Changing epidemiology of dengue haemorrhagic fever in Indonesia

Abstract

Dengue fever (DF)/dengue haemorrhagic fever (DHF) is a growing public health problem in the subtropics. Dengue was first reported in Indonesia in 1968 and since then the number of reports in the literature and the number of dengue virus (DENV)-infected cases reported by the Indonesian health authorities have increased. This review addresses the changing epidemiology of dengue in Indonesia by means of a chronological overview. Over time, the morbidity and mortality of dengue disease have increased and DHF epidemics occur throughout all the 29 provinces. The outbreak trend of DHF in the country has become irregular, with a high inter-epidemic background. All dengue serotypes are circulating, although severe disease is predominantly attributed to DENV-3. The case-fatality rate is dropping over time, probably reflecting increased awareness and improved treatment protocols. An increasing percentage of adolescents and adults develop DHF relatively earlier in the course of the disease, compared with the days when DHF was considered a primarily paediatric illness. Many inter-related factors such as environmental, biological and demographic issues influence dengue epidemiology and transmission.