Seroprevalence of Dengue Antibodies among Healthy Blood Donors from Sabah, Malaysian Borneo: Blood Safety in Dengue-Endemic Communities

Authors

  • Zulina Mazlan
  • Vijay Kumar Subbiah
  • Saleh Mohammad Abdullah
  • Rosalinah Julian
  • Nadia Iryani Najri
  • Nadia Iryani Najri
  • Mimi Azreen Abdullah
  • Helen Benedict Lasimbang
  • Mohammad Zahirul Hoque

DOI:

https://doi.org/10.51200/bijb.v3i.4243

Keywords:

Dengue fever, seroprevalence, blood safety, blood donor, Malaysia

Abstract

Dengue virus (DENV) infection which is an emerging and resurging mosquito-borne infection is a major public health concern in many countries in the tropics and subtropics. It is the most common arbovirus infection globally, and its incidence has increased dramatically in recent decades. Despite several reported transfusion-transmitted cases, the impact of dengue infection on the safety of the blood supply is still controversial. This study aims to determine the seroprevalence of dengue infection among healthy blood donors from Sabah, Malaysia, an area in Southeast Asia that is endemic to the four serotypes of the dengue virus. A cross-sectional study was conducted among 364 eligible blood donors from the Sabah Women and Children Hospital in Sabah State. Serum samples were examined for the presence of dengue-specific immunoglobulin G (IgG) using an enzyme-linked immunosorbent assay (ELISA). Overall, approximately one-third (36.5%, 133/364) of the participants tested positive for dengue anti-IgG. The prevalence of dengue anti-IgG significantly increased with age, with the lowest prevalence (30.5%) among young adults aged 18 – 26 years and the highest prevalence (73.3%) among those aged 56 – 65 years (χ2 = 10.984; P = 0.027). Likewise, the prevalence was higher among male blood donors

(38.9%) compared to female donors (31.3%); however, the difference was not statistically significant (χ2 = 0.295; P = 0.267). The high prevalence of dengue IgG seropositivity among healthy blood donors reflects the high endemicity of dengue disease in this region of Malaysia. The findings suggest the need for blood screening for DENV infection by blood donation services in Malaysia to improve transfusion safety, which is of paramount importance for the recipient.

Author Biographies

Zulina Mazlan

Department of Pathobiology & Medical Diagnostics,
Faculty of Medicine & Health Sciences,
Jalan UMS Universiti Malaysia Sabah,
Kota Kinabalu, Sabah, Malaysia

Department of Pathology,
Sabah Women and Children Hospital, 
Kota Kinabalu, Sabah, Malaysia

Vijay Kumar Subbiah

Biotechnology Research Institute,
Jalan UMS, Universiti Malaysia Sabah,
Kota Kinabalu, Sabah, Malaysia

Saleh Mohammad Abdullah

Department of Medical Laboratory,
Faculty of Applied Medical Sciences,
Jazan University, Jazan, Kingdom of Saudi Arabia

Rosalinah Julian

Department of Pathology,
Sabah Women and Children Hospital,
Kota Kinabalu, Sabah, Malaysia

Nadia Iryani Najri

Department of Pathobiology & Medical Diagnostics,
Faculty of Medicine & Health Sciences,
Universiti Malaysia Sabah,
Kota Kinabalu, Sabah, Malaysia

Nadia Iryani Najri

Department of Pathobiology & Medical Diagnostics, 
Faculty of Medicine & Health Sciences,
Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Mimi Azreen Abdullah

Department of Pathology,
Sabah Women and Children Hospital,
Kota Kinabalu, Sabah, Malaysia

Helen Benedict Lasimbang

Department of Reproductive Health,
Faculty of Medicine & Health Sciences, 
Jalan UMS, Universiti Malaysia Sabah,
Kota Kinabalu, Sabah, Malaysia

Mohammad Zahirul Hoque

Department of Pathobiology & Medical Diagnostics,
Faculty of Medicine & Health Sciences,
Jalan UMS, Universiti Malaysia Sabah,
Kota Kinabalu, Sabah, Malaysia

References

Aneke, J. C., & Okocha, C. E. (2017). Blood transfusion safety: Current status and challenges in Nigeria. Asian J Transfus Sci, 1, 1 – 5. https://doi.org/10.4103/0973-6247.200781

Ang, L. W., Cutter, J., James, L., & Goh, K. T. (2015). Seroepidemiology of dengue virus infection in the adult population in tropical Singapore. Epidemiol Infect,143 (8),1585 – 1593. https://doi.org/10.1017/S0950268814002507

