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. 2021 Oct 19;21(1):1078.
doi: 10.1186/s12879-021-06740-1.

Global dengue importation: a systematic review

Xiao Wei Sylvia Gwee  1   2 , Pearleen Ee Yong Chua  1   2 , Junxiong Pang  3   4   5
Affiliations

Global dengue importation: a systematic review

Xiao Wei Sylvia Gwee et al. BMC Infect Dis. .

Abstract

Background: Importation of dengue following globalization presents an emerging threat to global health. However, evidence on global geographical sources and the potential of dengue importation globally are lacking. This study aims to systematically review the sources of dengue importation globally and the risk of dengue outbreaks globally.

Methods: This systematic review was conducted in accordance to Cochrane's PRISMA guidelines. Articles published through 31 December 2019 with laboratory-confirmed dengue imported cases were consolidated from PubMed, EMBASE and Scopus. Sources of dengue importation reported worldwide were analysed by country and geographical regions. Sources of dengue importation into United States of America and Europe specifically were also analysed.

Results: A total of 3762 articles were found. Among which, 210 articles-documenting 14,972 imported dengue cases with reported sources-were eligible. 76.3% of imported cases worldwide were from Asia. 15.7%, 5.6%, 2.0% and 0.1% were imported from the Americas, Africa, Oceania and Europe regions respectively. Imported dengue cases in the U.S. were from Americas (55.3%), Asia (34.7%), Africa (6.7%) and Oceania (3.3%). Imported dengue cases in Europe were from Asia (66.0%), Americas (21.9%), Africa (10.8%) and Oceania (1.1%).

Conclusion: The potential of dengue outbreaks occurring globally, especially among non-endemic regions with dengue-susceptible populations is high. With the expansion of Aedes mosquito population globally due to global warming and globalisation, dengue importation constitutes an emerging global health security threat.

Keywords: Dengue; Global health; Importation; Outbreak; Public health.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of information through the search and screening phases of the review
Fig. 2
Fig. 2
Reported global sources of imported dengue (created using Microsoft Excel Powermaps 2016)
Fig. 3
Fig. 3
Geographical sources of imported dengue into US (created using Tableau 2021.1)
Fig. 4
Fig. 4
U.S. States reporting imported cases of dengue (1977–2017) (created using Microsoft Excel Powermaps 2016)
Fig. 5
Fig. 5
European countries reporting imported cases of dengue (created using Tableau 2021.1)
Fig. 6
Fig. 6
Sources of imported dengue into Europe (created using Tableau 2021.1)
See this image and copyright information in PMC

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