linnaeus, 1758) require immediate population-level control because exposure is widespread and continuous. Surveillance and source reduction should target the Northern House Mosquito (Culex pipiens Linnaeus, 1758) and Yellow Fever or Dengue Mosquito (Aedes aegypti Linnaeus, 1762) because extensive habitats may allow undetected pathogen transmission [27] [59]. Fleas, ticks, and rodent lice require integrated host–ectoparasite surveillance [40] [91], while scorpions and stinging Hymenoptera require risk communication, safe debris handling, trained nest management, and emergency referral [57] [97]. Priorities should adapt to seasonal change, displacement, waste accumulation, and service restoration.

The study has important limitations. Insecurity, repeated displacement, restricted access, and collapsed monitoring prevented standardized trapping, comparable abundance estimates, and systematic spatial coverage. Consequently, some taxa were directly documented, whereas others were considered potentially proliferating based on habitat suitability, regional occurrence, and known biology. The study therefore cannot estimate prevalence, confirm population increases or pathogen carriage, or attribute disease outbreaks to specific arthropods. Accordingly, Table 2 represents a qualitative prioritization framework rather than a quantitative risk score. Nevertheless, triangulating field observations, photographic and documentary evidence, humanitarian reports, local studies, and ecological knowledge strengthens the synthesis’s plausibility and practical relevance [36] [37] [70].

Future research should address the shortage of studies on Gaza’s terrestrial and aquatic invertebrates, particularly arthropods of medical and veterinary importance, despite their substantial ecological, health, and economic significance. Representative camps and shelters require sentinel surveillance, standardized adult and larval sampling, and documentation of species composition, abundance, distribution, and seasonality. Molecular testing of the Northern House Mosquito (Culex pipiens Linnaeus, 1758), Yellow Fever or Dengue Mosquito (Aedes aegypti Linnaeus, 1762), Housefly (Musca domestica Linnaeus, 1758), Oriental Latrine Fly (Chrysomya megacephala Fabricius, 1794), American Cockroach (Periplaneta americana Linnaeus, 1758), German Cockroach (Blattella germanica Linnaeus, 1767), fleas, and ticks should be integrated with clinical and environmental surveillance [59].

Geospatial mapping should identify clusters around wastewater, refuse, rubble, and animal hosts, while longitudinal studies should evaluate whether WASH restoration, waste removal, shelter improvement, and integrated vector management reduce arthropod abundance and related health outcomes [115] [116]. Comprehensive faunal and specialized taxonomic, ecological, epidemiological, and veterinary studies are also needed, particularly because invertebrates remain underrepresented in global biodiversity research [117]. Until then, this synthesis provides a baseline for precautionary, ecologically informed research and action.

5. CONCLUSION

The 20 arthropod taxa assessed reflect a conflict-modified ecological system in which WASH destruction, overcrowding, water storage, waste and rubble accumulation, vertebrate-host contact, and disrupted control services increased arthropod proliferation and human exposure. Synanthropic flies, cockroaches, head lice, and scabies mites posed the greatest cumulative concern, while mosquitoes, bed bugs, fleas, ticks, rodent lice, venomous scorpions, centipedes, bees, and wasps presented additional infectious, allergic, and envenomation risks. Although this descriptive study did not quantify abundance or confirm pathogen transmission, the findings warrant restoring WASH and waste services, improving shelter hygiene, implementing integrated vector and host management, ensuring emergency care, and establishing entomological and disease surveillance within a coordinated One Health framework.

 ACKNOWLEDGMENTS

I extend my deepest gratitude to the displaced Palestinian families residing in camps across the Gaza Strip, whose resilience and generous cooperation made this field research possible despite the extremely difficult conditions they endured. I am particularly grateful to the experienced wildlife hunters who shared their valuable field expertise and knowledge of vertebrate pests, scorpions, and centipedes. I also sincerely acknowledge the physicians and healthcare workers in displacement-camp clinics and nearby hospitals, whose invaluable support contributed substantially to the completion of this study. Finally, I thank everyone who contributed, directly or indirectly, to this work. I hope its findings will benefit the Palestinian community and contribute meaningfully to the advancement of scientific knowledge.

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