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International Journal of Infectious... Feb 2018Epidemiologic evidence suggests that patients with chikungunya virus (CHIKV) infection may be at risk of severe disease complications when they also have comorbidities... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Epidemiologic evidence suggests that patients with chikungunya virus (CHIKV) infection may be at risk of severe disease complications when they also have comorbidities such as obesity, diabetes, cardiac diseases, and/or asthma. However, the prevalence of these co-existing medical conditions in severe CHIKV cases has not been systematically reported.
OBJECTIVE
The aim of the present study is to conduct a systematic review and meta-analysis to describe the prevalence of chronic comorbidities in CHIKV and evaluate their possible contributions to disease severity.
METHODS
A search strategy was developed for online databases. Search terms used were "Chikungunya" AND "Diabetes, Hypertension, Stroke, Cardiovascular Diseases, Coronary Artery Diseases, Obesity, OR Asthma". Only 11 articles documenting the frequency of comorbidities in CHIKV were included. Meta-analyses were conducted to evaluate the overall prevalence of comorbidities in the CHIKV infection and stratify the estimates by severity.
RESULTS
Among 2,773 CHIKV patients, hypertension was the most prevalent comorbidity (31.3%; 95%CI: 17.9-48.8%) followed by diabetes (20.5%; 95%CI: 12.7-31.3%), cardiac diseases (14.8%; 95%CI: 8.1-25.5%) and asthma (7.9%; 95%CI: 3.3-17.7). There was 4- to 5-fold significant increased prevalence of diabetes, hypertension and cardiac diseases in CHIKV patients over 50 years of age compared to their younger counterparts. Severe CHIKV cases had a significantly higher proportion of diabetes than non-severe cases (p<0.05). CHIKV patients with diabetes had OR of 1.2 (95%CI: 1.05-1.48; p=0.0135) for developing severe infection outcome compared to those with no diabetes.
CONCLUSION
Hypertension, diabetes and cardiac diseases may contribute to the severe outcome of CHIKV. Diabetic subjects may be at higher risk of severe infection. These findings may be relevant in developing public health measures and practices targeting CHIKV patients with comorbidities to avert the severe outcome of the infectious disease.
Topics: Cardiovascular Diseases; Chikungunya Fever; Chikungunya virus; Chronic Disease; Comorbidity; Diabetes Mellitus; Humans; Hypertension; Obesity; Prevalence
PubMed: 29277382
DOI: 10.1016/j.ijid.2017.12.018 -
PLoS Neglected Tropical Diseases Jun 2018Chikungunya virus (CHIKV) is an emerging arboviral infection with a global distribution and may cause fetal and neonatal infections after maternal CHIKV-infections... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chikungunya virus (CHIKV) is an emerging arboviral infection with a global distribution and may cause fetal and neonatal infections after maternal CHIKV-infections during gestation.
METHODOLOGY
We performed a systematic review to evaluate the risk for: a) mother-to-child transmission (MTCT), b) antepartum fetal deaths (APFD), c) symptomatic neonatal disease, and d) neonatal deaths from maternal CHIKV-infections during gestation. We also recorded the neonatal clinical manifestations after such maternal infections (qualitative data synthesis). We searched PubMed (last search 3/2017) for articles, of any study design, with any of the above outcomes. We calculated the overall risk of MTCT, APFDs and risk of symptomatic neonatal disease by simple pooling. For endpoints with ≥5 events in more than one study, we also synthesized the data by random-effect-model (REM) meta-analysis.
PRINCIPAL FINDINGS
Among 563 identified articles, 13 articles from 8 cohorts were included in the quantitative data synthesis and 33 articles in the qualitative data synthesis. Most cohorts reported data only on symptomatic rather than on all neonatal infections. By extrapolation also of these data, the overall pooled-MTCT-risk across cohorts was at least 15.5% (206/1331), (12.6% by REMs). The pooled APFD-risk was 1.7% (20/1203); while the risk of CHIKV-confirmed-APFDs was 0.3% (3/1203). Overall, the pooled-risk of symptomatic neonatal disease was 15.3% (203/1331), (11.9% by REMs). The pooled risk of symptomatic disease was 50.0% (23/46) among intrapartum vs 0% (0/712) among antepartum/peripartum maternal infections. Infected newborns, from maternal infections during gestation were either asymptomatic or presented within their first week of life, but not at birth, with fever, irritability, hyperalgesia, diffuse limb edema, rashes and occasionally sepsis-like illness and meningoencephalitis. The pooled-risk of neonatal death was 0.6% (5/832) among maternal infections and 2.8% (5/182) among neonatal infections; long-term neurodevelopmental delays occurred in 50% of symptomatic neonatal infections.
