Dengue virus infection in people residing in Africa: a systematic review and meta-analysis of prevalence studies

Fredy Brice N Simo,Marie S Ndangang,Jean Joel Bigna,Paul F Moundipa,Elvis Temfack,Sebastien Kenmoe,Maurice Demanou

doi:10.1038/s41598-019-50135-x

Abstract

Better knowledge of the face of the current dengue virus (DENV) epidemiology in Africa can help to implement efficient strategies to curb the burden of dengue fever. We conducted this systematic review and meta-analysis to determine the prevalence of DENV infection in Africa. We searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to June 10th, 2019 without any language restriction. We used a random-effects model to pool studies. A total of 76 studies (80,977 participants; 24 countries) were included. No study had high risk of bias. Twenty-two (29%) had moderate and 54 (71%) had low risk of bias. In apparently healthy individuals, the pooled prevalence of DENV was 15.6% (95% confidence interval 9.9–22.2), 3.5% (0.8–7.8), and 0.0% (0.0–0.5) respectively for immunoglobulins (Ig) G, IgM, and for ribonucleic acid (RNA) in apparently healthy populations. In populations presenting with fever, the prevalence was 24.8% (13.8–37.8), 10.8% (3.8–20.6k) and 8.4% (3.7–14.4) for IgG, IgM, and for RNA respectively. There was heterogeneity in the distribution between different regions of Africa. The prevalence of DENV infection is high in the African continent. Dengue fever therefore deserves more attention from healthcare workers, researchers, and health policy makers.

Highlights

The incidence of dengue fever has grown in the last decade worldwide
dengue virus (DENV) infection had to be diagnosed by the detection of the three biological markers of DENV including ribonucleic acid (RNA), Immunoglobulins (Ig) M, or G; among people residing in Africa
There were not enough studies to perform subgroup analysis for RNA prevalence among apparently healthy participants. This first systematic review with meta-analysis of the prevalence of DENV infection among people residing in Africa depicted a relatively high prevalence with substantial heterogeneity depending on clinical presentation, viral markers considered, and geographical distribution

Summary

Introduction

The incidence of dengue fever has grown in the last decade worldwide. According to the World Health Organization (WHO), 3.9 billion people in 128 countries are at risk of infection and about 390 million of dengue infection occur each year in people worldwide among which 96 million (25%) clinically manifest the disease[1]. Several other African countries including Burkina-Faso, Egypt, South Africa and Senegal, reported unconfirmed outbreaks of dengue fever in early 1900s. Humphrey and colleagues conducted for Middle East and North Africa have shown a median seroprevalence of dengue infection in general population of 25% (range from 0 to 62%) with most of the seroprevalence studies reported from Red Sea region of Pakistan[9]. A total of 22 countries in Africa reported sporadic cases or outbreaks of dengue fever[2], to date there is no study accurately investigating the epidemiology of DENV infection among febrile and apparently healthy populations in this continent. This review would help better characterize the epidemiology in the continent and build effective interventions to curb the burden of dengue fever in the continent

Methods

Results

Conclusion