Abstract
The people of Indonesia have been afflicted by dengue, a mosquito-borne viral disease, for over 5 decades. The country is the world's largest archipelago with diverse geographic, climatic, and demographic conditions that may impact the dynamics of disease transmissions. A dengue epidemiology study was launched by us to compare and understand the dynamics of dengue and other arboviral diseases in three cities representing western, central, and eastern Indonesia, namely, Batam, Banjarmasin, and Ambon, respectively. A total of 732 febrile patients were recruited with dengue-like illness during September 2017–2019 and an analysis of their demographic, clinical, and virological features was performed. The seasonal patterns of dengue-like illness were found to be different in the three regions. Among all patients, 271 (37.0%) were virologically confirmed dengue, while 152 (20.8%) patients were diagnosed with probable dengue, giving a total number of 423 (57.8%) dengue patients. Patients' age and clinical manifestations also differed between cities. Mostly, mild dengue fever was observed in Batam, while more severe cases were prominent in Ambon. While all dengue virus (DENV) serotypes were detected, distinct serotypes dominated in different locations: DENV-1 in Batam and Ambon, and DENV-3 in Banjarmasin. We also assessed the diagnostic features in the study sites, which revealed different patterns of diagnostic agreements, particularly in Ambon. To detect the possibility of infection with other arboviruses, further testing on 461 DENV RT-PCR-negative samples was performed using pan-flavivirus and -alphavirus RT-PCRs; however, only one chikungunya infection was detected in Ambon. A diverse dengue epidemiology in western, central, and eastern Indonesia was observed, which is likely to be influenced by local geographic, climatic, and demographic conditions, as well as differences in the quality of healthcare providers and facilities. Our study adds a new understanding on dengue epidemiology in Indonesia.
Highlights
Indonesia is the world’s largest archipelagic country of about 18,000 islands spread over 1,904,569 km2, which can be roughly divided into three regions: western, central, and eastern
The vast geographical area of Indonesia warrants a comprehensive study to understand the epidemiology of dengue and other arboviral diseases, which was conducted in parallel to provide a comprehensive dengue epidemiology data in Indonesia
Of note is the dengue peak season in Ambon, which occurred during June– November, different from the common dengue peak seasons reported in Indonesia, which tends to occur during the first 6 months of the year [21, 22]
Summary
Indonesia is the world’s largest archipelagic country of about 18,000 islands spread over 1,904,569 km, which can be roughly divided into three regions: western, central, and eastern. The tropical climate of this country is favorable for the transmission of mosquito-borne diseases, including dengue and other arboviral diseases [1]. This condition has the potential for concurrent infections of multiple pathogens, which may have severe clinical and epidemiological implications [2]. While dengue surveillance data in Indonesia is accumulating, data on CHIKV and ZIKV transmission is very limited. Their infection rates tend to be underestimated in part because of their clinical similarity with dengue. Given the large number of cases with an unidentified etiology, there may be other pathogens in circulation that remain unknown or undetected
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