Anker, M., & Arima, Y. (2011). Male-female differences in the number of reported incident dengue fever cases in six Asian countries. Western Pac Surveill Response J, 2,17 – 23. https://doi.org/10.5365/wpsar.2011.2.1.002

Ashshi, A. M., Alghamdi, S., El-Shemi, A. G., Almdani, Refaat, B., Mohamed, A. M., Ghazi, H. O., Azhar, E. I., & Al-Allaf, F. A. (2017). Seroprevalence of asymptomatic dengue virus infection and its antibodies among healthy/eligible Saudi blood donors: findings from Holy Makkah City. Virology (Auckl), 8, 1 – 5. https://doi.org/10.1177/1178122X17691261

Azami, N. A. M., Salleh, S. A., Neoh, H. M., Syed Zakaria, S. Z. & Jamal, R. (2011). Dengue epidemic in Malaysia: Not a redominantly urban disease anymore. BMC Research Notes, 4, 216. https://doi.org/10.1186/1756-0500-4-216

Beckett, C. G., Kosasih, H., Faisal, I., Nurhayati, Tan, R., Widjaja, S., Listiyaningsih, E., Ma’roef, C., Wuryadi, S., Bangs, M. J., Samsi, T. K., Yuwono, D., Hayes, C. G., & Porter, K. R. (2005). Early detection of dengue infections using cluster sampling around index cases. Am J Trop Med Hyg, 72, 777 – 782. https://doi.org/10.4269/ajtmh.2005.72.777

Bhatt, S. (2013). The global distribution and burden of dengue. Nature, 7446, 504 – 507. https://doi.org/10.1038/nature12060

Bloch, E. M., Vermeulen, M., & Murphy, E. (2012). Blood transfusion safety in Africa: A literature review of infectious disease and organizational challenges. Transfus Med Rev, 2, 164 – 280. https://doi.org/10.1016/j.tmrv.2011.07.006

Busch, M. P., Caglioti, S., Robertson, E. F., McAuley, J. D., Tobler, L. H., Kamel, H., Linnen, J. M., Shyamala, V., Tomasulo, P., & Kleinman, S. H. (2015). Screening the blood supply for West Nile virus RNA by nucleic acid amplification testing. N Engl J Med, 5, 460 – 467. https://doi.org/10.1056/NEJMoa044029

Busch, M. P., Sabino, E. C., Brambilla, D., Lopes, M. E., Capuani, L., Chowdhury, McClure, C., Linnen, J. M., Prince, H., Simmons, G., Lee, T. H., Kleinman, S., Custer, B., & for the International Component of the NHLBI Recipient Epidemiology and Donor Evaluation Study-III (REDSIII). (2016). Duration of dengue viremia in blood donors and relationships between donor viremia, infection incidence and clinical case reports during a large epidemic. J. Infect, 1, 49 – 54. https://doi.org/10.1093/infdis/jiw122

Chastel, C. (2012). Eventual role of asymptomatic cases of dengue for the introduction and spread of dengue viruses in non-endemic regions. Front Physiol, 3, 70. https://doi.org/10.3389/fphys.2012.00070

Cheah, W. K., Ng, K. S., Marzilawati, A. R., & Lum, L. C. (2014). A review of dengue research in Malaysia. Med J Malaysia, 69, 59 – 67.

Cheng, W. S., Wong, C. H., & Cilleken, L. (2003). Dengue antibodies in a suburban community in Malaysia. Med J Malaysia, 58, 142 – 143.

Chew, C. H., Woon, Y. L., Amin, F., Adnan, T. H., Abdul Wahab, A. H., Ahmad, Z. E., Bujang, M. A., Abdul Hamid, A. M., Jamal, R., Chen, W. S., Hor, C. P., Yeap, L., Hoo, L. P., Goh, P. P., & Lim, T. O. (2016). Rural-urban comparisons of dengue seroprevalence in Malaysia. BMC Public Health, 1, 824. https://doi.org/10.1186/s12889-016-3496-9

Chuang, V., Wong, T. Y., Leung, Y. H., Ma, E., Law, Y. L., Tsang, O., Chan, K. M., Tsang, I., Que, T. L., Yung, R., & Liu, S. H. (2008). Review of dengue fever cases in Hong Kong during 1998 to 2005. Hong Kong Med J, 14,170 – 177.

