Epidemiology (2012-2019) and costs (2009-2019) of dengue in Malaysia: a systematic literature review

•Dengue epidemiology trends in Malaysia from 2012-2019.•Major dengue outbreaks occurred in 2015 and 2019.•All four dengue virus serotypes co-circulated, but dengue virus type 1 and dengue virus type 2 dominated.•There is a substantial societal impact on work and school days lost due to dengue.•Accurate reporting of dengue is challenging but crucial for assessing the burden. A systematic literature review was conducted to assess the epidemiology and economic burden of dengue in Malaysia. Embase, MEDLINE, Evidence-Based Reviews databases, and gray literature sources were searched for English and Malay studies and surveillance reports on the epidemiology (between 2012 and 2019) and costs (between 2009 and 2019) of dengue in Malaysia. Independent screening of titles/abstracts, followed by full texts was performed using prespecified criteria. A total of 198 publications were included (55 peer-reviewed and 143 gray literature). Dengue incidence has been increasing in recent years, with 130,101 cases (dengue fever 129,578 cases; dengue hemorrhagic fever 523 cases) reported in 2019, which is the highest since 2012. All dengue virus serotypes co-circulated between 2004 and 2017, and major outbreaks occurred in a cyclical pattern, often associated with a change in the predominant circulating serotype. Economic impacts are substantial, including the societal impact of lost work (7.2-8.8 days) and school days (3.2-4.1 days) due to dengue. The rising incidence and high cost of dengue, coupled with overlapping diseases, will likely result in further pressures on the healthcare system. To appropriately mitigate and control dengue, it is critical to implement integrated strategies, including vaccination, to reduce the burden of dengue.