Dengue Seroprevalence and Factors Associated with Dengue Seropositivity in Petaling District, Malaysia

Abstract

Dengue virus (DENV) infection is a major public health concern, posing huge economic and disease burdens globally. In Malaysia, the incidence of DENV infections has increased significantly over the years. Nevertheless, the passive surveillance mechanism applied may not capture the actual magnitude of DENV infection. There was also a paucity of community-based studies exploring DENV seroprevalence. This study aimed to determine the DENV seroprevalence and the associated factors among the urban population in Petaling district, Malaysia. A population-based cross-sectional study was conducted from 18 August to 26 October 2018 with 533 participants recruited. Blood samples were collected and analysed for DENV seropositivity using a composite reference standard comprised of three dengue serological tests. Associated factors were identified by fitting Generalised Linear Mixed Models with binomial error structure and logit link function. DENV seroprevalence obtained was 79.0% (95% CI: 75.2-82.4%). The age-specific DENV seroprevalence showed an increasing trend with advancing age, from 22.7% (95% CI: 9.6-45.0%) for those aged below five years old to 94.9% (95% CI: 81.3-98.7%) for those aged ≥60 years old. Only age group and house level were found to be significant factors associated with DENV seropositivity. The odds of being DENV seropositive generally increased with age, from 13.43 (95% CI: 2.77-65.22) for the 5-9 years old age group to 384.77 (95% CI: 39.27-3769.97) for the ≥60 years old age group, as compared to those aged below 5 years old. For house level, those who lived on the first and second floor (OR: 8.98, 95% CI: 3.16-25.12) and the third floor and above (OR: 4.82, 95% CI: 1.89-12.32) had greater odds of being DENV seropositive compared to those living on the ground floor. This study demonstrated the persistently high DENV seroprevalence among the urban population in Petaling district, which could be useful to evaluate dengue control measures taken and estimate more accurate disease incidence. The associated factors with DENV seropositivity identified could also contribute to undertaking more targeted preventive and control measures.

Keywords: Malaysia; community-based study; seroepidemiology; tropical disease; vector-borne disease.

Figure 1

Map of Petaling district, with the two selected communities. (Source: Map data ©2022 Google, with modification).

Figure 2

Age-specific dengue seroprevalence with 95% confidence interval by incidence category.