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

John M. Humphrey, Natalie B. Cleton, Chantal B.E.M. Reusken, Marshall J. Glesby, Marion P.G. Koopmans, Laith Aburaddad

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Dengue 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 Findings: Following 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 / Significance: DENV 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.

Original languageEnglish
Article numbere0005194
JournalPLoS Neglected Tropical Diseases
Volume10
Issue number12
DOIs
Publication statusPublished - 7 Dec 2016
Externally publishedYes

Fingerprint

Northern Africa
Eastern Africa
Dengue Virus
Middle East
Dengue
Aedes
Seroepidemiologic Studies
Disease Outbreaks
Indian Ocean
Pakistan
Virus Diseases
Epidemiology
Guidelines
Population
Cross Reactions
Cohort Studies
Cross-Sectional Studies
Incidence

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Humphrey, J. M., Cleton, N. B., Reusken, C. B. E. M., Glesby, M. J., Koopmans, M. P. G., & Aburaddad, L. (2016). Dengue in the Middle East and North Africa: A Systematic Review. PLoS Neglected Tropical Diseases, 10(12), [e0005194]. https://doi.org/10.1371/journal.pntd.0005194

Dengue in the Middle East and North Africa : A Systematic Review. / Humphrey, John M.; Cleton, Natalie B.; Reusken, Chantal B.E.M.; Glesby, Marshall J.; Koopmans, Marion P.G.; Aburaddad, Laith.

In: PLoS Neglected Tropical Diseases, Vol. 10, No. 12, e0005194, 07.12.2016.

Research output: Contribution to journalArticle

Humphrey, JM, Cleton, NB, Reusken, CBEM, Glesby, MJ, Koopmans, MPG & Aburaddad, L 2016, 'Dengue in the Middle East and North Africa: A Systematic Review', PLoS Neglected Tropical Diseases, vol. 10, no. 12, e0005194. https://doi.org/10.1371/journal.pntd.0005194
Humphrey, John M. ; Cleton, Natalie B. ; Reusken, Chantal B.E.M. ; Glesby, Marshall J. ; Koopmans, Marion P.G. ; Aburaddad, Laith. / Dengue in the Middle East and North Africa : A Systematic Review. In: PLoS Neglected Tropical Diseases. 2016 ; Vol. 10, No. 12.
@article{8ae45333e3a6492bb508263a46c0e9a1,
title = "Dengue in the Middle East and North Africa: A Systematic Review",
abstract = "Background: Dengue 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 Findings: Following 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 / Significance: DENV 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.",
author = "Humphrey, {John M.} and Cleton, {Natalie B.} and Reusken, {Chantal B.E.M.} and Glesby, {Marshall J.} and Koopmans, {Marion P.G.} and Laith Aburaddad",
year = "2016",
month = "12",
day = "7",
doi = "10.1371/journal.pntd.0005194",
language = "English",
volume = "10",
journal = "PLoS Neglected Tropical Diseases",
issn = "1935-2727",
publisher = "Public Library of Science",
number = "12",

}

TY - JOUR

T1 - Dengue in the Middle East and North Africa

T2 - A Systematic Review

AU - Humphrey, John M.

AU - Cleton, Natalie B.

AU - Reusken, Chantal B.E.M.

AU - Glesby, Marshall J.

AU - Koopmans, Marion P.G.

AU - Aburaddad, Laith

PY - 2016/12/7

Y1 - 2016/12/7

N2 - Background: Dengue 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 Findings: Following 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 / Significance: DENV 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.

AB - Background: Dengue 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 Findings: Following 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 / Significance: DENV 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.

UR - http://www.scopus.com/inward/record.url?scp=85008627558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008627558&partnerID=8YFLogxK

U2 - 10.1371/journal.pntd.0005194

DO - 10.1371/journal.pntd.0005194

M3 - Article

C2 - 27926925

AN - SCOPUS:85008627558

VL - 10

JO - PLoS Neglected Tropical Diseases

JF - PLoS Neglected Tropical Diseases

SN - 1935-2727

IS - 12

M1 - e0005194

ER -