Abstract
BackgroundDengue is a febrile illness transmitted by mosquitoes, causing disease across the tropical and sub-tropical world. Antibody prevalence data and serotype distributions describe population-level risk and inform public health decision-making.Methodology/Principal findingsIn this cross-sectional study we used data from a pediatric dengue seroprevalence study to describe historical dengue serotype circulation, according to age and geographic location. A sub-sample of 780 dengue IgG-positive sera, collected from 30 sites across urban Indonesia in 2014, were tested by the plaque reduction neutralization test (PRNT) to measure the prevalence and concentration of serotype-specific neutralizing antibodies according to subject age and geography. PRNT results were obtained from 776 subjects with mean age of 9.6 years. 765 (98.6%) neutralized one or more dengue serotype at a threshold of >10 (1/dil). Multitypic profiles were observed in 50.9% of the samples; a proportion which increased to 63.1% in subjects aged 15–18 years. Amongst monotypic samples, the highest proportion was reactive against DENV-2, followed by DENV-1, and DENV-3, with some variation across the country. DENV-4 was the least common serotype. The highest anti-dengue antibody titers were recorded against DENV-2, and increased with age to a geometric mean of 516.5 [1/dil] in the oldest age group.Conclusions/SignificanceWe found that all four dengue serotypes have been widely circulating in most of urban Indonesia, and more than half of children had already been exposed to >1 dengue serotype, demonstrating intense transmission often associated with more severe clinical episodes. These data will help inform policymakers and highlight the importance of dengue surveillance, prevention and control.
Highlights
Dengue is a febrile illness caused by dengue virus (DENV) infection
We present data from a dengue seroprevalence study in children in Indonesia; circulation of the four dengue serotypes (DENV-1, -2, -3, -4) was assessed, by age and location
Samples collected from 30 urban Indonesian sites were tested using the plaque reduction neutralization test (PRNT), which enabled us to measure prevalence and concentration of antibodies specific to dengue virus serotypes
Summary
Dengue is a febrile illness caused by dengue virus (DENV) infection. There are four evolutionarily distinct, antigenically related DENV serotypes; DENV-1, -2, -3, and -4 causing disease across the tropical and sub-tropical world [2, 3]. Plaque reduction neutralization tests (PRNT), which quantify serum concentrations required to neutralize live viruses, are the most specific assays for detecting flavivirus exposure history [5]. The dengue PRNT is able to target individual viral serotypes, and can infer serotype-exposure history, interpretation of heterotypic responses is complicated for reasons including original antigenic sin [6, 7]. Dengue is a febrile illness transmitted by mosquitoes, causing disease across the tropical and sub-tropical world. Antibody prevalence data and serotype distributions describe population-level risk and inform public health decision-making
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