The global epidemiology of chikungunya from 1999 to 2020: A systematic literature review to inform the development and introduction of vaccines

PLoS Negl Trop Dis. 2022 Jan 12;16(1):e0010069. doi: 10.1371/journal.pntd.0010069. eCollection 2022 Jan.

Abstract

Chikungunya fever is an acute febrile illness that is often associated with severe polyarthralgia in humans. The disease is caused by chikungunya virus (CHIKV), a mosquito-borne alphavirus. Since its reemergence in 2004, the virus has spread throughout the tropical world and several subtropical areas affecting millions of people to become a global public health issue. Given the significant disease burden, there is a need for medical countermeasures and several vaccine candidates are in clinical development. To characterize the global epidemiology of chikungunya and inform vaccine development, we undertook a systematic literature review in MEDLINE and additional public domain sources published up to June 13, 2020 and assessed epidemiological trends from 1999 to 2020. Observational studies addressing CHIKV epidemiology were included and studies not reporting primary data were excluded. Only descriptive analyses were conducted. Of 3,883 relevant sources identified, 371 were eligible for inclusion. 46% of the included studies were published after 2016. Ninety-seven outbreak reports from 45 countries and 50 seroprevalence studies from 31 countries were retrieved, including from Africa, Asia, Oceania, the Americas, and Europe. Several countries reported multiple outbreaks, but these were sporadic and unpredictable. Substantial gaps in epidemiological knowledge were identified, specifically granular data on disease incidence and age-specific infection rates. The retrieved studies revealed a diversity of methodologies and study designs, reflecting a lack of standardized procedures used to characterize this disease. Nevertheless, available epidemiological data emphasized the challenges to conduct vaccine efficacy trials due to disease unpredictability. A better understanding of chikungunya disease dynamics with appropriate granularity and better insights into the duration of long-term population immunity is critical to assist in the planning and success of vaccine development efforts pre and post licensure.

Publication types

  • Systematic Review

MeSH terms

  • Aedes / virology
  • Animals
  • Chikungunya Fever / epidemiology*
  • Chikungunya Fever / prevention & control*
  • Chikungunya virus / immunology*
  • Disease Outbreaks
  • Humans
  • Mosquito Vectors / virology
  • Neglected Diseases / epidemiology
  • Neglected Diseases / virology
  • Seroepidemiologic Studies
  • Vaccine Development*
  • Viral Vaccines / immunology

Substances

  • Viral Vaccines

Grants and funding

The Coalition for Epidemic Preparedness Innovations (CEPI), an innovative global partnership between public, private, philanthropic, and civil society organizations to develop vaccines to stop future epidemics (https://cepi.net/), funded the data collection and analysis of this work to P95 Epidemiology and Pharmacovigilance, Leuven, Belgium (award number: CALL-OFF 01 <201843NO-17>). AG is a P95 employee. CEPI has received funding from the European Union’s Horizon 2020 research and innovation programme (https://ec.europa.eu/programmes/horizon2020) under grant agreement No 857934. The CEPI’s authors (AAB, MLJ, IKY, JGB) contributed to study design, data collection and analysis, preparation of the manuscript and decision to publish. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.