A systematic review of dengue epidemiology in Indonesia: Ten-year trends in case distribution and viral serotype dynamics

Abstract

Objective: To analyze the trends of dengue virus infection case distribution and dengue virus (DENV) serotype dynamics in Indonesia over the last decade through a spatio-temporal analysis and systematic literature review. Methods: A mixed-methods approach was used, combining a descriptive spatio-temporal analysis of national dengue surveillance data from 2014-2023 and a systematic literature review of the DENV serotypes distribution in Indonesia. The national dengue surveillance data from 2014-2023 were analyzed through spatio-temporal analysis using QGIS 3.28.3 to visualize the distribution of dengue hemorrhagic fever cases and mortality. The articles for systematic literature review were retrieved from three databases (Scopus, PubMed, and Garuda) within the same period, and their quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional and experimental studies. Results: The highest number of cases occurred in 2016, and the lowest in 2018. The geographic spread of DENV transmission increased over time, reaching 484 affected districts in 2022. The highest case burden consistently occurred on Java Island (>10 ООО cases per year). All four serotypes were detected across regions with varying dominance, and DENV-3 was identified as the predominant serotype during the study period. High population density and human mobility were key factors influencing regional differences in serotype distribution, while the strong transovarial transmission capability of DENV-3 may contribute to its persistence within mosquito populations. Conclusions: Dengue virus infection in Indonesia demonstrates fluctuating trends with an expanding geographic distribution over the past decade. All four DENV serotypes continue to circulate nationwide, with DENV-3 remaining the predominant serotype. Variations in serotype dominance are likely influenced by population density, mobility, as well as the persistence of transovarial transmission within mosquito vectors. These findings highlight the importance of strengthening surveillance systems and implementing targeted control strategies to reduce dengue transmission in Indonesia.