Dengue Virus Serotype Distribution in Malaysian Hospitals: A Narrative Review
DOI:
https://doi.org/10.63719/johm.v23i1.244Keywords:
dengue serotype distribution, hospital, DENV-1 to DENV-4, diagnostic testing, RT-PCRAbstract
Background: Dengue, a mosquito-borne viral infection, remains a major public health concern in tropical regions such as Malaysia, where dengue virus serotype distribution fluctuates over time and geography. Despite its clinical significance, data on serotype distribution within hospital settings remain limited, posing challenges for targeted disease management.
Methods: A narrative review was conducted to synthesise available research on dengue serotype distribution in Malaysian hospital settings. A specific search string including “dengue” AND “serotype” AND “hospital*” AND “Malaysia” was used to screen potential reports in PubMed, Scopus, and Google Scholar. The main focus was on studies that reported serotype distribution, diagnostic methods, and gender distribution among hospitalised dengue patients. Data were extracted and analysed to identify patterns and gaps in dengue surveillance.
Results: Based on 12 reported studies, dengue virus serotype 1 (DENV-1) emerged as the predominant serotype in several hospitals. Hospitals in the Klang Valley conducted and reported dengue serotyping more frequently than hospitals in other Malaysian regions. This suggests a higher level of diagnostic capacity, surveillance, and research activity in this area. Dengue serotype distribution was influenced by urbanisation, environmental conditions, and population immunity. Serological methods, including the detection of Immunoglobulin M (IgM), Immunoglobulin G (IgG) antibodies, and non-structural protein 1 (NS1), were the primary screening for dengue diagnosis prior to molecular diagnostic methods such as Real-time polymerase chain reaction (RT-PCR). The male-to-female ratio among dengue patients was approximately 1.2:1, indicating a consistent trend of higher incidence in males within the Malaysian hospital setting.
Conclusion: This narrative review summarises dengue serotype distribution in Malaysian hospitals, emphasising the importance of ongoing dengue serotype surveillance strategies based on the predominant serotypes.
References
Ab-Fatah, M., Subenthiran, S., Abdul-Rahman, P.S.A., Saat, Z., Thayan, R., 2015. Dengue serotype surveillance among patients admitted for dengue in two major hospitals in Selangor, Malaysia, 2010-2011. Tropical biomedicine, 32(1), 187–91.
Ahuja, S., Muntode Gharde, P., 2023. A Narrative Review of Maternal and Perinatal Outcomes of Dengue in Pregnancy. Cureus 15(11). https://doi.org/10.7759/cureus.48640.
Aung, T.S., Gintarong, T., Balingi, D.B., Emran, A., Thein, T.T., Chua, T.H., 2020. Serotyping of dengue virus in 2016-17 outbreak in Kudat, Sabah, Malaysia. Tropical biomedicine, 37(1), 58–65.
Bosch, I., Reddy, A., de Puig, H., Ludert, J.E., Perdomo-Celis, F., Narváez, C.F., et al., 2019. Serotype-specific detection of dengue viruses in a nonstructural protein 1-based enzyme-linked immunosorbent assay validated with a multi-national cohort. PLoS 14(6), 1–15. https://doi.org/10.1371/journal.pntd.0008203.
Che Isa, Z., Lim, J.A., Ain, A.M., Othman, F.A., Kueh, Y.C., Tew, M.M., et al., 2023. Clinical profiles and predictors of survival in severe dengue cases. Singapore medical journal [Preprint]. https://doi.org/10.4103/singaporemedj.SMJ-2022-072.
Chem, Y.K., Yenamandra, S.P., Chong, C.K., Mudin, R.N., Wan, M.K., Tajudin, N., et al., 2024. Molecular epidemiology of dengue in Malaysia: 2015-2021. Frontiers in Genetics. 15, 1368843. https://doi.org/10.3389/fgene.2024.1368843.
Chew, M. H., Rahman, M.M., Jelip, J., Hassan, M.R., Isahak, I., 2012. All Serotypes of Dengue Viruses Circulating in Kuala Lumpur, Malaysia. Current Research Journal of Biological Sciences 49(2), 229–234.
Chew, Muhammad Hasyim, Rahman, M.M., Salleh, S., 2012. Dengue in Malaysia: An epidemiological perspective Study. Pakistan journal of medical sciences online 28(4), 643–647.
Fang, R., Lo, E., Lim, T.W., 1984. The 1982 dengue epidemic in Malaysia: epidemiological, serological and virological aspects. Southeast Asian Journal of Tropical Medicine and Public Heath 15(1), 51–58.
Gunasagaran, V., Rogayah, T., Saraswathy, T.S., Thayan, R., Apandi, M., Fauziah, M.K., Saat, Z., 2011. Molecular typing of dengue viruses circulating on the East Coast of Peninsular Malaysia from 2005 to 2009. Southeast Asian Journal of Tropical Medicine and Public Health 42(1), 94–99.
