Current challenges and implications for dengue, chikungunya and Zika seroprevalence studies worldwide: A scoping review.
Current challenges and implications for dengue, chikungunya and Zika seroprevalence studies worldwide: A scoping review.
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DOI：
10.1371/journal.pntd.0006533
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发表时间：
2018-07
影响因子：
3.8
通讯作者：
Flamand C
中科院分区：
文献类型：
--
作者：
Fritzell C;Rousset D;Adde A;Kazanji M;Van Kerkhove MD;Flamand C
虫媒病毒感染是一个公共卫生问题，也是一个全球范围内日益严重的问题。估计这些疾病的负担是一项重大挑战，由于大量隐性感染，特别是登革热感染，这一挑战变得更加复杂。因此，需要进行血清学调查，以确定这些疾病的分布情况并衡量其影响。因此，我们对文献进行了范围界定，以描述和总结与登革热、基孔肯雅和寨卡病毒血清阳性率研究相关的流行病学做法、发现和见解，这些病毒近年来在全球迅速扩张。通过文献检索MEDLINE、WHOLIS、LILACS、SCHELO和Scope us，检索相关研究(2000-2018)。总共确定了1389种出版物。其中包括用英语或法语编写并符合纳入和排除标准的关于登革热、基孔肯雅热和/或寨卡病毒血清阳性率的研究。总共包括147项研究，从中检索到185个数据点，因为一些研究使用了几个不同的样本。大多数研究专门针对登革热(66.5%)，但16%专门针对基孔肯雅热，7项专门针对寨卡病毒；其余研究针对多种虫媒病毒。研究应用了广泛的设计，但大多数研究是在普通人群(39%)和家庭(41%)中进行的。虽然使用了几种检测方法，但以酶联免疫吸附试验(ELISA)为主(77%)。基孔肯雅病研究的时间分布是在该病毒自2004年以来迅速扩张期间进行的。结果显示，登革热、基孔肯雅和寨卡病毒在各大洲之间和特定国家内的虫媒病毒血清阳性率不同，分别为0-100%、76%和73%。血清学调查为确定传染病的免疫状况提供了最直接的衡量标准，但方法学仍难以实施。总体而言，登革热、基孔肯雅热和寨卡病毒是在这些虫媒病毒扩大之后出现的，但它们的地理分布仍然存在差距。这篇综述阐述了研究人员在研究设计偏差方面面临的挑战。此外，可靠、快速和负担得起的诊断工具的开发是一个重大问题，涉及当多种病毒共同传播时，血清阳性率调查区分感染的能力。节肢动物传播的病毒(虫媒病毒)是全球面临的最重要的新发传染病之一。虫媒病毒在世界范围内的实际影响尚不清楚，估计这些疾病的真正负担是当前的挑战。血清学调查是评估虫媒病毒在特定地区暴发的影响的最可靠工具，这种调查的结果对疫苗接种等潜在的缓解措施具有影响。我们对2000年至2018年3月15日发表的关于登革热、基孔肯雅和/或寨卡病毒血清阳性率的文献进行了彻底的审查，以描述和总结方法学途径，并绘制这三种病毒血清阳性率研究的全球地理分布图。总共有185项关于登革热、基孔肯雅和/或寨卡病毒血清阳性率的研究被纳入审查范围。大多数研究专门针对登革热(66.5%)，但16%专门针对基孔肯雅热，7项研究专门针对寨卡病毒；其余研究针对多种虫媒病毒。我们的研究表明，在人口、招募和/或实验室测试方面采用了广泛的方法设计。这项研究还强调了登革热、基孔肯雅热和寨卡病毒在各大洲之间和特定国家内的高血清抗体异质性。这一结果突显了血清阳性率研究在全球分布方面存在的差距，以及开发最敏感和特异的诊断工具以为未来的血清学研究提供建议的必要性。
Arboviral infections are a public health concern and an escalating problem worldwide. Estimating the burden of these diseases represents a major challenge that is complicated by the large number of unapparent infections, especially those of dengue fever. Serological surveys are thus required to identify the distribution of these diseases and measure their impact. Therefore, we undertook a scoping review of the literature to describe and summarize epidemiological practices, findings and insights related to seroprevalence studies of dengue, chikungunya and Zika virus, which have rapidly expanded across the globe in recent years. Relevant studies were retrieved through a literature search of MEDLINE, WHOLIS, Lilacs, SciELO and Scopus (2000 to 2018). In total, 1389 publications were identified. Studies addressing the seroprevalence of dengue, chikungunya and/or Zika written in English or French and meeting the inclusion and exclusion criteria were included. In total, 147 studies were included, from which 185 data points were retrieved, as some studies used several different samples. Most of the studies were exclusively conducted on dengue (66.5%), but 16% were exclusively conducted on chikungunya, and 7 were exclusively conducted on Zika; the remainder were conducted on multiple arboviruses. A wide range of designs were applied, but most studies were conducted in the general population (39%) and in households (41%). Although several assays were used, enzyme-linked immunosorbent assays (ELISAs) were the predominant test used (77%). The temporal distribution of chikungunya studies followed the virus during its rapid expansion since 2004. The results revealed heterogeneity of arboviruses seroprevalence between continents and within a given country for dengue, chikungunya and Zika viruses, ranging from 0 to 100%, 76% and 73% respectively. Serological surveys provide the most direct measurement for defining the immunity landscape for infectious diseases, but the methodology remains difficult to implement. Overall, dengue, chikungunya and Zika serosurveys followed the expansion of these arboviruses, but there remain gaps in their geographic distribution. This review addresses the challenges for researchers regarding study design biases. Moreover, the development of reliable, rapid and affordable diagnosis tools represents a significant issue concerning the ability of seroprevalence surveys to differentiate infections when multiple viruses co-circulate. Arthropod-borne viruses (arboviruses) are among the most important of the emerging infectious disease public health problems facing the world. The actual impact of arboviruses worldwide remains unknown, and estimating the true burden of these diseases represents a current challenge. Serological surveys are the most reliable tool for estimating the impact of arboviruses outbreaks in a given territory, and the results of such surveys have implications for potential mitigation measures such as vaccination. We undertook a thorough review of the literature produced from 2000 to March 15, 2018, addressing the seroprevalence of dengue, chikungunya and/or Zika to describe and summarize methodological approaches and map the geographical distribution of seroprevalence studies for these three viruses worldwide. A total of 185 studies addressing the seroprevalence of dengue, chikungunya and/or Zika were included in the review. Most of the studies were exclusively conducted on dengue (66.5%), but 16% were exclusively conducted on chikungunya, and 7 studies were exclusively conducted on Zika; the remainder were conducted on multiple arboviruses. Our study reveals that a wide range of methodological designs were applied regarding population, recruitment and/or laboratory testing. This study also highlights the high seroprevalence heterogeneity between continents and within a given country for dengue, chikungunya and Zika viruses. The results underscore existing gaps in seroprevalence studies distribution worldwide and the need to develop the most sensitive and specific diagnosis tool to provide recommendations for future serological studies.