Prevalence rates of dengue may be higher than previously reported for children in Indonesia, with more than 80% of children aged 10 and older having experienced an infection at least once in their lives, according to a study published in PLOS Neglected Tropical Diseases.
“Dengue is hyper-endemic, with frequent epidemic cycles in Indonesia. The disease is most common in urban areas and in recent years has reportedly spread to smaller, more rural villages,” Sri Rezeki Hadinegoro, PhD, MD, and colleagues wrote. “Reported incidence remains highest in children 1 to 15 years of age, but since the 1980s, incidence in persons over 15 years of age has gradually increased.”
To gain a better understanding of the history of dengue infection and its risk factors, the researchers conducted a representative population-based cross-sectional dengue seroprevalence study that included 3,210 urban children between the ages of 1 and 18. The children were separated into 30 geographically dispersed clusters and were enrolled between October and November 2014.
Hadinegoro and colleagues tested serum samples to determine whether anti-dengue IgG antibodies were present by indirect ELISA. Additionally, they administered a questionnaire to examine whether household sociodemographic and behavioral factors were related to dengue serologic status.
An adjusted national seroprevalence rate was observed at 69.4% (95% CI: 64.4-74.3), with children between 1 and 4 years having a prevalence of 33.8% (95% CI: 26.4-41.2). Those aged 5 to 9 years had a prevalence of 65.4% (95% CI: 69.1-71.7). Higher rates were observed in children aged 10 to 14 years (83.1%; 95% CI: 77.1-89.0) and 15 to 18 years (89.0%; 95% CI: 83.1-94.1).
Children were most likely to change serologic status at a median of 4.8 years, with 13.1% of children contracting a primary infection annually. Additionally, the number of people infected in the household since the child’s birth (P =.0004) and the child’s age group (1-4 vs. 5-9 OR = 4.25; 1-4 vs. 10-14 OR = 12.60; and 1-4 vs. 15-18 OR = 21.87; P <.0001).
“A recent expansion in dengue virus transmission from urban to per-urban and rural areas has been described and the identification of provinces or areas of high transmission risk is a focus of prevention and control planning,” Hadinegoro and colleagues wrote. “This study showed a high level of exposure across urban Indonesia and, while we excluded rural areas from this study for operational reasons, it is likely that nearby peri-urban populations may have experienced similar high levels of exposure.”
Disclosure: Please see the study for a full list of relevant financial disclosures.