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Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia

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Title: Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia
Authors: Tam, CC
O'Driscoll, M
Taurel, A-F
Nealon, J
Hadinegoro, SR
Item Type: Journal Article
Abstract: Understanding the heterogeneous nature of dengue transmission is important for prioritizing and guiding the implementation of prevention strategies. However, passive surveillance data in endemic countries are rarely adequately informative. We analyzed data from a cluster-sample, cross-sectional seroprevalence study in 1-18 year-olds to investigate geographic differences in dengue seroprevalence and force of infection in Indonesia. We used catalytic models to estimate the force of infection in each of the 30 randomly selected sub-districts. Based on these estimates, we determined the proportion of sub-districts expected to reach seroprevalence levels of 50%, 70% and 90% by year of age. We used population averaged generalized estimating equation models to investigate individual- and cluster-level determinants of dengue seropositivity. Dengue force of infection varied substantially across Indonesia, ranging from 4.3% to 30.0% between sub-districts. By age nine, 60% of sub-districts are expected to have a seroprevalence ≥70%, rising to 83% by age 11. Higher odds of seropositivity were associated with higher population density (OR = 1.54 per 10-fold rise in population density, 95% CI: 1.03-2.32) and with City (relative to Regency) administrative status (OR = 1.92, 95% CI: 1.32-2.79). Our findings highlight the substantial variation in dengue endemicity within Indonesia and the importance of understanding spatial heterogeneity in dengue transmission intensity for optimal dengue prevention strategies including future implementation of dengue vaccination programmes.
Issue Date: 2-Nov-2018
Date of Acceptance: 17-Oct-2018
URI: http://hdl.handle.net/10044/1/65101
DOI: https://dx.doi.org/10.1371/journal.pntd.0006932
ISSN: 1935-2727
Publisher: Public Library of Science
Journal / Book Title: PLoS Neglected Tropical Diseases
Volume: 12
Issue: 11
Copyright Statement: © 2018 Tam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: 06 Biological Sciences
11 Medical And Health Sciences
Tropical Medicine
Publication Status: Published
Conference Place: United States
Open Access location: https://journals.plos.org/plosntds/article?id=10.1371%2Fjournal.pntd.0006932&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+plosntds%2FNewArticles+(PLOS+Neglected+Tropical+Diseases+-+New+Articles)
Article Number: e0006932
Online Publication Date: 2018-11-02
Appears in Collections:School of Public Health