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. 2022 Jan 24;14(2):219.
doi: 10.3390/v14020219.

Hyperendemic Dengue and Possible Zika Circulation in the Westernmost Region of the Indonesian Archipelago

Harapan Harapan  1   2   3   4 , Kritu Panta  4 , Alice Michie  4 , Timo Ernst  4 , Suzi McCarthy  4   5 , Muhsin Muhsin  6   7 , Safarianti Safarianti  7 , Tjut Mariam Zanaria  7 , Mudatsir Mudatsir  1   2   3 , R Tedjo Sasmono  8 , Allison Imrie  4
Affiliations

Hyperendemic Dengue and Possible Zika Circulation in the Westernmost Region of the Indonesian Archipelago

Harapan Harapan et al. Viruses. .

Abstract

The transmission of dengue and other medically important mosquito-borne viruses in the westernmost region of Indonesia is not well described. We assessed dengue and Zika virus seroprevalence in Aceh province, the westernmost area of the Indonesian archipelago. Serum samples collected from 199 randomly sampled healthy residents of Aceh Jaya in 2017 were analyzed for neutralizing antibodies by plaque reduction neutralization test (PRNT). Almost all study participants (198/199; 99.5%) presented with multitypic profiles of neutralizing antibodies to two or more DENV serotypes, indicating transmission of multiple DENV in the region prior to 2017. All residents were exposed to one or more DENV serotypes by the age of 30 years. The highest geometric mean titers were measured for DENV-4, followed by DENV-1, DENV-2 and DENV-3. Among a subset of 116 sera, 27 neutralized ZIKV with a high stringency (20 with PRNT90 > 10 and 7 with PRNT90 > 40). This study showed that DENV is hyperendemic in the westernmost region of the Indonesian archipelago and suggested that ZIKV may have circulated prior to 2017.

Keywords: Aceh; Indonesia; PRNT; Zika; dengue; seroprevalence.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Number of participants based on age and gender (n = 199).
Figure 2
Figure 2
Status of DENV infection by age group (n = 199). Status of individuals with naïve, monotypic, or multitypic infections classified using two thresholds (PRNT50 and PRNT90 at >10). For each threshold, all monotypic infections were observed in individuals younger than 30 years old.
Figure 3
Figure 3
Geometric mean titers (GMT) of DENV NAb at two different thresholds: PRNT50 (A) and PRNT90 (B) (n = 199). Neutralizing antibody (NAb) GMTs were interpolated using non-linear regression.
Figure 4
Figure 4
Stratification of geometric mean titer (GMT) of DENV neutralizing antibody (NAb) titers by age (n = 199). DENV NAb GMTs for each age group for all serotypes were calculated based on two thresholds PRNT50 (blue), and PRNT90 (red).
Figure 5
Figure 5
Geometric mean titer (GMT) of ZIKV neutralizing antibody (NAb) and the distribution of ZIKV NAb-positive sera at different thresholds (n = 116). (A) GMT of ZIKV NAb using two thresholds (PRNT50 and PRNT90). (B) ZIKV seropositive sera were classified using a combination of four cut-offs (two thresholds of plaque reductions percentage and two cut-offs for serum dilutions).
Figure 6
Figure 6
Geometric mean titers (GMTs) of ZIKV neutralizing antibody (NAb) at two thresholds (PRNT50 and PRNT90).
Figure 7
Figure 7
Neutralizing antibody (NAb) titers for ZIKV and DENV at PRNT90 (n = 116). (A) ZIKV NAb titers and corresponding DENV NAb titers were plotted to show dengue infection background. (B) For seven serum samples that had ZIKV NAb titers > 40, the DENV NAb titers were plotted individually and the GMTs were calculated. Using criteria developed in the Indonesian context [34] none of the samples can be classified as ZIKV-seropositive. One dot indicates an individual sample; grey dots indicate samples that have ZIKV NAb titers < 40 at PRNT90, while colored dots represent samples that had ZIKV NAb titers > 40 at PRNT90.
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