Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.

<h4>Background</h4>Flavivirus diseases such as dengue fever (DENV), West Nile virus (WNV), Zika and yellow fever represent a substantial global public health concern. Preexisting chronic conditions such as cardiovascular diseases, diabetes, obesity, and asthma were thought to predict ris...

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Main Authors: Alaa Badawi, Russanthy Velummailum, Seung Gwan Ryoo, Arrani Senthinathan, Sahar Yaghoubi, Denitsa Vasileva, Emma Ostermeier, Mikayla Plishka, Marcel Soosaipillai, Paul Arora
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200200&type=printable
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author Alaa Badawi
Russanthy Velummailum
Seung Gwan Ryoo
Arrani Senthinathan
Sahar Yaghoubi
Denitsa Vasileva
Emma Ostermeier
Mikayla Plishka
Marcel Soosaipillai
Paul Arora
author_facet Alaa Badawi
Russanthy Velummailum
Seung Gwan Ryoo
Arrani Senthinathan
Sahar Yaghoubi
Denitsa Vasileva
Emma Ostermeier
Mikayla Plishka
Marcel Soosaipillai
Paul Arora
author_sort Alaa Badawi
collection DOAJ
description <h4>Background</h4>Flavivirus diseases such as dengue fever (DENV), West Nile virus (WNV), Zika and yellow fever represent a substantial global public health concern. Preexisting chronic conditions such as cardiovascular diseases, diabetes, obesity, and asthma were thought to predict risk of progression to severe infections.<h4>Objective</h4>We aimed to quantify the frequency of chronic comorbidities in flavivirus diseases to provide an estimate for their prevalence in severe and non-severe infections and examine whether chronic diseases contribute to the increased risk of severe viral expression.<h4>Methods</h4>We conducted a comprehensive search in PubMed, Ovid MEDLINE(R), Embase and Embase Classic and grey literature databases to identify studies reporting prevalence estimates of comorbidities in flavivirus diseases. Study quality was assessed with the risk of bias tool. Age-adjusted odds ratios (ORs) were estimated for severe infection in the presence of chronic comorbidities.<h4>Results</h4>We identified 65 studies as eligible for inclusion for DENV (47 studies) and WNV (18 studies). Obesity and overweight (i.e., BMI> 25 kg/m2, prevalence: 24.5%, 95% CI: 18.6-31.6%), hypertension (17.1%, 13.3-21.8%) and diabetes (13.3%, 9.3-18.8%) were the most prevalent comorbidities in DENV. However, hypertension (45.0%, 39.1-51.0%), diabetes (24.7%, 20.2-29.8%) and heart diseases (25.6%, 19.5-32.7%) were the most prevalent in WNV. ORs of severe flavivirus diseases were about 2 to 4 in infected patients with comorbidities such as diabetes, hypertension and heart diseases. The small number of studies in JEV, YFV and Zika did not permit estimating the prevalence of comorbidities in these infections.<h4>Conclusion</h4>Higher prevalence of chronic comorbidities was found in severe cases of flavivirus diseases compared to non-severe cases. Findings of the present study may guide public health practitioners and clinicians to evaluate infection severity based on the presence of comorbidity, a critical public health measure that may avert severe disease outcome given the current dearth of clear prevention practices for some flavivirus diseases.
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spelling doaj.art-83d1d8887ab94816aadc162266f21c242025-02-28T05:32:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01137e020020010.1371/journal.pone.0200200Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.Alaa BadawiRussanthy VelummailumSeung Gwan RyooArrani SenthinathanSahar YaghoubiDenitsa VasilevaEmma OstermeierMikayla PlishkaMarcel SoosaipillaiPaul Arora<h4>Background</h4>Flavivirus diseases such as dengue fever (DENV), West Nile virus (WNV), Zika and yellow fever represent a substantial global public health concern. Preexisting chronic conditions such as cardiovascular diseases, diabetes, obesity, and asthma were thought to predict risk of progression to severe infections.<h4>Objective</h4>We aimed to quantify the frequency of chronic comorbidities in flavivirus diseases to provide an estimate for their prevalence in severe and non-severe infections and examine whether chronic diseases contribute to the increased risk of severe viral expression.<h4>Methods</h4>We conducted a comprehensive search in PubMed, Ovid MEDLINE(R), Embase and Embase Classic and grey literature databases to identify studies reporting prevalence estimates of comorbidities in flavivirus diseases. Study quality was assessed with the risk of bias tool. Age-adjusted odds ratios (ORs) were estimated for severe infection in the presence of chronic comorbidities.<h4>Results</h4>We identified 65 studies as eligible for inclusion for DENV (47 studies) and WNV (18 studies). Obesity and overweight (i.e., BMI> 25 kg/m2, prevalence: 24.5%, 95% CI: 18.6-31.6%), hypertension (17.1%, 13.3-21.8%) and diabetes (13.3%, 9.3-18.8%) were the most prevalent comorbidities in DENV. However, hypertension (45.0%, 39.1-51.0%), diabetes (24.7%, 20.2-29.8%) and heart diseases (25.6%, 19.5-32.7%) were the most prevalent in WNV. ORs of severe flavivirus diseases were about 2 to 4 in infected patients with comorbidities such as diabetes, hypertension and heart diseases. The small number of studies in JEV, YFV and Zika did not permit estimating the prevalence of comorbidities in these infections.<h4>Conclusion</h4>Higher prevalence of chronic comorbidities was found in severe cases of flavivirus diseases compared to non-severe cases. Findings of the present study may guide public health practitioners and clinicians to evaluate infection severity based on the presence of comorbidity, a critical public health measure that may avert severe disease outcome given the current dearth of clear prevention practices for some flavivirus diseases.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200200&type=printable
spellingShingle Alaa Badawi
Russanthy Velummailum
Seung Gwan Ryoo
Arrani Senthinathan
Sahar Yaghoubi
Denitsa Vasileva
Emma Ostermeier
Mikayla Plishka
Marcel Soosaipillai
Paul Arora
Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.
PLoS ONE
title Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.
title_full Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.
title_fullStr Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.
title_full_unstemmed Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.
title_short Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.
title_sort prevalence of chronic comorbidities in dengue fever and west nile virus a systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200200&type=printable
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