Herpes simplex virus type 1 epidemiology in Africa: Systematic review, meta-analyses, and meta-regressions

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Abstract

Objective: To assess herpes simplex virus type 1 (HSV-1) epidemiology in Africa. Methods: This systematic review was conducted per the Cochrane Collaboration guidelines. Findings were reported following the PRISMA guidelines. Research questions were addressed using random-effects meta-analyses and meta-regressions. Results: Forty-three overall (and 69 stratified) HSV-1 seroprevalence measures, and 18 and eight proportions of HSV-1 viral detection in genital ulcer disease (GUD) and in genital herpes, respectively, were extracted from 37 reports. Pooled mean seroprevalence was 67.1% (95% confidence interval (CI): 54.7–78.5%) in children, and 96.2% (95% CI: 95.0–97.3%) in adults. Across age groups, pooled mean was 44.4% (95% CI: 29.9–59.3%) in ≤5 years-old, 85.6% (95% CI: 81.0–89.6%) in 6–15 years-old, 93.3% (95% CI: 89.2–96.6%) in 16–25 years-old, and 93.8% (95% CI: 84.6–99.4%) in >25 years-old. Age explained 78.8% of seroprevalence variation. Pooled mean proportion of HSV-1 detection was 0.4% (95% CI: 0.0–1.5%) in GUD, and 1.2% (95% CI: 0.0–4.0%) in genital herpes. Conclusions: HSV-1 is universally prevalent in Africa, at higher levels than other regions, with no evidence for declines in seroprevalence in recent decades. Nearly every person acquires the infection in childhood through oral-to-oral transmission, before sexual debut. Sexual oral-to-genital and genital-to-genital transmission appear very limited.

Original languageEnglish
Pages (from-to)289-299
Number of pages11
JournalJournal of Infection
Volume79
Issue number4
DOIs
Publication statusPublished - 1 Oct 2019

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Human Herpesvirus 1
Meta-Analysis
Epidemiology
Confidence Intervals
Seroepidemiologic Studies
Herpes Genitalis
Ulcer
Guidelines
Age Groups
Infection
Research

Keywords

  • Genital herpes
  • Genital ulcer disease
  • Region
  • Seroprevalence
  • Synthesis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{c6907087f6cc4dadb28f4e579a2e3d25,
title = "Herpes simplex virus type 1 epidemiology in Africa: Systematic review, meta-analyses, and meta-regressions",
abstract = "Objective: To assess herpes simplex virus type 1 (HSV-1) epidemiology in Africa. Methods: This systematic review was conducted per the Cochrane Collaboration guidelines. Findings were reported following the PRISMA guidelines. Research questions were addressed using random-effects meta-analyses and meta-regressions. Results: Forty-three overall (and 69 stratified) HSV-1 seroprevalence measures, and 18 and eight proportions of HSV-1 viral detection in genital ulcer disease (GUD) and in genital herpes, respectively, were extracted from 37 reports. Pooled mean seroprevalence was 67.1{\%} (95{\%} confidence interval (CI): 54.7–78.5{\%}) in children, and 96.2{\%} (95{\%} CI: 95.0–97.3{\%}) in adults. Across age groups, pooled mean was 44.4{\%} (95{\%} CI: 29.9–59.3{\%}) in ≤5 years-old, 85.6{\%} (95{\%} CI: 81.0–89.6{\%}) in 6–15 years-old, 93.3{\%} (95{\%} CI: 89.2–96.6{\%}) in 16–25 years-old, and 93.8{\%} (95{\%} CI: 84.6–99.4{\%}) in >25 years-old. Age explained 78.8{\%} of seroprevalence variation. Pooled mean proportion of HSV-1 detection was 0.4{\%} (95{\%} CI: 0.0–1.5{\%}) in GUD, and 1.2{\%} (95{\%} CI: 0.0–4.0{\%}) in genital herpes. Conclusions: HSV-1 is universally prevalent in Africa, at higher levels than other regions, with no evidence for declines in seroprevalence in recent decades. Nearly every person acquires the infection in childhood through oral-to-oral transmission, before sexual debut. Sexual oral-to-genital and genital-to-genital transmission appear very limited.",
keywords = "Genital herpes, Genital ulcer disease, Region, Seroprevalence, Synthesis",
author = "Harfouche Manale and Hiam Chemaitelly and Laith Aburaddad",
year = "2019",
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language = "English",
volume = "79",
pages = "289--299",
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TY - JOUR

