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Meta-Analysis
. 2022 Oct 24;15(1):389.
doi: 10.1186/s13071-022-05409-1.

Epidemiology of dengue in SAARC territory: a systematic review and meta-analysis

Dhan Bahadur Shrestha  1 , Pravash Budhathoki  2 , Bipana Gurung  3 , Subash Subedi  3 , Shishir Aryal  3 , Anisha Basukala  4 , Barun Aryal  5 , Anurag Adhikari  6 , Ayusha Poudel  7 , Gopal Kumar Yadav  8 , Mtanis Khoury  1 , Binod Rayamajhee  9   10 , Lok Bahadur Shrestha  11   12
Affiliations
Meta-Analysis

Epidemiology of dengue in SAARC territory: a systematic review and meta-analysis

Dhan Bahadur Shrestha et al. Parasit Vectors. .

Abstract

Background: Dengue is one of the common arboviral infections and is a public health problem in South East Asia. The aim of this systematic review and meta-analysis was to evaluate the prevalence and distribution of dengue in SAARC (South Asian Association for Regional Cooperation) countries.

Methods: The PubMed, PubMed Central, Embase and Scopus databases were searched for relevant studies. Statistical analysis on data extracted from the selected studied was conducted using the Comprehensive Meta-Analysis Software (CMA) version 3 software package. Proportions were used to estimate the outcome with a 95% confidence interval (CI).

Results: Across all studies, among cases of suspected dengue, 30.7% were confirmed dengue cases (proportion: 0.307, 95% CI: 0.277-0.339). The seroprevalence of dengue immunoglobulin (Ig)G, IgM or both (IgM and IgG) antibodies and dengue NS1 antigen was 34.6, 34.2, 29.0 and 24.1%, respectively. Among the different strains of dengue, dengue virus (DENV) strains DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 21.8, 41.2, 14.7 and 6.3% of cases, respectively. The prevalence of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was 80.5, 18.2 and 1.5%, respectively. Fever was a commonly reported symptom, and thrombocytopenia was present in 44.7% of cases. Mortality was reported in 1.9% of dengue cases.

Conclusions: Dengue is a common health problem in South East Asia with high seroprevalence. DENV-2 was found to be the most common strain causing infection, and most dengue cases were dengue fever. In addition, thrombocytopenia was reported in almost half of the dengue cases.

Keywords: Dengue; Dengue fever; Dengue shock syndrome; SAARC region.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram of study selection process
Fig. 2
Fig. 2
Forest plot showing the proportion of dengue cases across different countries among suspected cases of dengue using a random-effect model. Abbreviation: CI confidence, interval
Fig. 3
Fig. 3
Forest plot showing the proportion of seroprevalence of dengue immunoglobulin M (IgM) antibodies across different countries among suspected cases of dengue using a random-effect model
Fig. 4
Fig. 4
Forest plot showing the proportion of dengue IgM seroprevalence across different countries among suspected cases of dengue using a random-effect model
Fig. 5
Fig. 5
Forest plot showing the proportion of dengue immunoglobulin G (IgG) seroprevalence across different countries among suspected cases of dengue using a random-effect model
Fig. 6
Fig. 6
Forest plot showing the proportion of both IgM and IgG seroprevalence of dengue across different countries among suspected cases of dengue using a random-effect model
Fig. 7
Fig. 7
Forest plot showing the proportion of dengue virus strains 1 and 2 (DENV-1, DENV-2) across different countries among confirmed cases of dengue using a random-effect model
Fig. 8
Fig. 8
Forest plot showing the proportion of DENV-3 and DENV-4 across different countries among confirmed cases of dengue using a random-effect model
Fig. 9
Fig. 9
Forest plot showing the proportion of dengue cases based on residential setting across different countries among cases of dengue using a random-effect model
Fig. 10
Fig. 10
Forest plot showing the proportion of dengue fever cases across different countries among cases of dengue using a random-effects model
Fig. 11
Fig. 11
Forest plot showing the proportion of dengue hemorrhagic fever cases across different countries among cases of dengue using a random-effects model
Fig. 12
Fig. 12
Forest plot showing the proportion of dengue shock syndrome cases across different countries among cases of dengue using a random-effects model
Fig. 13
Fig. 13
Forest plot showing the proportion of fever among cases of dengue across different countries using a random-effects model
Fig. 14
Fig. 14
Forest plot showing the proportion of thrombocytopenia among cases of dengue across different countries using a random-effects model
Fig. 15
Fig. 15
Forest plot showing mortality among cases of dengue across different countries using a random-effects model
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