Department of Virology, Reference Laboratory for Chikungunya and Dengue Viruses, Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon; Department of Biochemistry, Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon.
Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Member of the International Network of Pasteur Institutes, 451 Street 2005, P.O. Box 1274, Yaoundé, Cameroon; School of Public Health, Faculty of Medicine, University of Paris Sud, 63 Rue Gabriel Péri, 94270, Le Kremlin-Bicêtre, France.
Public Health. 2019 Jan;166:79-88. doi: 10.1016/j.puhe.2018.09.027. Epub 2018 Nov 21.
The (re)emergence of chikungunya virus (CHIKV) in Africa requires better knowledge on the epidemiology of CHIKV infection in the continent for efficient public health strategies. We aimed to describe the epidemiology of CHIKV infection in Africa, a neglected tropical disease (NTD).
This was a systematic review with meta-analysis of studies reporting CHIKV infection prevalence. We searched Embase, PubMed, Africa Journal Online and Global Index Medicus to identify observational studies published from January 2000 to September 2017.
We used a random-effect model to pool the prevalence of CHIKV infections reported with their 95% confidence interval (CI). Heterogeneity was assessed via the Chi-squared test on Cochran's Q statistic. Review registration is in PROSPERO CRD42017080395.
A total of 39 studies (37,881 participants; 18 countries) were included. No study was reported from Southern Africa. Thirty-two (82.0%), seven (18.0%) and no studies had low, moderate and high risk of bias, respectively. Outside outbreak periods, the pooled immunoglobulin M (IgM) and immunoglobulin G (IgG) seroprevalence was 9.7% (95% CI 3.0-19.6; 16 studies) and 16.4% (95% CI 9.1-25.2; 23 studies), respectively. The IgM seroprevalence was lower in Northern Africa, and there was no difference for IgG prevalence across regions in Africa. The IgM and IgG seroprevalences were not different between acute and non-acute febrile participants. The seroprevalence was not associated with GPS coordinates (latitude, longitude and altitude).
Although considered a NTD, we find high prevalence of CHIKV infection in Africa. As such, chikungunya fever should deserve more attention from healthcare providers, researchers, policymakers and stakeholders from many sectors.
基孔肯雅热病毒（CHIKV）在非洲的再次出现，需要更好地了解该大陆 CHIKV 感染的流行病学情况，以制定有效的公共卫生策略。我们旨在描述非洲基孔肯雅热（一种被忽视的热带病）的 CHIKV 感染流行病学情况。
这是一项对报告 CHIKV 感染流行率的研究进行系统回顾和荟萃分析。我们检索了 Embase、PubMed、Africa Journal Online 和 Global Index Medicus，以确定 2000 年 1 月至 2017 年 9 月期间发表的观察性研究。
我们使用随机效应模型汇总报告的 CHIKV 感染流行率及其 95%置信区间（CI）。通过 Cochran's Q 统计量的 Chi-squared 检验评估异质性。审查登记在 PROSPERO CRD42017080395。
共纳入 39 项研究（37881 名参与者；18 个国家）。没有来自南部非洲的研究报告。分别有 32 项（82.0%）、7 项（18.0%）和无研究存在低、中、高偏倚风险。在疫情暴发期之外，免疫球蛋白 M（IgM）和免疫球蛋白 G（IgG）的血清流行率分别为 9.7%（95%CI 3.0-19.6；16 项研究）和 16.4%（95%CI 9.1-25.2；23 项研究）。北部非洲的 IgM 血清流行率较低，而非洲各地区的 IgG 流行率没有差异。急性和非急性发热参与者的 IgM 和 IgG 血清流行率无差异。血清流行率与 GPS 坐标（纬度、经度和海拔）无关。
尽管基孔肯雅热被认为是一种被忽视的热带病，但我们发现非洲的 CHIKV 感染率很高。因此，基孔肯雅热应该引起医疗保健提供者、研究人员、政策制定者和来自多个部门的利益相关者的更多关注。
