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

Abstract

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.

Dengue and chikungunya seroprevalence among Qatari nationals and immigrants residing in Qatar

“…Our study is the first, to our knowledge, to estimate the seroprevalence of anti-DENV and anti-CHIKV IgG among nationals of Qatar and Syria [1, 2]. We cannot be certain that individuals from these countries developed antibodies as a result of DENV and CHIKV exposure in their home countries or Qatar rather than through traveling or residing in other endemic countries, or that these antibodies definitively represent prior exposure and not cross-reactions to other pathogens.…”

“…Sample sizes were calculated for a significance level of α = 0.05. A minimum sample size of 100 was estimated for each country based on a projected overall anti-DENV antibody seroprevalence of 25% with 9% precision and an anti-CHIKV antibody prevalence of 1% with 2% precision [1, 2]. However, up to 200 samples were analyzed per country based on sample availability in order to increase the precision of the estimates.…”

“…Age-specific seroprevalence for each virus was also cross-tabulated by region: Asia (India, Philippines), Middle East (Iran, Jordan, Lebanon, Pakistan, Palestine, Syria, Yemen), North Africa (Egypt, Sudan), and Qatar. Regions were defined according to the MENA definitions of the World Health Organization Regional Office for the Eastern Mediterranean (WHO/EMRO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Word Bank, and for consistency with our earlier dengue, chikungunya, and HIV regional publications [1, 2, 33–36]. Associations between nationality, age and seropositivity were summarized with odds ratios (ORs) and 95% CIs.…”

“…Although dengue (DENV) and chikungunya (CHIKV) viruses rank among the most important causes of arboviral diseases in the world, their epidemiology in the Middle East and North Africa (MENA) is sparsely characterized [1, 2]. Recent outbreaks of DENV and CHIKV have been documented in several MENA countries including Pakistan, Sudan, and Yemen, while in over half of MENA countries, no seroprevalence data has ever been published [1–8].…”

A a Influência Da Precipitação E Da Temperatura Sobre as Ocorrências De Febre Chikungunya No Município De Belém Do Pará, Brasil

“…A febre chikungunya (CHIKF) é uma doença viral com primeira epidemia documentada na Tanzânia, no continente africano, em 1952, com focos subsequentes identificados na África e na Ásia nos anos 1950 e 60 (JANSEN et al, 2015;PANDEY et al, 2015;WIMALA-SIRI-YAPA et al, 2019). Em 2004, um (HONÓRIO et al, 2015;GOULD et al, 2010;HUMPHREY et al, 2017;MAHAJAN;MAHAJAN, 2018;WIMALASIRI-YAPA et al, 2019).…”