Molecular epidemiology of dengue in a setting of low reported endemicity: Kupang, East Nusa Tenggara province, Indonesia

Author:

Hayati Rahma F1ORCID,Denis Dionisius1ORCID,Tallo Karolina T2,Sirait Tuppak2,Tukan Joanita2,Santoso Marsha S1ORCID,Yohan Benediktus1ORCID,Haryanto Sotianingsih3ORCID,Frost Simon D W45ORCID,Stubbs Samuel C B4,Sasmono R Tedjo1ORCID

Affiliation:

1. Eijkman Institute for Molecular Biology, Jakarta, Indonesia

2. SK Lerik Regional Public Hospital, Kupang, Indonesia

3. Siloam Hospitals Jambi, Indonesia

4. London School of Hygiene and Tropical Medicine, London, UK

5. Microsoft Research, Redmond, WA, USA

Abstract

Abstract Background Most regions in Indonesia experience annual dengue epidemics. However, the province of East Nusa Tenggara has consistently reported low incidence. We conducted a dengue molecular epidemiology study in Kupang, the capital of the province. Methods Dengue patients were recruited from May 2016 to September 2017. Dengue virus (DENV) screening was performed using NS1 and immunoglobulin G (IgG)/IgM detection. Serotype was determined using reverse transcription polymerase chain reaction and the envelope genes were sequenced to infer the genetic identity and phylogeny. Results From 119 patients, dengue was confirmed in 62 (52%). Compared with official data, underreporting of dengue incidence was observed. The majority (36%) of patients were children <10 y of age. Most patients (80%) experienced mild fever. All serotypes were detected, with DENV-3 as the predominant (57%). Kupang DENV-1 isolate was classified as genotype IV, an old and endemic strain, DENV-2 as cosmopolitan, DENV-3 as genotype I and DENV-4 as genotype II. Most isolates showed relatively low evolutionary rates and are closely related with strains from Bali and Timor Leste. Conclusions The low dengue incidence was most likely caused by sustained local circulation of endemic viruses. This study provides information on the epidemiology of dengue in a low-endemicity setting that should help future mitigation and disease management.

Funder

Medical Research Council

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology

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