Epidemiology of arboviruses in humans and livestock in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Arbovirus infections are a global public health threat, accounting for approximately 73% of the total emerging and re-emerging human infections, where the burden is worsened in sub-Saharan Africa, including Ethiopia. However, the surveillance system has been still challenged, and their burden and magnitude are not well estimated due to underestimates of true arbovirus burdens by passive case detections. To support targeted evidence-based public health decision-making, comprehensive evidence of arbovirus prevalence is crucial. Thus, the aim of this study was to assess the prevalence of arboviruses in humans and livestock in Ethiopia.

Method: Articles were extensively searched in bibliographic databases and gray literatures using entry terms or phrases. PRISMA 2020 flow diagram was used and data among studies meeting eligibility criteria extracted in MS Excel sheet and exported into STATA-17 software for analysis. A random-effects model was used to compute the pooled magnitude of arboviruses in humans and livestock. The heterogeneity was quantified using the I² value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis, subgroup analysis and meta-regression were performed to explore heterogeneity.

Result: Of the 1957 studies identified, 39 human and 6 livestock studies were eligible for meta-analysis. The overall pooled sero-epidemiology of arboviruses in humans using anti-IgG and anti-IgM was 15.43% (95% CI: 12.11-18.76) and 10.04% (95% CI: 6.46-13.62), respectively. The molecular prevalence of arboviruses in humans was 38.42% (95% CI: 21.77-55.08). The pooled prevalence of arboviruses in livestock was 15.77% (95% CI: 0.45, 31.08). Dengue virus, Yellow fever virus, Zika virus, Rift valley fever, West Nile virus, and chikungunya virus in humans and Rift valley fever, West Nile virus, and Schmallenberg virus in livestock were reported.

Conclusion: The magnitude of arboviruses in humans and livestock in Ethiopia alarms the need for immediate multi-sectoral interventions such as strengthening laboratory diagnostic capacities, undertaking an integrated regular national surveillance, and implementation of one-health initiatives and a planetary health approach.

Keywords: Arboviruses; Ethiopia; Human; Livestock; Systematic review and meta-analysis.

Fig. 1

Flow diagram for the selection process of eligible studies

Fig. 2

Map showing Ethiopian regions for which data were included in the systematic review and meta-analysis created using https://www.mapchart.net/world-subdivisions.html. The depth of different color shading indicates the number of studies performed in each region of SNNPR the country.

Fig. 3

Forest plot showing pooled prevalence of arboviruses among humans in Ethiopia

Fig. 4

Forest plot showing pooled prevalence of arboviruses IgM seroprevalence among livestock in Ethiopia

Fig. 5

Forest plot showing pooled prevalence of arboviruses IgM seroprevalence among livestock in Ethiopia

Fig. 6

Forest plot showing subgroup analysis of arboviruses by study design, approach, diagnostic method and markers among humans in Ethiopia

Fig. 7

Forest plot showing distribution of arboviruses among humans in Ethiopia by region and districts

Fig. 8

Forest plot showing cumulative meta-analysis of arboviruses among humans in Ethiopia

Fig. 9

Prevalence of arboviruses in humans over time in Ethiopia. The graph is created by chart.js library.

Fig. 10

Forest plot showing distribution of arboviruses among humans in Ethiopia by type of pathogen and quality of studies