CONCLUSIONS/SIGNIFICANCE
Published cohorts with data on the risk to the fetus and/or newborn from maternal CHIKV-infections during gestation were sparse compared to the number of recently reported CHIKV-infection outbreaks worldwide; however perinatal infections do occur, at high rates during intrapartum period, and can be related to neonatal death and long-term disabilities.
Topics: Chikungunya Fever; Chikungunya virus; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious
PubMed: 29897898
DOI: 10.1371/journal.pntd.0006510 -
Immunological Investigations Jan 2021: Chikungunya virus (CHIKV) is a global concern, inducing chikungunya fever and trigging an arthritogenic chronic phase beyond some severe forms. Outcomes of CHIKV... (Meta-Analysis)
Meta-Analysis
: Chikungunya virus (CHIKV) is a global concern, inducing chikungunya fever and trigging an arthritogenic chronic phase beyond some severe forms. Outcomes of CHIKV infections in humans are dependent on genetic variations. Here, a systematic review was performed to show evidence of genetic variations on infection outcomes of patients. : Searches were performed in Scopus, SciELO, MEDLINE/PubMed, Web of Science, OneFile (GALE), Periódicos CAPES and ScienceDirect Journals databases. The PICOS approach was used to assess the eligibility of records. A meta-analysis was also conducted to show an association between described alleles/genes and CHIKV infection outcome. : Reviews of genetic variants were conducted on genes: and . Studies were performed on Gabon, Singapore, and India, including Indians, Malay, Gabonese and Chinese ethnicities and published between 2009-2017. The meta-analysis was performed with *01; *03; *04; *07; *10; *11; *13; *14 and *15 and *02; *03; *05 and *06 alleles with Indian population sample. Sampling power was >80% and a significant positive association between *14 and CHIKV infection was found (OR = 1.67, 95% CI = 1.04-2.67; = .03). : Majority of the studies were conducted in India. Meta-analysis suggests that *14 is related to the susceptibility of symptomatic CHIKV infection in Indian population. The literature about CHIKV infection and genetic variations is scarce. The precise role of genetic variation in CHIKV is not clear yet. Further studies are necessary to provide more concrete evidences.
Topics: Alleles; Chikungunya Fever; Chikungunya virus; Disease Susceptibility; Genetic Predisposition to Disease; Histocompatibility Antigens Class II; Host-Pathogen Interactions; Humans; Odds Ratio; Patient Outcome Assessment; Polymorphism, Genetic; Prognosis
PubMed: 32204641
DOI: 10.1080/08820139.2020.1733011 -
PLoS Neglected Tropical Diseases Feb 2018Arbovirus infections are a serious concern in tropical countries due to their high levels of transmission and morbidity. With the outbreaks of chikungunya (CHIKV) in... (Review)
Review
Evidence of previous but not current transmission of chikungunya virus in southern and central Vietnam: Results from a systematic review and a seroprevalence study in four locations.
BACKGROUND
Arbovirus infections are a serious concern in tropical countries due to their high levels of transmission and morbidity. With the outbreaks of chikungunya (CHIKV) in surrounding regions in recent years and the fact that the environment in Vietnam is suitable for the vectors of CHIKV, the possibility of transmission of CHIKV in Vietnam is of great interest. However, information about CHIKV activity in Vietnam remains limited.
METHODOLOGY
In order to address this question, we performed a systematic review of CHIKV in Vietnam and a CHIKV seroprevalence survey. The seroprevalence survey tested for CHIKV IgG in population serum samples from individuals of all ages in 2015 from four locations in Vietnam.
