Evaluation of land cover and prevalence of dengue in Malaysia.

Serological confirmation of dengue in 1,410 school-going children aged 7-18 years provided prevalence data for 16 different sites in Malaysia. These sites ranged from highly urbanized cities to small towns. We found that at least ~7 % of children in the study group had been exposed to dengue by age 12 and ~16% by age 18. Here we report that the dengue seroprevalence correlates with i) increasing land development and decreased vegetation, and ii) the overall population growth. Water bodies did not significantly affect dengue prevalence. High prevalence of dengue was also recorded in few of the non-urban sites suggesting the expanding geographical locality of those who get dengue in Malaysia in tandem with increased land usage activities. These findings highlight the need to give closer consideration to future urban planning and development, taking into consideration the changing demography and the importance of built environment to mitigate the increasing incidence of dengue in the non-urban areas of Malaysia.