Retrospective surveillance study reveals a shift in dengue burden toward adults in Thailand, highlighting the need to expand prevention programs beyond schools.
Dengue has historically been characterized as a childhood disease, but evidence of shifting age distribution is increasing. We analyzed 20 years (2005–2024) of national dengue surveillance data from Thailand comprising 1,639,442 cases to examine temporal trends in age-specific incidence, quantify age shift magnitude using the ratio of incidence rate ratios (RIRR), and decompose observed changes using Kitagawa decomposition. The proportion of cases among adults ≥25 years nearly doubled from 19.56% to 36.16%, while the children's proportion declined from 54.49% to 41.63%. RIRR for adults 25–44 years was 1.78 (95% CI 1.76-1.80), and for older adults ≥45 years was 2.19 (95% CI 2.15-2.24). Kitagawa decomposition attributed +178.7% of change to epidemiological factors and -78.7% to demographic shifts, supporting a declining force of infection rather than population aging as the primary driver. These findings necessitate expanding dengue prevention beyond school-based programs and enhancing clinical vigilance for adult dengue.
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Sornlorm et al. (2026) studied this question.
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