Current challenges and implications for dengue, chikungunya and Zika seroprevalence studies worldwide: A scoping review

Abstract

BackgroundArboviral infections are a public health concern and an escalating problem worldwide. Estimating the burden of these diseases represents a major challenge that is complicated by the large number of unapparent infections, especially those of dengue fever. Serological surveys are thus required to identify the distribution of these diseases and measure their impact. Therefore, we undertook a scoping review of the literature to describe and summarize epidemiological practices, findings and insights related to seroprevalence studies of dengue, chikungunya and Zika virus, which have rapidly expanded across the globe in recent years.Methodology/Principal findingsRelevant studies were retrieved through a literature search of MEDLINE, WHOLIS, Lilacs, SciELO and Scopus (2000 to 2018). In total, 1389 publications were identified. Studies addressing the seroprevalence of dengue, chikungunya and/or Zika written in English or French and meeting the inclusion and exclusion criteria were included. In total, 147 studies were included, from which 185 data points were retrieved, as some studies used several different samples. Most of the studies were exclusively conducted on dengue (66.5%), but 16% were exclusively conducted on chikungunya, and 7 were exclusively conducted on Zika; the remainder were conducted on multiple arboviruses. A wide range of designs were applied, but most studies were conducted in the general population (39%) and in households (41%). Although several assays were used, enzyme-linked immunosorbent assays (ELISAs) were the predominant test used (77%). The temporal distribution of chikungunya studies followed the virus during its rapid expansion since 2004. The results revealed heterogeneity of arboviruses seroprevalence between continents and within a given country for dengue, chikungunya and Zika viruses, ranging from 0 to 100%, 76% and 73% respectively.Conclusions/SignificanceSerological surveys provide the most direct measurement for defining the immunity landscape for infectious diseases, but the methodology remains difficult to implement. Overall, dengue, chikungunya and Zika serosurveys followed the expansion of these arboviruses, but there remain gaps in their geographic distribution. This review addresses the challenges for researchers regarding study design biases. Moreover, the development of reliable, rapid and affordable diagnosis tools represents a significant issue concerning the ability of seroprevalence surveys to differentiate infections when multiple viruses co-circulate.

Dengue and Chikungunya among Febrile Outpatients in Kinshasa, Democratic Republic of Congo: a cross-sectional study

“…The IgG-seroprevalence increased with age suggesting a continuous exposure to the flaviviridae over time. The findings on CHIKV, 0.9% acute and 26.4% past infection rates respectively, were in line with the estimated seroprevalence of 34.4% in Congo Brazzaville before the outbreak of 2011 (19) and were on par with other African sites reporting an overall alphavirus seroprevalence oscillating between 0 and 72% (24). Remarkably, CHIKV IgG was also detected in small children, born after the 2011 epidemic, pointing towards an endemic circulation of the virus.…”

“…and 30.2% of the participants, respectively. This is on the higher end of the spectrum compared to other studies in Africa reporting an overall flavivirus seroprevalence ranging between 0 and 35% with a mean of 18.1% (9,24). The IgG-seroprevalence increased with age suggesting a continuous exposure to the flaviviridae over time.…”

“…We used DENV ELISA tests on all samples. Although it is widely known that there is cross-reactivity among flaviviruses, ELISA is still the most affordable -hence most commonly used -test (24). Since YFV vaccination is an expected cause of cross-reactions, we performed PRNT for DENV and YFV in a subset of samples, and found that the congruence between DENV ELISA and PRNT was lower than in American and Asian settings (33)(34)(35)(36)(37).…”

A Mapping Review on Urban Landscape Factors of Dengue Retrieved from Earth Observation Data, GIS Techniques, and Survey Questionnaires

“…To improve surveillance and monitor of dengue occurrences and Aedes mosquitoes, intercomparison model projects could help to identify the most general and efficient models considering various geographical contexts and data set: ( [94], e.g., Airborne spread of foot-and-mouth disease -Model intercomparison; https://www.theia-land.fr/en/anisette-tracking-mosquitoes-thatcarry-disease/, e.g., Inter-Site Analysis: Evaluation of Remote Sensing as a predictive tool for the surveillance and control of diseases caused by mosquito, and future impacts of climate and/or land use changes may also be considered; [95], e.g., Malaria and climate; [17,23,96], e.g., Urbanization). Review of literature are also needed to update the ever-increasing output of scientific publications, and lead to new synthetic insights ( [97]; [10], e.g., Determinants of Aedes Mosquito Habitat for Risk Mapping, [98], e.g., New frontiers for environmental epidemiology in a changing world, [99], e.g., Current challenges for dengue; [100], e.g., Mosquito-Borne Diseases: Advances in Modelling Climate-Change Impacts; [101], e.g., A 10 years view of scientific literature on Aedes aegypti; [102], e.g., Satellite Earth Observation Data in Epidemiological Modeling).…”

Zika Virus infection and Guillain-Barré syndrome in Northeastern Mexico: A case-control study

“…Arthropod-borne viruses (arboviruses) such as Zika virus (ZIKV), dengue virus (DENV) and chikungunya virus (CHIKV) have become an increasingly important global health threat. DENV and ZIKV are arboviruses belonging to the Flavivirus genus of the Flaviviridae family, and are both transmitted by the Aedes species mosquito vectors [5,6]. CHIKV is an arbovirus belonging to the alphavirus genus of the Togaviridae family [6].…”