T1 - Herpes simplex virus type 1 epidemiology in Africa

T2 - Systematic review, meta-analyses, and meta-regressions

AU - Manale, Harfouche

AU - Chemaitelly, Hiam

AU - Aburaddad, Laith

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Objective: To assess herpes simplex virus type 1 (HSV-1) epidemiology in Africa. Methods: This systematic review was conducted per the Cochrane Collaboration guidelines. Findings were reported following the PRISMA guidelines. Research questions were addressed using random-effects meta-analyses and meta-regressions. Results: Forty-three overall (and 69 stratified) HSV-1 seroprevalence measures, and 18 and eight proportions of HSV-1 viral detection in genital ulcer disease (GUD) and in genital herpes, respectively, were extracted from 37 reports. Pooled mean seroprevalence was 67.1% (95% confidence interval (CI): 54.7–78.5%) in children, and 96.2% (95% CI: 95.0–97.3%) in adults. Across age groups, pooled mean was 44.4% (95% CI: 29.9–59.3%) in ≤5 years-old, 85.6% (95% CI: 81.0–89.6%) in 6–15 years-old, 93.3% (95% CI: 89.2–96.6%) in 16–25 years-old, and 93.8% (95% CI: 84.6–99.4%) in >25 years-old. Age explained 78.8% of seroprevalence variation. Pooled mean proportion of HSV-1 detection was 0.4% (95% CI: 0.0–1.5%) in GUD, and 1.2% (95% CI: 0.0–4.0%) in genital herpes. Conclusions: HSV-1 is universally prevalent in Africa, at higher levels than other regions, with no evidence for declines in seroprevalence in recent decades. Nearly every person acquires the infection in childhood through oral-to-oral transmission, before sexual debut. Sexual oral-to-genital and genital-to-genital transmission appear very limited.

AB - Objective: To assess herpes simplex virus type 1 (HSV-1) epidemiology in Africa. Methods: This systematic review was conducted per the Cochrane Collaboration guidelines. Findings were reported following the PRISMA guidelines. Research questions were addressed using random-effects meta-analyses and meta-regressions. Results: Forty-three overall (and 69 stratified) HSV-1 seroprevalence measures, and 18 and eight proportions of HSV-1 viral detection in genital ulcer disease (GUD) and in genital herpes, respectively, were extracted from 37 reports. Pooled mean seroprevalence was 67.1% (95% confidence interval (CI): 54.7–78.5%) in children, and 96.2% (95% CI: 95.0–97.3%) in adults. Across age groups, pooled mean was 44.4% (95% CI: 29.9–59.3%) in ≤5 years-old, 85.6% (95% CI: 81.0–89.6%) in 6–15 years-old, 93.3% (95% CI: 89.2–96.6%) in 16–25 years-old, and 93.8% (95% CI: 84.6–99.4%) in >25 years-old. Age explained 78.8% of seroprevalence variation. Pooled mean proportion of HSV-1 detection was 0.4% (95% CI: 0.0–1.5%) in GUD, and 1.2% (95% CI: 0.0–4.0%) in genital herpes. Conclusions: HSV-1 is universally prevalent in Africa, at higher levels than other regions, with no evidence for declines in seroprevalence in recent decades. Nearly every person acquires the infection in childhood through oral-to-oral transmission, before sexual debut. Sexual oral-to-genital and genital-to-genital transmission appear very limited.

KW - Genital herpes

KW - Genital ulcer disease

KW - Region

KW - Seroprevalence

KW - Synthesis

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