Epidemic dengue 2 in the city of Djibouti 1991–1992

Kodier, Guénaël R.; Gubler, Duane J.; Cope, Stanton E.; Cropp, C B; Soliman, Atef K.; Polycarpe, D; Abdourhaman, Mohamed A.; Parra, Jean-Pierre; Maslin, J.; Arthur, Ray R.

doi:10.1016/s0035-9203(96)90228-x

Cited by 46 publications

(34 citation statements)

References 18 publications

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“…Viral neutralization tests, considered the gold standard serologic assay for DENV, were performed in only 5% of general population seroprevalence studies in our review. Compared to ELISAs, seroprevalence measures were 22–86% lower by secondary/confirmatory testing with immunofluorescence or VNT in our review [14, 36, 37, 113]. This illustrates the potential uncertainty surrounding the reliability of ELISAs in DENV serologic studies, particularly in areas where the prevalence of antigenically similar viruses is broad or unknown.…”

Section: Discussionmentioning

confidence: 84%

“…Inter-regional migration poses risk for imported DENV, as millions of migrants travel from DENV-endemic countries to the Arabian Peninsula [111, 126, 146–149] and to Mecca, Saudi Arabia to attend Umra and Hajj [126]. Intra-regionally, heavy commerce in the Red Sea region likely drives DENV serotype mixing and spread [116, 148], as evidenced by multiple DENV outbreaks occurring at port cities in Djibouti [37, 45], Saudi Arabia [126], Sudan [39], and Yemen [116, 148]. Contiguous spread of DENV from Yemen to Oman [150], or from Pakistan to Iran or Afghanistan [14], may also pose risk.…”

Section: Discussionmentioning

confidence: 99%

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Dengue in the Middle East and North Africa: A Systematic Review

et al. 2016

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BackgroundDengue virus (DENV) infection is widespread and its disease burden has increased in past decades. However, little is known about the epidemiology of dengue in the Middle East and North Africa (MENA).Methodology / Principal FindingsFollowing Cochrane Collaboration guidelines and reporting our findings following PRISMA guidelines, we systematically reviewed available records across MENA describing dengue occurrence in humans (prevalence studies, incidence studies, and outbreak reports), occurrence of suitable vectors (Aedes aegypti and Aedes albopictus), and DENV vector infection rates. We identified 105 human prevalence measures in 13 of 24 MENA countries; 81 outbreaks reported from 9 countries from 1941–2015; and reports of Ae. aegypti and/or Ae. albopictus occurrence in 15 countries. The majority of seroprevalence studies were reported from the Red Sea region and Pakistan, with multiple studies indicating >20% DENV seroprevalence in general populations (median 25%, range 0–62%) in these subregions. Fifty percent of these studies were conducted prior to 1990. Multiple studies utilized assays susceptible to serologic cross-reactions and 5% of seroprevalence studies utilized viral neutralization testing. There was considerable heterogeneity in study design and outbreak reporting, as well as variability in subregional study coverage, study populations, and laboratory methods used for diagnosis.Conclusions / SignificanceDENV seroprevalence in the MENA is high among some populations in the Red Sea region and Pakistan, while recent outbreaks in these subregions suggest increasing incidence of DENV which may be driven by a variety of ecologic and social factors. However, there is insufficient study coverage to draw conclusions about Aedes or DENV presence in multiple MENA countries. These findings illustrate the epidemiology of DENV in the MENA while revealing priorities for DENV surveillance and Aedes control.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Dengue in the Middle East and North Africa: A Systematic Review

et al. 2016

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“…A CHIKV outbreak was reported in Djibouti City [31] the same year of the Yemen outbreak, and the following year, autochthonous transmission of CHIKV was noted in Saudi Arabia [53]. Similar transmission patterns have been cited as risk for DENV infection spread in the Red Sea sub-region [10, 12, 27, 66, 67]. High rainfall in Al Hudaydah months prior to the outbreak may have also amplified the Aedes population to a level capable of sustaining an outbreak.…”

Section: Discussionmentioning

confidence: 92%

Urban Chikungunya in the Middle East and North Africa: A systematic review

et al. 2017

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BackgroundThe epidemiology of Chikungunya virus (CHIKV) in the Middle East and North Africa (MENA) is not well characterized despite increasing recognition of its expanding infection and disease burden in recent years.Methodology / Principal findingsFollowing Cochrane Collaboration guidelines and reporting our findings following PRISMA guidelines, we systematically reviewed records describing the human prevalence and incidence, CHIKV prevalence/infection rates in vectors, outbreaks, and reported cases for CHIKV across the MENA region. We identified 29 human seroprevalence measures, one human incidence study, one study reporting CHIKV infection rates in Aedes, and nine outbreaks and case reports/series reported in the MENA from 1970–2015. Overall, anti-CHIKV antibody or reports of autochthonous transmission were identified from 10 of 23 countries in the MENA region (Djibouti, Egypt, Iraq, Iran, Kuwait, Pakistan, Saudi Arabia, Somalia, Sudan, and Yemen), with seroprevalence measures among general populations (median 1.0%, range 0–43%) and acute febrile illness populations (median 9.8%, range 0–30%). Sudan reported the highest number of studies (n = 11) and the highest seroprevalence among general populations (median 12%, range 0–43%) and undifferentiated acute febrile illness populations (median 18%, range 10–23%). CHIKV outbreaks were reported from Djibouti, Pakistan, Sudan, and Yemen.Conclusions / SignificanceSeroprevalence studies and outbreak reports suggest endemic transmission of urban cycle CHIKV in at least the Red Sea region and Pakistan. However, indications of seroprevalence despite a low quantity of CHIKV epidemiologic research from the region suggests that CHIKV transmission is currently underrecognized.

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“…Since then, however, major epidemics caused by all four serotypes have occurred in both East and West Africa (41,48). Outbreaks have been more common in East Africa and the Middle East in the 1990s, with major epidemics in Djibouti in 1991 and in Jeddah, Saudi Arabia, in 1994; both were the first outbreaks in those countries in over 50 years (41,120).…”

Section: Emergence Of Dengue As a Global Public Health Problemmentioning

confidence: 99%