Dengue Virus is Hyperendemic in Nigeria from 2009 to 2020: A Contemporary Systematic Review

Abstract

Backround Data on Dengue virus (DENV) infection prevalence, geographic distribution and risk factors are necessary to direct appropriate utilization of existing and emerging control strategies. This study aimed to determine the pooled prevalence, risk factors of DENV infection and the circulating serotypes within Nigeria from January 1, 2009 to December 31, 2020. Materials and methods Twenty-one studies out of 2,215 available articles were eligible and included for this systematic review. Relevant articles were searched, screened and included in this study according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) criteria. The risk of bias in primary studies was assessed by Cochrane's method. Heterogeneity of pooled prevalence was calculated using the chi-square test on Cochrane's Q statistic, which was quantified by I-square values. The random-effects analyses of proportions were used to determine the pooled prevalence of DENV antibodies, antigen and RNA from eligible studies. Results Of these, 3 studies reported co-circulation of all the 4 serotypes, while 2 separately reported co-circulation of DENV-1 &2 and DENV-1 to -3. All the antibody-based studies had significantly high heterogeneity (I 2 >90%, P <0.05), while the NS1 and PCR-based studies had low heterogeneity (I 2 <25%, P >0.05). The pooled prevalence of DENV IgM, IgG, RNA, NS1 and neutralizing antibodies were 16.8%, 34.7%, 7.7%, 7.7% and 0.7%, respectively. South-east Nigeria had the highest pooled DENV-IgG seropositivity, 77.1%. Marital status, gender, educational level and occupation status, the proximity of residence to refuse dumpsite, frequent use of trousers and long sleeve shirts were significantly associated with DENV IgG seropositivity ( P <0.05). Conclusion Based on these findings, it can be inferred that Nigeria is hyperendemic for Dengue fever and needs concerted efforts to control its spread within and outside the country.

The Seroprevalence of Dengue Virus Infection and Its Association With Iron (Fe) Level in Pregnant Women in Guangzhou, China

“…Our findings suggested that the risk of dengue infection may be related to several maternal demographic characteristics including age, occupation, education, and income level, which is consistent with previous studies (41)(42)(43). Pregnant women with an older age may be more likely exposed to dengue virus over time (41).…”

The Seroprevalence and Hidden Burden of Chikungunya Endemicity and Malaria Mono- and Coinfection in Nigeria

“…As a result, several factors, including poor housing favouring mosquito breeding habitats, uncontrolled urbanisation, cultural and behavioural practices resulting in poor sewage and drainage infrastructures, and unhygienic conditions of the environment, were compounded by the unwholesome location of waste disposal dumpsites close to various homes in slums and urban areas in the study regions. Rural–urban migration, expansion of agricultural activities to sylvatic areas in rural settings, and political and conflict fatigue may also be the drivers of these high seroprevalences in the three regions [ 8 , 13 , 17 ].…”

“…Secondary vectors often have relatively little contact with humans and may be less susceptible to residual insecticide spraying or insecticide-impregnated bednets than primary vectors [ 7 ]. There is an increased risk of chikungunya and malaria occurring concurrently and causing malaria and nonmalaria febrile illnesses [ 11 , 12 , 13 ]. Chikungunya and malaria can also coexist in areas where the two vectors are present [ 4 , 8 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]; therefore, super- or coinfection is a possibility.…”

Addressing the Dengue fever challenges in Nigeria: A narrative review and recommendations for control

“…Additionally, most cases of dengue fever are misdiagnosed as malaria or typhoid fever in most healthcare facilities [20]. In Nigeria, dengue fever is endemic in almost all states and may be the leading cause of unclassified febrile illness [21]. Dengue fever has a different prevalence in urban and rural areas and has been reported predominantly in urban areas rather than rural areas [21].…”