{
  "abstract": "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. Author summary: Dengue has long been regarded as a childhood disease, and prevention in endemic countries such as Thailand has centered on schools. Using two decades of national surveillance data (2005–2024) covering more than 1.6 million dengue cases, we show that the age of people affected by dengue in Thailand has shifted substantially upward. The average age of cases rose from about 17 to 26 years, and the share of cases in adults aged 25 years and older nearly doubled, from roughly one-fifth to more than one-third. This upward shift was seen in almost every province and region and, using a demographic decomposition method, was driven mainly by changing infection risk at each age (a declining “force of infection”) rather than by aging of the population itself. These findings indicate that dengue prevention, clinical vigilance and vaccination planning in Thailand and similar settings must expand beyond children to protect the growing number of affected adults, while continuing to safeguard children, who still bear the largest share of cases.",
  "abstract_shown": true,
  "affiliations": [
    "Khon Kaen University, Khon Kaen, Thailand",
    "Khon Kaen Provincial Public Health Office, Khon Kaen, Thailand",
    "Suratthani Rajabhat University, Surat Thani, Thailand"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
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        0
      ],
      "name": "Kittipong Sornlorm"
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    {
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        1
      ],
      "name": "Roshan Kumar Mahato"
    },
    {
      "affs": [
        2
      ],
      "name": "Sarayu Muntaphan"
    },
    {
      "name": "Kanit Hnuploy"
    },
    {
      "name": "Rajitra Nawawonganun"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/egv4y8jjkk3yz.bib",
  "cited_by": 1,
  "doi": "10.1371/journal.pntd.0014697",
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  "id": "egv4y8jjkk3yz",
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  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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  "native_subjects": [
    [
      "openalex",
      "2739|Mosquito-borne diseases and control"
    ],
    [
      "plos",
      "/Biology and life sciences/Population biology/Population metrics/Age distribution"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology"
    ],
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      "plos",
      "/Medicine and health sciences/Epidemiology/Disease surveillance/Infectious disease surveillance"
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      "/Medicine and health sciences/Epidemiology/Medical risk factors"
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    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Infectious disease control/Infectious disease surveillance"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/Dengue fever"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Tropical diseases/Neglected tropical diseases/Dengue fever"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Asia/Thailand"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups/Adults/Elderly"
    ]
  ],
  "openalex": "W7204829985",
  "pdf_url": "https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0014697&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-31",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/egv4y8jjkk3yz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:02Z",
      "native_id": "10.1371/journal.pntd.0014697",
      "source": "plos",
      "url": "https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014697"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
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    {
      "field": "medicine",
      "origin": "plos:infectious diseases",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Epidemiological shift in age distribution of dengue in Thailand, 2005–2024",
  "title_text": "Epidemiological shift in age distribution of dengue in Thailand, 2005–2024",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:02Z",
  "url": "https://research.draconitic.com/paper/egv4y8jjkk3yz",
  "venue": "PLOS Neglected Tropical Diseases",
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}