Duong, V., Lambrechts, L., Paul, R. E., Ly, S., Lay, R. S., Long, K. C., Huy, R., Tarantola, A., Scott, T. W., Sakuntabhai, A., & Buchy, P. (2015). Asymptomatic humans transmit dengue virus to mosquitoes. Proc Natl Acad Sci USA, 112 (47), 14688 – 14693. https://doi.org/10.1073/pnas.1508114112

Guo, C., Zhou, Z., Wen, Z., Liu, Y., Zeng, C., Xiao, D., Ou, M., Han, Y., Huang, S., Liu, D., Ye, X., Zou, X., Wu, J., Wang, H., Zeng, E. Y., Jing, C., & Yang, G. (2017). Global epidemiology of dengue outbreaks in 1990 – 2015: A systematic review and meta-analysis. Front Cell Infect Microbiol, 7, 317. https://doi.org/10.3389/fcimb.2017.00317

Harif, N. F., Kader, Z. S., Joshi, S. R., & Yusoff, N. M. (2014). Seropositive status of dengue virus infection among blood donors in North Malaysia. Asian J Transfus Science, 1, 64. https://doi.org/10.4103/0973-6247.126702

Hussin, N., Jaafar, J., Naing, N. N., Mat, H. A., Muhamad, A. H., & Mamat, M. N. (2005). A review of dengue fever incidence in Kota Bharu, Kelantan, Malaysia during the years 1998 – 2003. Southeast Asian J Trop Med Public Health, 36 (5), 1179 – 1186.

Ifland, L., Bloch, E. M., & Pitman, J. P. (2018). Funding blood safety in the 21st century. Transfusion, 58 (1), 105 – 112. https://doi.org/10.1111/trf.14374

Ismail, N. A. M., Abd. Rahim, W. E. R. W., Salleh, S. A., Neoh, H., Jamal, R., & Jamil, M. A. (2014). Seropositivity of dengue antibodies during pregnancy. Sci World J, 436975. https://doi.org/10.1155/2014/436975

Jayaraman, S., Chalabi, Z., Perel, P., Gurriero, C., & Roberts, I. (2010). The risk of transfusion-transmitted infections in sub-Saharan Africa. Transfusion, 2, 433 – 442. https://doi.org/10.1111/j.1537-2995.2009.002402.x

Karim, F., Nasir, N., & Moiz, B. (2017). Transfusion-transmitted dengue: One donor infects two patients. Transfus Apher Sci, 2,151 – 153. https://doi.org/10.1016/j.transci.2016.10.013

Low, S. L., Lam, S., Wong, W. Y., Teo, D., Ng, L. C., & Tan, L. K. (2015). Dengue seroprevalence of healthy adults in Singapore: Serosurvey among blood donors, 2009. Am J Trop Med Hyg, 93 (1), 40 – 45. https://doi.org/10.4269/ajtmh.14-0671

Low, S. L., Lam, S., Wong, W. Y., Teo, D., Ng, L. C., & Tan, L. K. (2009). Dengue seroprevalence of healthy adults in Singapore: Serosurvey among blood donors, Am J Trop Med Hyg 2015, 93 (1), 40 – 45. https://doi.org/10.4269/ajtmh.14-0671

Mallhi, T. H., Khan, A. H., Adnan, A. S., Sarriff, A., Khan, Y. H., & Jummaat, F. (2015). Clinical-laboratory spectrum of dengue viral infection and risk factors associated with dengue hemorrhagic fever: A retrospective study. BMC Infectious Diseases, 15, 99. https://doi.org/10.1186/s12879-015-1141-3

MOH. (2017). History and epidemiology of dengue. Ministry of Health Malaysia. Retrieved from http://denggi.myhealth.gov.my/history-and-epidemiology-of-dengue/?lang=en

Mustafa, M. S., Rasotgi, V., Jain, S., & Gupta, V. (2015). Discovery of the fifth serotype of dengue virus (DENV-5): A new public health dilemma in dengue control. Med J Armed Forces India, 1, 67-70. https://doi.org/10.1016/j.mjafi.2014.09.011

Najri, N. I., Mazlan, Z., Jaimin J. J., Mohammad, R., Mohd, T. A. A., Hameed, A. A., Kumar, V., & Hoque, M. Z. (2017). The circulating serotypes of dengue in Sabah, Malaysian Borneo. Ann Transl Med, 5 2, AB084. https://doi.org/10.21037/atm.2017.s084

Ng, L., Chem, Y., Koo, C., Mudin, R. N. B., Amin, F. M., Lee, K., & Kheong, C. C. (2015). 2013 dengue outbreaks in Singapore and Malaysia were caused by different viral strains. Am J Trop Med Hyg, 6,1150-5. https://doi.org/10.4269/ajtmh.14-0588

