Epidemiological burden of dengue in Sri Lanka: A systematic review of literature from 2000-2020

Objectives: The objective of this systematic literature review (SLR) was to analyze changes in theepidemiological pattern of dengue in Sri Lanka from 2000 to 2020.

Methods: The review adhered to Cochrane Handbook and PRISMA guidelines, with data sourced from PubMed, Embase, Cochrane, and DARE. The search focused on English-language publications from 2000 to 2020, using keywords such as dengue epidemiology, incidence, serotype prevalence, and case fatality rates in Sri Lanka.

Results: A total of 149 publications (68 peer-reviewed and 81 grey literature sources) were included. Findings confirmed that dengue is endemic in Sri Lanka, with a marked increase in cases during major epidemics. The highest incidences were recorded in 2017 (186,101 cases) and 2019 (105,049 cases). Among the affected districts Colombo and Gampaha have the highest notification rates. The disease is reported year-round, with peaks during the monsoon seasons. From 2012 to 2019, the most affected age groups were 25-49-year-olds, followed by younger demographics. All four DENV serotypes cocirculated, with DENV-2 dominating since 2017. Case fatality rates ranged from 0.11% to 1.0%, peaking in 2009.

Conclusions: This review underscores the rising burden of dengue in Sri Lanka, highlighting the need for enhanced surveillance, prevention strategies, and potential vaccination to curb its spread.