PRINCIPAL FINDINGS
The four locations were An Giang province (n = 137), Ho Chi Minh City (n = 136), Dak Lak province (n = 137), and Hue City (n = 136). The findings give us evidence of some CHIKV activity: 73/546 of overall samples were seropositive (13.4%). The age-adjusted seroprevalences were 12.30% (6.58-18.02), 13.42% (7.16-19.68), 7.97% (3.56-12.38), and 3.72% (1.75-5.69) in An Giang province, Ho Chi Minh City, Dak Lak province, and Hue City respectively. However, the age-stratified seroprevalence suggests that the last transmission ended around 30 years ago, consistent with results from the systematic review. We see no evidence for on-going transmission in three of the locations, though with some evidence of recent exposure in Dak Lak, most likely due to transmission in neighbouring countries. Before the 1980s, when transmission was occurring, we estimate on average 2-4% of the population were infected each year in HCMC and An Giang and Hue (though transmision ended earlier in Hue). We estimate lower transmission in Dak Lak, with around 1% of the population infected each year.
CONCLUSION
In conclusion, we find evidence of past CHIKV transmission in central and southern Vietnam, but no evidence of recent sustained transmission. When transmission of CHIKV did occur, it appeared to be widespread and affect a geographically diverse population. The estimated susceptibility of the population to chikungunya is continually increasing, therefore the possibility of future CHIKV transmission in Vietnam remains.
Topics: Adolescent; Adult; Aged; Antibodies, Viral; Chikungunya Fever; Chikungunya virus; Child; Child, Preschool; Disease Outbreaks; Female; Geography; Humans; Infant; Male; Middle Aged; Seroepidemiologic Studies; Vietnam; Young Adult
PubMed: 29425199
DOI: 10.1371/journal.pntd.0006246 -
Le Infezioni in Medicina 2024Dengue is a vector-borne disease, especially important in tropical and subtropical areas. The first presentation of many arboviral diseases occurred mainly in animals,... (Review)
Review
INTRODUCTION
Dengue is a vector-borne disease, especially important in tropical and subtropical areas. The first presentation of many arboviral diseases occurred mainly in animals, including multiple and , such as dengue.
OBJECTIVE
To determine the serological and molecular frequency of the dengue virus in animals.
METHODS
A systematic literature review was carried out in five databases for the proportion of animals infected with dengue, defined by molecular and serological tests. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% confidence intervals (CI). Cochran?s Q test and the I2 statistic were used to assess the heterogeneity between the two studies.
RESULTS
The presence of dengue in bats, primates, birds, sheep, horses, cattle, pigs, rodents and buffaloes, according to serological methods, had a prevalence of 10%, 29%, 8%, 1%, 11%, 0%, 49%, 2%, 7%, respectively. According to molecular methods, the presence of dengue in bats had a seroprevalence of 6.0%.
CONCLUSION
The present study confirms the presence of the Dengue virus in a large group of animal species, with potential implications as possible reservoirs of this virus, raising the possibility of zoonotic transmission.
PubMed: 38827825
DOI: 10.53854/liim-3202-7 -
PLoS Neglected Tropical Diseases Jun 2017The epidemiology of Chikungunya virus (CHIKV) in the Middle East and North Africa (MENA) is not well characterized despite increasing recognition of its expanding... (Review)
Review
BACKGROUND
The 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 FINDINGS
Following 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 / SIGNIFICANCE
Seroprevalence 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.
Topics: Aedes; Africa, Northern; Animals; Chikungunya Fever; Chikungunya virus; Disease Outbreaks; Disease Transmission, Infectious; Endemic Diseases; Humans; Incidence; Middle East; Seroepidemiologic Studies; Urban Population
PubMed: 28651007
DOI: 10.1371/journal.pntd.0005707 -
PLoS Neglected Tropical Diseases Mar 2021Throughout the last decade, chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have spread globally, causing a spectrum of disease that ranges from self-limited...
