Evaluating the burden and transmission dynamics of chikungunya virus infections in the Eastern Mediterranean Region: a systematic review and meta-analysis

Abstract

The Chikungunya virus (CHIKV) presents substantial public health challenges in the Eastern Mediterranean Region (EMR), with its prevalence and interaction with other arboviruses (ABVs) remaining poorly understood. This systematic review and meta-analysis aimed to assess the prevalence of CHIKV and its association with other ABVs, such as dengue virus (DENV), Rift Valley fever virus (RVFV), malaria, and yellow fever virus (YFV), in the EMR. We systematically searched databases including PubMed, Embase, Web of Science, Scopus, Cochrane Library, CINAHL, PsycINFO, and ScienceDirect to identify epidemiological studies that report CHIKV prevalence and provide odds ratios (ORs) for CHIKV compared to other ABVs. Data analysis was performed using a random-effects model. Heterogeneity was evaluated using the χ2 test and I2 statistic. The GRADE approach was used to evaluate the quality of the studies while the AXIS tool, NOS tool, and AHRQ checklist assessed the risk of bias. The meta-analysis revealed a significant prevalence of CHIKV in the EMR. However, the studies exhibited heterogeneity, indicating variability in the results. A comparison of CHIKV with other ABVs did not show any statistically significant differences in prevalence. The meta-analysis found a notable prevalence of CHIKV in the EMR. The results also indicated that the prevalence of CHIKV is comparable to that of other ABVs in the region. These findings provide an overview of the burden of CHIKV in the EMR.