Nkohkwo, A., Agbor, G., Asongalem, E., Tagny, C., & Asonganyi, T. (2016). Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion. Afr J Lab Med; 1, 363. https://doi.org/10.4102/ajlm.v5i1.363

Pang, E. L., & Loh, H. S. (2016). The current perspectives on dengue episodes in Malaysia. Asian Pac J Trop Med, 4, 395-401. https://doi.org/10.1016/j.apjtm.2016.03.004

Patankar, M., Patel, B., Gandhi, V., Shah, P., & Vegad, M. (2014). Seroprevalence of dengue in Gujarat, Western India: A study at a tertiary care hospital. Int J Med Sci Public Health, 1, 16 – 18. https://doi.org/10.5455/ijmsph.2013.140920131

Petersen, L. R., & Busch, M. P. (2010). Transfusion-transmitted arboviruses. Vox Sang, 98, 495–503. https://doi.org/10.1111/j.1423-0410.2009.01286.x

Petersen, L. R., Tomashek, K. M., & Biggerstaff, B. J. (2012). Estimated prevalence of Dengue viremia in Puerto Rican blood donations, 1995 through 2010. Transfusion, 8, 1647 – 1651. https://doi.org/10.1111/j.1537-2995.2011.03529.x

Ranjan, P., Natarajan, V., Bajpai, M., & Gupta, E. (2016). High seroprevalence of dengue virus infection in blood donors from Delhi: A single centre study. J Clin Diagn Res, 10, DC08 – DC10. https://doi.org/10.7860/JCDR/2016/21262.8711

Rohde, J. M., Dimcheff, D. E., & Blumberg, N., Saint, S., Langa, K. M., Kuhn, L., Hickner, A., Rogers, M. A. M. (2014). Healthcare-associated infection after red blood cell transfusion: A systematic review and meta-analysis. JAMA, 13, 1317 – 1326. https://doi.org/10.1001/jama.2014.2726

Rooks, K., Seed, C. R., & Fryk. J. J., Hyland, C. A., Harley, R. J., Holmbelg, J. A., Marks, D. C., Flower, R. L. P., & Faddy, H. M. (2016) Mitigating the risk of transfusion-transmitted dengue in Australia. J Blood Transfus., 3059848. https://doi.org/10.1155/2016/3059848

Rubens Costa Lima, J., Rouquayrol, M. Z., Monteiro Callado, M. R., Florindo Guedes, M. I., & Pessoa, C. (2012). Interpretation of the presence of IgM and IgG antibodies in a rapid test for dengue: analysis of dengue antibody prevalence in Fortaleza City in the 20th year of the epidemic. Rev Soc Bras Med Trop, 2, 63 – 67.

Sabino, E. C., Loureiro, P., Lopes, M. E., Capuani, L., McClure, C., Chowdhury, D., Di-Lorenzo- Oliveira, C., Oliveira, L. C., Linnen, J. M., Lee, T. H., Gonçalez, T., Brambilla, D., Kleinman, S., Busch, M. P., Custer, B., de Almeida Neto, C., Mendrone-Junior, A., Carneiro-Proietti, A. B., de Almeida Sampaio, D., … for the International Component of the NHLBI Recipient Epidemiology and Donor Evaluation Study-III (2015). Transfusion-transmitted dengue and associated clinical symptoms during the 2012 epidemic in Brazil. J Infect, 5, 694 –702. https://doi.org/10.1093/infdis/jiv326

Salpeter, S. R., Buckley, J. S., & Chatterjee, S. (2014). Impact of more restrictive blood transfusion strategies on clinical outcomes: A meta-analysis and systematic review. The American Journal of Medicine, 2, 124 – 131. https://doi.org/10.1016/j.amjmed.2013.09.017

Simmons, C. P., McPherson, K., Van Vinh Chau, N., & Hoai Tam, D. T., Young, P., Mackenzie, J., & Wills, B. (2015). Recent advances in dengue pathogenesis and clinical management. Vaccine, 50, 7061 – 7068. https://doi.org/10.1016/j.vaccine.2015.09.103

Stanaway, J. D., Shepard, D. S., Undurraga, E. A., Halasa, Y. A., Coffeng, L. E., Brady, O. J., Hay, S. I., Bedi, N., Bensenor, I. M., Castañeda-Orjuela, C. A., Chuang, T. W., Gibney, K. B., Memish, Z. A., Rafay, A., Ukwaja, K. N., Yonemoto N., & Murray, C. J. L. (2016). The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis, 16, 712 – 723. https://doi.org/10.1016/S1473-3099(16)00026-8