Throughout the last decade, chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have spread globally, causing a spectrum of disease that ranges from self-limited febrile illness to permanent severe disability, congenital anomalies, and early death. Nevertheless, estimates of their aggregate health impact are absent from the literature and are currently omitted from the Global Burden of Disease (GBD) reports. We systematically reviewed published literature and surveillance records to evaluate the global burden caused by CHIKV and ZIKV between 2010 and 2019, to calculate estimates of their disability-adjusted life year (DALY) impact. Extracted data on acute, chronic, and perinatal outcomes were used to create annualized DALY estimates, following techniques outlined in the GBD framework. This study is registered with PROSPERO (CRD42020192502). Of 7,877 studies identified, 916 were screened in detail, and 21 were selected for inclusion. Available data indicate that CHIKV and ZIKV caused the average yearly loss of over 106,000 and 44,000 DALYs, respectively, between 2010 and 2019. Both viruses caused substantially more burden in the Americas than in any other World Health Organization (WHO) region. This unequal distribution is likely due to a combination of limited active surveillance reporting in other regions and the lack of immunity that left the previously unexposed populations of the Americas susceptible to severe outbreaks during the last decade. Long-term rheumatic sequelae provided the largest DALY component for CHIKV, whereas congenital Zika syndrome (CZS) contributed most significantly for ZIKV. Acute symptoms and early mortality accounted for relatively less of the overall burden. Suboptimal reporting and inconsistent diagnostics limit precision when determining arbovirus incidence and frequency of complications. Despite these limitations, it is clear from our assessment that CHIKV and ZIKV represent a significant cause of morbidity that is not included in current disease burden reports. These results suggest that transmission-blocking strategies, including vector control and vaccine development, remain crucial priorities in reducing global disease burden through prevention of potentially devastating arboviral outbreaks.
Topics: Americas; Chikungunya Fever; Chikungunya virus; Cost of Illness; Disease Outbreaks; Female; Global Burden of Disease; Humans; Incidence; Pregnancy; Treatment Outcome; Vector Borne Diseases; Zika Virus; Zika Virus Infection
PubMed: 33661908
DOI: 10.1371/journal.pntd.0009055 -
Arthritis Care & Research Dec 2016To determine the percentage of patients who would develop chronic inflammatory rheumatism (CIR) following chikungunya (CHIK) virus disease. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine the percentage of patients who would develop chronic inflammatory rheumatism (CIR) following chikungunya (CHIK) virus disease.
METHODS
We conducted a systematic review of the literature in 3 databases (PubMed, Science Citation Index, and Scopus) to identify studies assessing the proportion of patients who progress to CHIK-CIR. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence intervals (95% CIs). A 2-tailed alpha level of 5% was used for hypothesis testing. Measures of heterogeneity, including Cochran's Q statistic, the I index, and the tau-squared test, were calculated and reported. Subgroup analyses were conducted by type of study and country, by studies evaluating chronic arthritis, and by studies with ≥200 patients and followup ≥18 months. Publication bias was assessed using a funnel-plot.
RESULTS
Up to June 15, 2015, our literature search yielded 578 citations. The pooled prevalence of CHIK-CIR in 18 selected studies among 5,702 patients was 40.22% (95% CI 31.11-49.34; τ = 0.0838). From studies derived from India, prevalence was 27.27% (95% CI 15.66-38.88; τ = 0.0411), while from France, prevalence was 50.25% (95% CI 25.38-75.12; τ = 0.1797). The prevalence of CHIK chronic arthritis was 13.66% (95% CI 9.31-18.00; τ = 0.0060). Considering just those studies with ≥200 patients assessed, prevalence was 34.14% (95% CI 23.99-44.29; τ = 0.0525). In studies with a followup ≥18 months, prevalence was 32.13% (95% CI 22.21-42.04; τ = 0.0453).
CONCLUSION
According to our results in the most conservative scenario, approximately 25% of CHIK cases would develop CHIK-CIR (34% if we just consider the most representative studies), and 14% would develop chronic arthritis.
