Chikungunya virus infection in Indonesia: a systematic review and evolutionary analysis

Abstract

BackgroundDespite the high number of chikungunya cases in Indonesia in recent years, comprehensive epidemiological data are lacking. The systematic review was undertaken to provide data on incidence, the seroprevalence of anti-Chikungunya virus (CHIKV) IgM and IgG antibodies, mortality, the genotypes of circulating CHIKV and travel-related cases of chikungunya in the country. In addition, a phylogenetic and evolutionary analysis of Indonesian CHIKV was conducted.MethodsA systematic review was conducted to identify eligible studies from EMBASE, MEDLINE, PubMed and Web of Science as of October 16th 2017. Studies describing the incidence, seroprevalence of IgM and IgG, mortality, genotypes and travel-associated chikungunya were systematically reviewed. The maximum likelihood phylogenetic and evolutionary rate was estimated using Randomized Axelerated Maximum Likelihood (RAxML), and the Bayesian Markov chain Monte Carlo (MCMC) method identified the Time to Most Recent Common Ancestors (TMRCA) of Indonesian CHIKV. The systematic review was registered in the PROSPERO database (CRD42017078205).ResultsChikungunya incidence ranged between 0.16-36.2 cases per 100,000 person-year. Overall, the median seroprevalence of anti-CHIKV IgM antibodies in both outbreak and non-outbreak scenarios was 13.3% (17.7 and 7.3% for outbreak and non-outbreak events, respectively). The median seroprevalence of IgG antibodies in both outbreak and non-outbreak settings was 18.5% (range 0.0–73.1%). There were 130 Indonesian CHIKV sequences available, of which 120 (92.3%) were of the Asian genotype and 10 (7.7%) belonged to the East/Central/South African (ECSA) genotype. The ECSA genotype was first isolated in Indonesia in 2008 and was continually sampled until 2011. All ECSA viruses sampled in Indonesia appear to be closely related to viruses that caused massive outbreaks in Southeast Asia countries during the same period. Massive nationwide chikungunya outbreaks in Indonesia were reported during 2009–2010 with a total of 137,655 cases. Our spatio-temporal, phylogenetic and evolutionary data suggest that these outbreaks were likely associated with the introduction of the ECSA genotype of CHIKV to Indonesia.ConclusionsAlthough no deaths have been recorded, the seroprevalence of anti-CHIKV IgM and IgG in the Indonesian population have been relatively high in recent years following re-emergence in early 2001. There is sufficient evidence to suggest that the introduction of ECSA into Indonesia was likely associated with massive chikungunya outbreaks during 2009–2010.Electronic supplementary materialThe online version of this article (10.1186/s12879-019-3857-y) contains supplementary material, which is available to authorized users.

Dengue Virus Serotype 4 Is Responsible for the Outbreak of Dengue in East Java City of Jember, Indonesia

“…Out of DENV-negative samples, we did not detect any other arbovirus infections. This may be due to the low prevalence of Chikungunya [22,42] and Zika [25] infections in Indonesia. However, we detected cases of typhoid fever with a positivity of 18.9%, including those also infected with DENV, with very similar reported symptoms and laboratory results.…”

“…Infection with other Aedes-transmitted viruses often show very similar symptoms to those of dengue and will often share spatio-temporal distribution with dengue. One such disease, chikungunya, caused by the Alphavirus chikungunya virus (CHIKV), not only shares a large amount of clinical symptoms with DF, but is also widespread in Indonesia [22]. While point-of-care rapid antibody testing kits for DENV, such as those developed for IgG and IgM, can exclude chikungunya patients, these immunoglobulins may be cross-reactive for DENV if the patient is infected with another Flaviviridae virus, such as the Zika virus (ZIKV) [23] or the Japanese encephalitis virus (JEV) [24].…”

Clinical manifestations in patients with musculoskeletal pain post-chikungunya

“…Albopictus 1 . Since the first outbreak of chikungunya reported in Tanzania in mid-1953 2 , there has been an increase in infection in Asian 3,4 and African 5,6 countries. In Brazil, the first indigenous cases were confirmed in Oiapoque (AP) in 2014 7 .…”

Epidemiological and Entomological Investigation of Chikungunya Fever Outbreak, in Serdang Bedagai District, North Sumatera Province, Indonesia, 2013

“…Indonesia has some of the greatest chikungunya burden in Southeast Asia. Samarinda city, East Kalimantan was the first area that reported chikungunya cases based on clinical symptoms in 1973, with the first virologically confirmed cases reported in Jambi in 1982 (10,11). The disease rapidly moved to other provinces in Indonesia, and since 1985 all provinces have reported chikungunya outbreaks (6).…”

“…The disease rapidly moved to other provinces in Indonesia, and since 1985 all provinces have reported chikungunya outbreaks (6). Many chikungunya outbreaks have been reported in North Sumatera, West Java, Central Java, West Kalimantan, Bali, and other parts of the country (11)(12)(13)(14). The main risk factors of these outbreaks were failure to routinely eliminate mosquitoes breeding sites (15)(16)(17), lack of use of personal protective measures against mosquitoes (12,17), hanging out worn clothes (6,17), and having a household contact with chikungunya (17).…”