Varicella zoster virus-associated morbidity and mortality in Africa – a systematic review

Abstract

BackgroundVaricella zoster virus (VZV) causes varicella and herpes zoster. These vaccine preventable diseases are common globally. Most available data on VZV epidemiology are from industrialised temperate countries and cannot be used to guide decisions on the immunization policy against VZV in Africa. This systematic review aims to review the published data on VZV morbidity and mortality in Africa.MethodsAll published studies conducted in Africa from 1974 to 2015 were eligible. Eligible studies must have reported any VZV epidemiological measure (incidence, prevalence, hospitalization rate and mortality rate). For inclusion in the review, studies must have used a defined VZV case definition, be it clinical or laboratory-based.ResultsTwenty articles from 13 African countries were included in the review. Most included studies were cross-sectional, conducted on hospitalized patients, and half of the studies used varying serological methods for diagnosis. VZV seroprevalence was very high among adults. Limited data on VZV seroprevalence in children showed very low seropositivity to anti-VZV antibodies. Co-morbidity with VZV was common.ConclusionThere is lack of quality data that could be used to develop VZV control programmes, including vaccination, in Africa.Trial registrationPROSPERO 2015: CRD42015026144.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2815-9) contains supplementary material, which is available to authorized users.

Varicella in Tshuapa Province, Democratic Republic of Congo, 2009–2014

“…A literature review of papers published on varicella in Africa between 1974 and 2015 found only 20 articles from 13 countries (24% of the countries in Africa) . Though we were able to collect data on varicella through this monkeypox surveillance platform, distinguishing between varicella and monkeypox in areas where both diseases are endemic—such as in DRC—can be challenging.…”

“…Few data are available on varicella epidemiology in Africa and most are limited to specific sub-populations, such as HIV-positive populations or refugees [8][9][10][11][12][13][14][15][16]. Varicella epidemiology in temperate climates usually differs from that in tropical climates; in temperate climates most children are infected by 10 years of age while children in tropical climates acquire varicella at older ages and a higher proportion of young adults remain susceptible [17][18][19][20].…”

Polymyalgia Rheumatica After Herpes Zoster

“…1 Herpes zoster (HZ) is characterized by painful vesicular rash with dermatomal distribution. 2 Although it causes many complications, to our knowledge, PMR secondary to HZ has not been previously reported.…”

Herpes Infections in Suspected Cases of Yellow Fever in the Democratic Republic of the Congo

“…Indeed, the seroprevalence of HSV1, HSV2, and CMV are estimated to be 87%, 31%, and 82%, respectively [5][6][7][8]. The seroprevalence of VZV is variable across countries and studies in Africa (0-90%) [9]. Few data exist on the prevalence of HHV-6, but it can reach 100% in many regions of the world [10].…”