Molecular epidemiology of dengue in North Kalimantan, a province with the highest incidence rates in Indonesia in 2019

R Tedjo Sasmono; Angeline Sutjianto; Marsha S Santoso; Karomah Sriwedari; Benediktus Yohan; Erna Mayasanti; Rahma F Hayati; Dionisius Denis

doi:10.1016/j.meegid.2021.105036

Molecular epidemiology of dengue in North Kalimantan, a province with the highest incidence rates in Indonesia in 2019

Infect Genet Evol. 2021 Nov:95:105036. doi: 10.1016/j.meegid.2021.105036. Epub 2021 Aug 16.

Authors

R Tedjo Sasmono¹, Angeline Sutjianto², Marsha S Santoso³, Karomah Sriwedari⁴, Benediktus Yohan³, Erna Mayasanti⁵, Rahma F Hayati³, Dionisius Denis³

Affiliations

¹ Eijkman Institute for Molecular Biology, Jakarta, Indonesia. Electronic address: sasmono@eijkman.go.id.
² Malinau Regional Hospital, Malinau, North Kalimantan, Indonesia.
³ Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
⁴ Tarakan Regional Hospital, Tarakan, North Kalimantan, Indonesia.
⁵ Gunung Lingkas Public Health Center, Tarakan, North Kalimantan, Indonesia.

PMID: 34411743
DOI: 10.1016/j.meegid.2021.105036

Abstract

Objectives: Dengue is endemic to Indonesia, a country that has largely varied geographical and demographic conditions across different regions. In 2019, dengue epidemic occurred in North Kalimantan province and recorded as the highest incidence rate in Indonesia. This study aims to investigate the molecular epidemiology of dengue during outbreak in the province and compare the epidemiological characteristics between two cities/towns in North Kalimantan, namely Malinau, an inland town surrounded by a dense rainforest, and Tarakan, an island city.

Methods: A cross sectional study was conducted between September 2018 and July 2019. Dengue-like illness patients were recruited in hospitals and tested for dengue NS1 and IgG/IgM. Serological prevalence was measured using IgG ELISA, dengue virus (DENV) serotyping was conducted using RT-PCR and Envelope gene sequencing was performed to infer the virus origins and phylogeny. Clinical, demographical, and diagnostics data were also recorded and analyzed.

Results: We recruited 523 patients, 261 from Malinau and 262 from Tarakan. Among them, 349 patients were confirmed dengue. Cases in Malinau had a higher proportion of confirmed dengue (82.0%) compared to those in Tarakan (51.5%). Cases in Malinau were more likely to be dengue hemorrhagic fever with more severe hematological features compared to those in Tarakan. All four DENV serotypes were detected in both cities, the most prevalent serotype being DENV-2. The genetic characteristics of the viruses in the two towns was similar except for DENV-3. No sylvatic DENV was detected as well as alphaviruses and non-dengue flaviviruses during the outbreak.

Conclusions: The molecular epidemiology of dengue in North Kalimantan revealed the similar virological characteristics but different clinical and demographic aspects in Malinau and Tarakan. The distinct dengue dynamics between different regions of Indonesia is prominent and this knowledge will be important for understanding future patterns of DENV transmission in the region.

Keywords: Arbovirus; Clinical; Dengue; Epidemiology; Indonesia; Serotypes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Borneo / epidemiology
Child
Child, Preschool
Dengue / epidemiology*
Dengue Virus / genetics*
Humans
Incidence
Indonesia / epidemiology
Infant
Middle Aged
Molecular Epidemiology
Prevalence
Seroepidemiologic Studies
Serogroup
Young Adult