Seropositivity of Chikungunya in an outbreak setting, India: A systematic review and meta-analysis.

Abstract

<h4>Context</h4>Since 2005, the chikungunya virus (CHIKV) has caused numerous outbreaks in India. Though it causes many outbreaks every year, the disease dynamics are poorly understood in an outbreak setting.<h4>Aims</h4>Hence, we conducted this review to estimate the seropositivity of the chikungunya infection during a community-based outbreak in India.<h4>Settings and design</h4>We conducted a systematic review and meta-analysis as per the PRISMA guidelines. We included all the articles from India reporting the seropositivity of CHIKV in a community-based outbreak setting.<h4>Methods and material</h4>Data on year, geographic location, and laboratory tests used to confirm the diagnosis were also extracted.<h4>Statistical analysis used</h4>We assessed the quality of the included studies using the National Institute of Health's study quality assessment tool.<h4>Results</h4>We included 18 articles for the review. The pooled seropositivity of chikungunya infection is 38% (95%CI: 30- 45%; 95% PI: 0.03- 72%). The pooled seropositivity for males and females is 41%, respectively (male: 95% CI: 27- 54%; female: 95%CI: 26- 55%). The subgroup analysis by geographic location shows a high seropositivity in southern India (48%, 95% CI: 32- 64%) followed by eastern India (45%, 95% CI: 13- 77%).<h4>Conclusions</h4>Chikungunya has shown high seropositivity in an outbreak setting in India. This shows a high disease burden in the community, leading to local transmission. Though the seroprevalence has reduced over the years, we should still watch out for potential outbreaks in the community.