Geographical distribution of enteric pathogenic viruses in Burkina Faso: a systematic review and meta-analysis

Abstract

Background: Viruses, which are transmitted mainly via the digestive tract, are responsible for the high morbidity and mortality of diseases, particularly in low-income countries. Although several studies have established the prevalence and characterization of various enteric viruses in Burkina Faso, to date, no aggregate data have been released.

Objective: Our objective was to describe the available data on the prevalence and circulating genotypes of enteric pathogen viruses responsible for human infections in Burkina Faso by carrying out a systematic review and meta-analysis.

Methods: Potentially relevant studies were identified by a search of PubMed, ScienceDirect, Google Scholar, university libraries and by a manual search of the reference lists of identified studies. The search with no restrictions on language or age was limited to studies conducted only in Burkina. Study selection, data extraction, and methodological quality of the included studies were performed independently by two investigators. Heterogeneity between studies was assessed using the Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis (CMA 3.7) was employed to compute the pooled prevalence of pathogens identified in the studies.

Results: Forty-three (43) studies reporting 4,214 diagnosed cases in all aged human populations were selected. Overall, 72.6% of the pathogens diagnosed were gastroenteritis, and 27.2% were entero-transmissible hepatitis viruses. Rotavirus was the most common cause of human viral gastroenteritis, accounting for 27.7% (95% CI: 20.9 - 35.8) of the cases, followed by norovirus (16% (95% CI: 12.25 - 20.6)) and sapovirus (11.2% (95% CI: 6.2 - 19.4)). In terms of human entero-transmissible infections, hepatitis A virus (HAV) was the most prevalent (52% [95% CI: 14.2-87.7] of total antibodies), followed by hepatitis E virus (HEV) (28.3% [95% CI: 17.7-42]).

Conclusions: This study highlights the substantial burden of viral enteric infections and highlights the need for more molecular epidemiological studies to improve preventive measures against these viruses.

Keywords: Burkina Faso; Enteric hepatitis viruses; Gastroenteric viruses; Systematic review and meta-analysis.

Fig. 1

Flow chart of study selection and criteria

Fig. 2

Map of Burkina Faso showing the study area. Legend: RV: Rotavirus  ; NoV: Norovirus  ; AdV: Adenovirus  ; SaV: Sapovirus  ; AstV: Astrovirus ; PoV: Poliovirus ; PaV: Parvovirus ; HAV: Hepatitis A virus ; HEV: Hepatitis E virus . AiV: Aichi virus

Fig. 3

Cheese diagram showing study shares

Fig. 4

Forest plot of the pooled prevalence of viral gastroenteritis in Burkina. Legend: RV: Rotavirus; NoV: Norovirus; AdV: Adenovirus; SapV: Sapovirus; AstV: Astrovirus; PaV: Parvovirus; AiV: Aichi Virus

Fig. 5

Forest plot of the pooled prevalence of enterovirus-transmissible viral hepatitis. Legend: HAV: hepatitis A virus, HEV: hepatitis E virus

Fig. 6

Forest plot of the pooled prevalence of enteric viruses in animals and the environment. Legend: RV: Rotavirus; AdV: Adenovirus; HEV: Hepatitis E Virus

Fig. 7

Publication bias assessment funnel plot of Egger’s regression test (p = 0.062) and Begg’s rank correlation (p = 0.123)

Fig. 8

Distribution of rotavirus genotypes in the population

Fig. 9

Genotype distribution of the norovirus strains in the population

Fig. 10

Distribution of sapovirus genotypes in the population

Fig. 11

Pooled estimates of rotavirus stratified by diagnostic methods. Legend: ICG: Immunochromatography; EIA: Enzyme immunoassay; PCR: Polymerase chain reaction; ELISA: Enzyme-linked immunosorbent assay; RV: Rotavirus