Topics: Adult; Arthritis, Reactive; Chikungunya Fever; Chikungunya virus; Female; France; Humans; India; Male; Middle Aged; Prevalence
PubMed: 27015439
DOI: 10.1002/acr.22900 -
Acta Tropica May 2023Chikungunya fever is a disease caused by the Chikungunya virus (CHIKV), which is transmitted through the bite of infected female hematophagous mosquitoes of the genus... (Review)
Review
Chikungunya fever is a disease caused by the Chikungunya virus (CHIKV), which is transmitted through the bite of infected female hematophagous mosquitoes of the genus Aedes (Diptera: Culicidae). In the Americas, the first autochthonous cases of the disease were recorded in 2013. A year later, in 2014, the first records of the disease were acquired locally in Brazil, in the states of Bahia and Amapá. The present study aimed to carry out a systematic review of the literature on the prevalence and epidemiological aspects of Chikungunya fever in states of the Northeast region of Brazil, between the years 2018 to 2022. This study was registered in the Open Science Framework (OSF) and in the International Prospective Register of Systemactic Reviews (PROSPERO) and followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in the scientific electronic databases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), U. S. National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO), using descriptors cataloged in Descritores em Ciências da Saúde (DeCS) and Medical Subject Headings (MeSH) in Portuguese, English and Spanish. Gray literature was also searched by accessing Google Scholar to search for additional publications not captured in the selected electronic databases. Of the 19 studies included in the present systematic review, seven referred to the state of Ceará. Most cases of Chikungunya fever corresponded to the female gender (ranging from 7.5% to 100.0%), to the age group younger than 60 years (84.2%), to literate individuals (93.3%), belonging to the non-white race/color (95.21%) and blacks (100.0%), and residents of the urban area (range from 51.95% to 100.0%). As for laboratory characteristics, most notifications were diagnosed using clinical-epidemiological criteria (ranging from 71.21% to 90.35%). The epidemiological information about Chikungunya fever in the Northeast region of Brazil presented in this systematic review is useful to better understand the characteristics of the disease introduction process in the country. To this end, prevention and control strategies must be adopted, especially in the Northeast, as this region is most responsible for the number of cases of the disease in the country.
Topics: Animals; Humans; Female; Middle Aged; Chikungunya Fever; Brazil; Prevalence; Chikungunya virus; Aedes
PubMed: 36868369
DOI: 10.1016/j.actatropica.2023.106872 -
Infection and Drug Resistance 2021Flaviviruses are a genus of enveloped single-stranded RNA viruses that include dengue virus (DENV), yellow fever virus, West Nile virus (WNV), Japanese encephalitis... (Review)
Review
INTRODUCTION
Flaviviruses are a genus of enveloped single-stranded RNA viruses that include dengue virus (DENV), yellow fever virus, West Nile virus (WNV), Japanese encephalitis virus, and Zika virus. Nowadays, diverse serological assays are available to diagnose flaviviruses. However, infection with flaviviruses induces cross-reactive antibodies, which are a challenge for serological diagnosis.
OBJECTIVE
This systematic review aimed to assess the magnitude of medically important mosquito-borne flavivirus-induced antibody cross-reactivity and its influence on serological test outcomes.
METHODS
This study was designed based on the PRISMA guidelines. It includes original research articles published between 1994 and 2019 that reported serological cross-reactions between medically important mosquito-borne flaviviruses. Articles were searched on PubMed using controlled vocabulary. Eligibility was assessed by title, abstract, and finally by reading the full paper. The articles included are compared, evaluated, and summarized narratively.
RESULTS
A total of 2,911 articles were identified, and finally 14 were included. About 15.4%-84% of antibodies produced against non-DENV flaviviruses were cross-reactive with DENV on different assays. Up to 30% IgM and up to 60% IgG antibodies produced against non-WNV flaviviruses were cross-reactive with WNV on EIA assays. The magnitude of antibodies produced against flaviviruses that are cross-reactive with chikungunya virus () was minimal (only about 7%). The highest antibody cross-reactivity of flaviviruses was reported in IgG-based assays compared to IgM-based assays and assays based on E-specific immunoglobulin compared to NS1-specific immunoglobulin. It was found that preexisting immunity due to vaccination or prior flavivirus exposure to antigenetically related species enhanced the cross-reactive antibody titer.
CONCLUSION
This review found the highest cross-reaction between DENV and non-DENV flaviviruses, especially yellow fever virus, and the least between chikungunya virus and DENV. Moreover, cross-reaction was higher on IgG assays than IgM ones and assays based on Eprotein compared to NS1protein. This implies that the reliability of serological test results in areas where more than one flavivirus exists is questionable. Therefore, interpretation of the existing serological assays should be undertaken with a great caution. Furthermore, research on novel diagnostic signatures for differential diagnosis of flaviviruses is needed.
PubMed: 34703255
DOI: 10.2147/IDR.S336351