The Immunogenicity and Safety of the Live-Attenuated CYD- Tetravalent Dengue Vaccine( CYD-TDV) in Children and Adolescents: A Systematic Review of Randomized Controlled Trials
Raksheeth Agarwal a, Oliver Emmanuel b, Sharon Hanmy Angel c, Angga Wiratama d
a) Universitas Indonesia –(+ 62) 85777808310, raksheeth @ hotmail. com
b) Universitas Indonesia –(+ 62) 818635925, oliveremmanuel @ hotmail. com
c) Universitas Indonesia –(+ 62) 81362873803, sharonhanmyangel @ gmail. com d) Universitas Indonesia –(+ 62) 81291004704, lokeswaraangga @ gmail. com
1. Introduction
Dengue disease is caused by one of the four serotypes of dengue virus, namely DENV-1, DENV-2, DENV-3, and DENV-4. The transmission of the four serotypes is arthropodborne, with the main vector being the mosquito Aedes aegypti. Most of the infections of dengue virus are asymptomatic, but infections can also cause diseases ranging from a mild fever to a shock syndrome, which can be lethal. Even though infection with one serotype provides immunity against it for life, disease can subsequently be caused
again by other serotypes in later life. 1
In recent decades, the incidence of dengue has increased dramatically across the world. An epidemiological study estimates that 3.9 billion people from 128 countries are at risk
of infection with dengue viruses. 2 One recent estimate reports that there are 390 million dengue infections per year, of which 96 million cases progressed to manifest
clinically. 3
Indonesia experiences a high burden of disease from dengue virus, and is considered an endemic region. The National Health Ministry reports that in 2015, the incidence of dengue disease amount to 126,675, with 1229 deaths in Indonesia. This is a drastic
increase from 100,347 cases with 907 deaths reported in 2014. 4
In January and February of 2016, Extraordinary Outbreak Events( Kejadian Luar Biasa; KLB) occurred in 12 regencies in Indonesia. 5 This outbreak resulted in 492 cases and 25
deaths in January 2016, while in February 2016 there were 116 cases with 9 deaths. 5 The term Extraordinary Outbreak Events refers to the outbreak of a disease based on the following criteria: The number of new cases of dengue in a particular month shows an increase of two-fold or more than the average number per month in the previous year; The incidence of dengue cases in an area that had never occurred; or The mortality rate of dengue in a specified period showed an increase of 50 % or more compared to the
previous period. 5