Kaur, N., Rahim, S.S.S.A., Jaimin, J.J., Dony, J.J.F., Khoon, K.T., Ahmed, K., 2020. The east coast districts are the possible epicenter of severe dengue in Sabah.Journal of physiological anthropology, 39(1). 39. https://doi.org/10.1186/S40101-020-00230-0.
Mahadi, M., Muhammad Azami, N.A., Abdullah, N., Othman, S.N., Kori, N., Neoh, H.-M., et al., 2023. Emergence Of Dengue Virus Type 4 During COVID-19 Pandemic in Patients Admitted to a Teaching Hospital in Malaysia. Jurnal Sains Kesihatan Malaysia 21(1), 115–125. https://doi.org/10.17576/JSKM-2021-1902.
Ministry of Health (MOH) Malaysia, 2024. Health Facts 2024.
Mohd-Zaki, A.H., Brett, J., Ismail, E., L’Azou, M., 2014. Epidemiology of Dengue Disease in Malaysia (2000–2012): A Systematic Literature Review. PLOS Neglected Tropical Diseases, 8(11), e3159. https://doi.org/10.1371/journal.pntd.0003159.
Nur Liyana, K., Fauziah, M.K., Zainah, S., Nor Aziyah, R., Salbiah, N., Lau, I.S., et al., 2016. Sequence analysis of E/NS1 gene junction of Dengue Type-1 viruses isolated in Klang Valley 2010 to 2012. Tropical biomedicine, 33(2), 348–358.
Phadungsombat, J., Nakayama, E.E., Shioda, T., 2024. Unraveling Dengue Virus Diversity in Asia: An Epidemiological Study through Genetic Sequences and Phylogenetic Analysis. Viruses 16(7). https://doi.org/10.3390/V16071046.
Qinglin, L., Zhao Ming, L., Chen Yong, T., Shunmugarajoo, A.A., Bt Azmel, A., Soong Yiing, Y., 2023. Association of dengue serotypes and its complications: a retrospective cohort study. Medical Journal of Malaysia 78(3), 378.
Rudnick, A., Tan, E.E., Lucas, J.K., Omar, M. Bin, 1965. Mosquito-borne Haemorrhagic Fever in Malaya. British medical journal, 1(5445), 1269–1272. https://doi.org/10.1136/BMJ.1.5445.1269.
Suppiah, J., Ali, E.Z., Mohd Khalid, M.K.N., Mohd Ghazali, S., Tee, K.K., Zulkifli, M.M.S., et al., 2023. Resurgence of Dengue Virus Serotype 4 in Malaysia: A Comprehensive Clinicodemographic and Genomic Analysis. Tropical Medicine and Infectious Disease, 8(8), 409. https://doi.org/10.3390/tropicalmed8080409. 175
Suppiah, J., Chan, S.Y., Ng, M.W., Khaw, Y.S., Ching, S.M., Mat-Nor, L.A., et al., 2017. Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever - a pilot study. Journal of biomedical science, 24(1). https://doi.org/10.1186/S12929-017-0344-X.
Suppiah, J., Ching, S.M., Amin-Nordin, S., Mat-Nor, L.A., Ahmad-Najimudin, N.A., Low, G.K.K., et al., 2018. Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: A retrospective observational study. PLoS neglected tropical diseases, 12(9). https://doi.org/10.1371/journal.pntd.0006817.
Vicente, C.R., Herbinger, K.H., Fröschl, G., Romano, C.M., Cabidelle, A. de S.A., Junior, C.C., 2016. Serotype influences on dengue severity: a cross-sectional study on 485 confirmed dengue cases in Vitória, Brazil. BMC infectious diseases, 16(1). https://doi.org/10.1186/S12879-016-1668-Y.
Wan Mohamad Ali, W.N., Mohamed Nor, Z., Ali, R., Ahmad, R., Lim, Y.A.-L., 2023. Genotypic Diversity of Dengue Virus in Aedes Mosquitoes Collected from Dengue Hotspot Areas in Kuala Lumpur and Selangor. Science Heritage Journal (GWS) 7(1), 9–17. https://doi.org/10.26480/gws.01.2023.09.17.
Willeam Peter, S.S., Hassan, S.S., Khei Tan, V.P., Ngim, C.F., Azreen Adnan, N.A., Pong, L.Y., Dhanoa, A., 2019. Admission Clinicopathological Factors Associated with Prolonged Hospital Stay Among Hospitalized Patients with Dengue Viral Infections. Vector borne and zoonotic diseases (Larchmont, N.Y.), 19(7), 549–552. https://doi.org/10.1089/VBZ.2018.2379.
