Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions
Background: Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with a sizable disease burden that is highest in sub-Saharan Africa. This study aimed to characterize HSV-2 epidemiology in this region. Methods: Cochrane and PRISMA guidelines were followed to s...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021001565 |
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| author | Manale Harfouche Farah M. Abu-Hijleh Charlotte James Katharine J. Looker Laith J. Abu-Raddad |
| author_facet | Manale Harfouche Farah M. Abu-Hijleh Charlotte James Katharine J. Looker Laith J. Abu-Raddad |
| author_sort | Manale Harfouche |
| collection | DOAJ |
| description | Background: Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with a sizable disease burden that is highest in sub-Saharan Africa. This study aimed to characterize HSV-2 epidemiology in this region. Methods: Cochrane and PRISMA guidelines were followed to systematically review, synthesize, and report HSV-2 related findings up to August 23, 2020. Meta-analyses and meta-regressions were conducted. Findings: From 218 relevant publications, 451 overall outcome measures and 869 stratified measures were extracted. Pooled incidence rates ranged between 2.4–19.4 per 100 person-years across populations. Pooled seroprevalence was lowest at 37.3% (95% confidence interval (CI): 34.9–39.7%) in general populations and high in female sex workers and HIV-positive individuals at 62.5% (95% CI: 54.8–70.0%) and 71.3% (95% CI: 66.5–75.9%), respectively. In general populations, pooled seroprevalence increased steadily with age. Compared to women, men had a lower seroprevalence with an adjusted risk ratio (ARR) of 0.61 (95% CI: 0.56–0.67). Seroprevalence has decreased in recent decades with an ARR of 0.98 (95% CI: 0.97–0.99) per year. Seroprevalence was highest in Eastern and Southern Africa. Pooled HSV-2 proportion in genital ulcer disease was 50.7% (95% CI: 44.7–56.8%) and in genital herpes it was 97.3% (95% CI: 84.4–100%). Interpretation: Seroprevalence is declining by 2% per year, but a third of the population is infected. Age and geography play profound roles in HSV-2 epidemiology. Temporal declines and geographic distribution of HSV-2 seroprevalence mirror that of HIV prevalence, suggesting sexual risk behavior has been declining for three decades. HSV-2 is the etiological cause of half of genital ulcer disease and nearly all genital herpes cases with limited role for HSV-1. Funding: This work was supported by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar and by the Qatar National Research Fund [NPRP 9–040–3–008]. |
| first_indexed | 2024-12-17T00:30:03Z |
| format | Article |
| id | doaj.art-9cff8c87b8124b818d08e5559713563d |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-17T00:30:03Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-9cff8c87b8124b818d08e5559713563d2022-12-21T22:10:21ZengElsevierEClinicalMedicine2589-53702021-05-0135100876Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressionsManale Harfouche0Farah M. Abu-Hijleh1Charlotte James2Katharine J. Looker3Laith J. Abu-Raddad4Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, QatarDepartment of Public Health, College of Health Sciences, Academic Quality Affairs Office, QU Health, Qatar University, Doha, QatarPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, United KingdomInfectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States; Reprints or correspondence at: Infectious Disease Epidemiology Group, World Health Organization Collaborating centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine - Qatar, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar.Background: Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with a sizable disease burden that is highest in sub-Saharan Africa. This study aimed to characterize HSV-2 epidemiology in this region. Methods: Cochrane and PRISMA guidelines were followed to systematically review, synthesize, and report HSV-2 related findings up to August 23, 2020. Meta-analyses and meta-regressions were conducted. Findings: From 218 relevant publications, 451 overall outcome measures and 869 stratified measures were extracted. Pooled incidence rates ranged between 2.4–19.4 per 100 person-years across populations. Pooled seroprevalence was lowest at 37.3% (95% confidence interval (CI): 34.9–39.7%) in general populations and high in female sex workers and HIV-positive individuals at 62.5% (95% CI: 54.8–70.0%) and 71.3% (95% CI: 66.5–75.9%), respectively. In general populations, pooled seroprevalence increased steadily with age. Compared to women, men had a lower seroprevalence with an adjusted risk ratio (ARR) of 0.61 (95% CI: 0.56–0.67). Seroprevalence has decreased in recent decades with an ARR of 0.98 (95% CI: 0.97–0.99) per year. Seroprevalence was highest in Eastern and Southern Africa. Pooled HSV-2 proportion in genital ulcer disease was 50.7% (95% CI: 44.7–56.8%) and in genital herpes it was 97.3% (95% CI: 84.4–100%). Interpretation: Seroprevalence is declining by 2% per year, but a third of the population is infected. Age and geography play profound roles in HSV-2 epidemiology. Temporal declines and geographic distribution of HSV-2 seroprevalence mirror that of HIV prevalence, suggesting sexual risk behavior has been declining for three decades. HSV-2 is the etiological cause of half of genital ulcer disease and nearly all genital herpes cases with limited role for HSV-1. Funding: This work was supported by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar and by the Qatar National Research Fund [NPRP 9–040–3–008].http://www.sciencedirect.com/science/article/pii/S2589537021001565SeroprevalenceGenital ulcer diseaseGenital herpesSynthesisRegion |
| spellingShingle | Manale Harfouche Farah M. Abu-Hijleh Charlotte James Katharine J. Looker Laith J. Abu-Raddad Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions EClinicalMedicine Seroprevalence Genital ulcer disease Genital herpes Synthesis Region |
| title | Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions |
| title_full | Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions |
| title_fullStr | Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions |
| title_full_unstemmed | Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions |
| title_short | Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions |
| title_sort | epidemiology of herpes simplex virus type 2 in sub saharan africa systematic review meta analyses and meta regressions |
| topic | Seroprevalence Genital ulcer disease Genital herpes Synthesis Region |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021001565 |
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