Stramer, S. L., Linnen, J. M., Carrick, J. M., Foster, G. A., Krysztof, D. E., Zou, S., Dodd, R. Y., Tirado- Marrero, L. M., Hunsperger, E., Santiago, G. A., Muñoz-Jordan, J. L., & Tomashek, K. M. (2012). Dengue viremia in blood donors identified by RNA and detection of dengue transfusion transmission during the 2007 dengue outbreak in Puerto Rico. Transfusion, 81, 657 – 666. https://doi.org/10.1111/j.1537-2995.2012.03566.x

Tambyah, P. A., Koay, E. S. C., Poon, M. L. M., Lin, R. V. T. P., & Ong, B. K. C. (2008). Transfusion-Transmitted Dengue Infection Study Group. Dengue hemorrhagic fever transmitted by blood transfusion. N Engl J Med, 14, 1526 – 1527. https://doi.org/10.1056/NEJMc0708673

Tangnararatchakit, K., Tirapanich, W., Tapaneya-Olarn, W., Sumethkul, V., Sirachainan, N., Watcharananan, S., Leenanupunth, C., Yoksan, S., & Chuansumrit, A. (2012). Severe nonfebrile dengue infection in an adolescent after postoperative kidney

transplantation: A case report. Transplant Proc, 44 (1), 303 – 306. https://doi.org/10.1016/j.transproceed.2011.11.025

Teo, D., Ng, L. C., & Lam, S. (2009). Is dengue a threat to the blood supply? Transfus Med, 19, 66 – 77. https://doi.org/10.1111/j.1365-3148.2009.00916.x

The Star Online. (2016). 50% rise in dengue deaths. https://www.thestar.com.my/news/nation/2016/01/06/50-rise-in-dengue-deaths-health-ministry-upward-trend-alsoobserved-in-other-countries/

Tiong, V., Abd-Jamil, J., Mohamed Zan, H. A., Abu-Bakar, R. S., Ew, C. L., Jafar, F. L., Nellis, S., Fauzi, R., & Abu Bakar, S. (2015). Evaluation of land cover and prevalence of dengue in Malaysia. Trop Biomed, 32 (4), 587 – 597.

Velasco-Salas, Z. I., Sierra, G. M., Guzmán, D. M., Zambrano, J., Vivas, D., Comach, G., Wilschut, J. C., & Tami, A. (2014). Dengue seroprevalence and risk factors for past and recent viral transmission in Venezuela: A comprehensive community-based study. Am J Trop Med Hyg, 91, 1039 – 1048. https://doi.org/10.4269/ajtmh.14-0127

Wartel, T. A., Prayitno, A., Hadinegoro, S. R. S., Capeding, M. R., Thisyakorn, U., Tran, N. H., Moureau, A., Bouckenooghe, A., Nealon, J., & Taurel, A. F.(2017). Three decades of dengue surveillance in five highly endemic Southeast Asian Countries. Asia Pac J Public Health, 1, 7 – 16. https://doi.org/10.1177/1010539516675701

WHO. (2010). Screening donated blood for transfusion-transmissible infections: recommendations. Geneva: World Health Organization. http://www.who.int/bloodsafety/ScreeningDonatedBloodforTransfusion.pdf

WHO. (2017). Global status report on blood safety and availability 2016. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/10665/254987/1/9789241565431-eng.pdf

Wilder-Smith, A., Chen, L. H., Massad, E., & Wilson, M. E. (2009). Threat of dengue to blood safety in dengue-endemic countries. Emerg Infect, 15, 8 – 11. https://doi.org/10.3201/eid1501.071097

Yew, Y. W., Ye, T., Ang, L. W., Ng, L. C., Yap, G., James, L., Chew, S. K., Goh, K. T. (2009). Seroepidemiology of dengue virus infection among adults in Singapore. Ann Acad Med Singapore, 8, 667 – 675. https://doi.org/10.47102/annals-acadmedsg.V38N8p667

Published

2023-12-22 — Updated on 2023-12-01

Versions

How to Cite

Zulina Mazlan, Vijay Kumar Subbiah, Saleh Mohammad Abdullah, Rosalinah Julian, Nadia Iryani Najri, Nadia Iryani Najri, Mimi Azreen Abdullah, Helen Benedict Lasimbang, & Mohammad Zahirul Hoque. (2023). Seroprevalence of Dengue Antibodies among Healthy Blood Donors from Sabah, Malaysian Borneo: Blood Safety in Dengue-Endemic Communities. Borneo International Journal of Biotechnology (BIJB), 3, 49–62. https://doi.org/10.51200/bijb.v3i.4243 (Original work published December 22, 2023)
Total Views: 228 | Total Downloads: 132