Three Decades of Dengue Surveillance in Five Highly Endemic South East Asian Countries

Abstract

We described and quantified epidemiologic trends in dengue disease burden in 5 Asian countries (Indonesia, Thailand, Malaysia, Philippines, and Vietnam) and identified and estimated outbreaks impact over the last 3 decades. Dengue surveillance data from 1980 to 2010 were retrieved from DengueNet and from World Health Organization sources. Trends in incidence, mortality, and case fatality rate (CFR) were systematically analyzed using annual average percent change (AAPC), and the contribution of epidemic years identified over the observation period was quantified. Over the 30-year period, incidence increased in all countries (AAPC 1980-2010: 6.7% in Thailand, 10.4% in Vietnam, 12.0% in Indonesia, 18.1% in Malaysia, 24.4% in Philippines). Mortality also increased in Indonesia, Malaysia, and Philippines (AAPC: 6.8%, 7.0%, and 29.2%, respectively), but slightly decreased in Thailand and Vietnam (AAPC: -1.3% and -2.5%), and CFR decreased in all countries (AAPC: -4.2% to -8.3%). Epidemic years, despite representing less than a third of the observation period, contributed from 1 to 3 times more cases versus nonepidemic years. Implementation of more sensitive surveillance methods over the study period may have contributed to a reporting or ascertainment bias in some countries. Nonetheless, these data support the urgent need for novel, integrated, or otherwise effective dengue prevention and control tools and approaches.

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“…Most of the cases were male (54.5%), were iTaukei (indigenous Fijians) (53.5%) and were residents of the Central Division (65.5%) ( Table 1). The median age (interquartile range [IQR]) was 25 years (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). The majority of cases (80%) were reported during the METHODS Dengue surveillance in Fiji includes notification of laboratory-confirmed and clinically suspected cases.…”

“…27 Malaria is a legally notifiable disease under the Infectious Disease Act and all medical practitioners and laboratories are required to notify the MOH within 24 hours of diagnosis. 28 The MOH then investigates all cases of malaria to determine if transmission is likely to as well as the genetic background of parasites in the GMS were thought to have contributed to the development of resistance. 18 Since then, emergence of resistance to artemisinin and ACT partner drugs such as piperaquine have been reported in other areas in the GMS.…”

“…28, 29 Literature suggests dengue deaths have increased over the last few decades in some countries and regions. [28][29][30] Increased mortality has also been attributed to greater health-seeking behaviour and increased sensitivity of surveillance for detecting dengue deaths. 28 The higher mortality among males has been reported previously 31 and is thought to be due largely to differences in health-seeking behaviour.…”

“…[28][29][30] Increased mortality has also been attributed to greater health-seeking behaviour and increased sensitivity of surveillance for detecting dengue deaths. 28 The higher mortality among males has been reported previously 31 and is thought to be due largely to differences in health-seeking behaviour. 30 In this study, mortality progressively increased after the age of 55 years, particularly for males.…”

Does Bangkok have a central role in the dengue dynamics of Thailand?

“…2004-2008 and 2014-2017), which can largely be attributable to the two dengue epidemic years (i.e. 2010 and 2013) [14]. Limkittikul et al [15] have reported that Central Thailand was a region with high number of dengue cases and deaths from 2000 to 2011, and this region has a higher population density compared with other regions.…”