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Comparative Study
. 2016 Aug 18;16(1):824.
doi: 10.1186/s12889-016-3496-9.

Rural-urban comparisons of dengue seroprevalence in Malaysia

Cheng Hoon Chew  1 , Yuan Liang Woon  1 , Faridah Amin  2 , Tassha H Adnan  1 , Asmah Hani Abdul Wahab  2 , Zul Edzhar Ahmad  2 , Mohd Adam Bujang  1 , Abdul Muneer Abdul Hamid  1 , Rahman Jamal  3 , Wei Seng Chen  4 , Chee Peng Hor  5 , Lena Yeap  6 , Ling Ping Hoo  6 , Pik Pin Goh  1 , Teck Onn Lim  7
Affiliations
Comparative Study

Rural-urban comparisons of dengue seroprevalence in Malaysia

Cheng Hoon Chew et al. BMC Public Health. .

Abstract

Background: Each year an estimated 390 million dengue infections occur worldwide. In Malaysia, dengue is a growing public health concern but estimate of its disease burden remains uncertain. We compared the urban-rural difference of dengue seroprevalence and determined age-specific dengue seroprevalence in Malaysia.

Methods: We undertook analysis on 11,821 subjects from six seroprevalence surveys conducted in Malaysia between 2001 and 2013, which composed of five urban and two rural series.

Results: Prevalence of dengue increased with age in both urban and rural locations in Malaysia, which exceeded 90 % among those aged 70 years or beyond. The age-specific rates of the 5 urban surveys overlapped without clear separation among them, while prevalence was lower in younger subjects in rural series than in urban series, the trend reversed in older subjects. There were no differences in the seroprevalence by gender, ethnicity or region. Poisson regression model confirmed the prevalence have not changed in urban areas since 2001 but in rural areas, there was a significant positive time trend such that by year 2008, rural prevalence was as high as in urban areas.

Conclusion: Dengue seroprevalence has stabilized but persisted at a high level in urban areas since 2001, and is fast stabilizing in rural areas at the same high urban levels by 2008. The cumulative seroprevalence of dengue exceeds 90 % by the age of 70 years, which translates into 16.5 million people or 55 % of the total population in Malaysia, being infected by dengue by 2013.

Keywords: Dengue; Malaysia; Seroprevalence; Urban rural difference.

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Figures

Fig. 1
Fig. 1
Age-specific seroprevalence of dengue observed between 2000 and 2013
Fig. 2
Fig. 2
Age-specific dengue seroprevalence estimates* by gender. Cubic spline smoothed and pooled across all surveys
Fig. 3
Fig. 3
Age-specific dengue seroprevalence estimates* by ethnicity. Cubic spline smoothed and pooled across all surveys
Fig. 4
Fig. 4
Age-specific dengue seroprevalence estimates* by region. Cubic spline smoothed and pooled across all surveys
Fig. 5
Fig. 5
Age-specific dengue seroprevalence estimates* by urban-rural location. Cubic spline smoothed and pooled across all surveys
Fig. 6
Fig. 6
Predicted age-specific dengue seroprevalence rate using Poisson regression model by urban-rural locations
See this image and copyright information in PMC

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