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PLoS Negl Trop Dis. 2018 Jun 28;12(6):e0006616. doi: 10.1371/journal.pntd.0006616. eCollection 2018 Jun.

Dengue virus serotype distribution based on serological evidence in pediatric urban population in Indonesia.

Author information

Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
Sanofi Pasteur, Asia & JPAC Region, Singapore.
Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.



Dengue is a febrile illness transmitted by mosquitoes, causing disease across the tropical and sub-tropical world. Antibody prevalence data and serotype distributions describe population-level risk and inform public health decision-making.


In this cross-sectional study we used data from a pediatric dengue seroprevalence study to describe historical dengue serotype circulation, according to age and geographic location. A sub-sample of 780 dengue IgG-positive sera, collected from 30 sites across urban Indonesia in 2014, were tested by the plaque reduction neutralization test (PRNT) to measure the prevalence and concentration of serotype-specific neutralizing antibodies according to subject age and geography. PRNT results were obtained from 776 subjects with mean age of 9.6 years. 765 (98.6%) neutralized one or more dengue serotype at a threshold of >10 (1/dil). Multitypic profiles were observed in 50.9% of the samples; a proportion which increased to 63.1% in subjects aged 15-18 years. Amongst monotypic samples, the highest proportion was reactive against DENV-2, followed by DENV-1, and DENV-3, with some variation across the country. DENV-4 was the least common serotype. The highest anti-dengue antibody titers were recorded against DENV-2, and increased with age to a geometric mean of 516.5 [1/dil] in the oldest age group.


We found that all four dengue serotypes have been widely circulating in most of urban Indonesia, and more than half of children had already been exposed to >1 dengue serotype, demonstrating intense transmission often associated with more severe clinical episodes. These data will help inform policymakers and highlight the importance of dengue surveillance, prevention and control.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: Anne-Frieda Taurel, Alain Bouckenooghe, Hermin Sitompul and Joshua Nealon are employees of Sanofi Pasteur, a company engaged in the production of vaccines including against dengue. R. Tedjo Sasmono, Ari Prayitno and Sri Rezeki Hadinegoro have been investigators for clinical or epidemiological studies sponsored by Sanofi Pasteur, and have been remunerated accordingly.

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