Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia.
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 sero...
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doaj-8082b9cfc592497e93922c1edf8823ef2020-11-25T01:38:43ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352018-11-011211e000693210.1371/journal.pntd.0006932Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia.Clarence C TamMegan O'DriscollAnne-Frieda TaurelJoshua NealonSri Rezeki HadinegoroUnderstanding 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.http://europepmc.org/articles/PMC6241133?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Clarence C Tam Megan O'Driscoll Anne-Frieda Taurel Joshua Nealon Sri Rezeki Hadinegoro |
spellingShingle |
Clarence C Tam Megan O'Driscoll Anne-Frieda Taurel Joshua Nealon Sri Rezeki Hadinegoro Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. PLoS Neglected Tropical Diseases |
author_facet |
Clarence C Tam Megan O'Driscoll Anne-Frieda Taurel Joshua Nealon Sri Rezeki Hadinegoro |
author_sort |
Clarence C Tam |
title |
Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. |
title_short |
Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. |
title_full |
Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. |
title_fullStr |
Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. |
title_full_unstemmed |
Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. |
title_sort |
geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of indonesia. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Neglected Tropical Diseases |
issn |
1935-2727 1935-2735 |
publishDate |
2018-11-01 |
description |
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. |
url |
http://europepmc.org/articles/PMC6241133?pdf=render |
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