Seroepidemiology of dengue virus infection in the adult population in tropical Singapore

To assess the impact of past dengue epidemics in Singapore, we undertook a national seroepidemiological study to determine the prevalence of past dengue virus (DENV) infection in the adult population in 2010 and make comparisons with the seroprevalence in 2004. The study involved residual sera from 3293 adults aged 18-79 years who participated in a national health survey in 2010. The overall prevalence of anti-DENV IgG antibodies was 568% (95% confidence interval 551-585) in 2010. The seroprevalence increased significantly with age. Males had significantly higher seroprevalence than females (615% vs. 532%). Among the three major ethnic groups, Malays had the lowest seroprevalence (502%) compared to Chinese (570%) and Indians (620%). The age-standardized seroprevalence in adults was significantly lower in 2010 (544%) compared to 2004 (631%). Older age, male gender, Indian ethnicity, permanent residency and being home-bound were independent risk factors significantly associated with seropositivity. About 43% of the Singapore adult resident population remain susceptible to DENV infection as a result of the successful implementation of a comprehensive nationwide Aedes surveillance and control programme since the 1970s. Vector suppression and concerted efforts of all stakeholders in the community remain the key strategy in the prevention and control of dengue.