Chikungunya virus infection in Indonesia: a systematic review and evolutionary analysis

Harapan Harapan, Alice Michie, Mudatsir Mudatsir, Roy Nusa, Benediktus Yohan, Abram Luther Wagner, R. Tedjo Sasmono, Allison Imrie

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

BackgroundDespite the high number of chikungunya cases in Indonesia in recent years, comprehensive epidemiological data are lacking. The systematic review was undertaken to provide data on incidence, the seroprevalence of anti-Chikungunya virus (CHIKV) IgM and IgG antibodies, mortality, the genotypes of circulating CHIKV and travel-related cases of chikungunya in the country. In addition, a phylogenetic and evolutionary analysis of Indonesian CHIKV was conducted.MethodsA systematic review was conducted to identify eligible studies from EMBASE, MEDLINE, PubMed and Web of Science as of October 16th 2017. Studies describing the incidence,seroprevalence of IgM and IgG, mortality, genotypes and travel-associated chikungunya were systematically reviewed. The maximum likelihood phylogenetic and evolutionary rate was estimated using Randomized Axelerated Maximum Likelihood (RAxML), and the Bayesian Markov chain Monte Carlo (MCMC) method identified the Time to Most Recent Common Ancestors (TMRCA) of Indonesian CHIKV. The systematic review was registered in the PROSPERO database (CRD42017078205).ResultsChikungunya incidence ranged between 0.16-36.2 cases per 100,000 person-year.Overall, the median seroprevalence of anti-CHIKV IgM antibodies in both outbreak and non-outbreak scenarios was 13.3% (17.7 and 7.3% for outbreak and non-outbreak events, respectively). The median seroprevalence of IgG antibodies in both outbreak and non-outbreak settings was 18.5% (range 0.0-73.1%). There were 130 Indonesian CHIKV sequences available, of which 120 (92.3%) were of the Asian genotype and 10 (7.7%) belonged to the East/Central/South African (ECSA) genotype. The ECSA genotype was first isolated in Indonesia in 2008 and was continually sampled until 2011. All ECSA viruses sampled in Indonesia appear to be closely related to viruses that caused massive outbreaks in Southeast Asia countries during the same period. Massive nationwide chikungunya outbreaks in Indonesia were reported during 2009-2010 with a total of 137,655 cases. Our spatio-temporal, phylogenetic and evolutionary data suggest that these outbreaks were likely associated with the introduction of the ECSA genotype of CHIKV to Indonesia.ConclusionsAlthough no deaths have been recorded, the seroprevalence of anti-CHIKV IgM and IgG in the Indonesian population have been relatively high in recent years following re-emergence in early 2001. There is sufficient evidence to suggest that the introduction of ECSA into Indonesia was likelyassociated with massive chikungunya outbreaks during 2009-2010.

Original languageEnglish
Article number243
Number of pages20
JournalBMC Infectious Diseases
Volume19
DOIs
Publication statusPublished - 12 Mar 2019

Cite this

Harapan, Harapan ; Michie, Alice ; Mudatsir, Mudatsir ; Nusa, Roy ; Yohan, Benediktus ; Wagner, Abram Luther ; Sasmono, R. Tedjo ; Imrie, Allison. / Chikungunya virus infection in Indonesia : a systematic review and evolutionary analysis. In: BMC Infectious Diseases. 2019 ; Vol. 19.
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title = "Chikungunya virus infection in Indonesia: a systematic review and evolutionary analysis",
abstract = "BackgroundDespite the high number of chikungunya cases in Indonesia in recent years, comprehensive epidemiological data are lacking. The systematic review was undertaken to provide data on incidence, the seroprevalence of anti-Chikungunya virus (CHIKV) IgM and IgG antibodies, mortality, the genotypes of circulating CHIKV and travel-related cases of chikungunya in the country. In addition, a phylogenetic and evolutionary analysis of Indonesian CHIKV was conducted.MethodsA systematic review was conducted to identify eligible studies from EMBASE, MEDLINE, PubMed and Web of Science as of October 16th 2017. Studies describing the incidence,seroprevalence of IgM and IgG, mortality, genotypes and travel-associated chikungunya were systematically reviewed. The maximum likelihood phylogenetic and evolutionary rate was estimated using Randomized Axelerated Maximum Likelihood (RAxML), and the Bayesian Markov chain Monte Carlo (MCMC) method identified the Time to Most Recent Common Ancestors (TMRCA) of Indonesian CHIKV. The systematic review was registered in the PROSPERO database (CRD42017078205).ResultsChikungunya incidence ranged between 0.16-36.2 cases per 100,000 person-year.Overall, the median seroprevalence of anti-CHIKV IgM antibodies in both outbreak and non-outbreak scenarios was 13.3{\%} (17.7 and 7.3{\%} for outbreak and non-outbreak events, respectively). The median seroprevalence of IgG antibodies in both outbreak and non-outbreak settings was 18.5{\%} (range 0.0-73.1{\%}). There were 130 Indonesian CHIKV sequences available, of which 120 (92.3{\%}) were of the Asian genotype and 10 (7.7{\%}) belonged to the East/Central/South African (ECSA) genotype. The ECSA genotype was first isolated in Indonesia in 2008 and was continually sampled until 2011. All ECSA viruses sampled in Indonesia appear to be closely related to viruses that caused massive outbreaks in Southeast Asia countries during the same period. Massive nationwide chikungunya outbreaks in Indonesia were reported during 2009-2010 with a total of 137,655 cases. Our spatio-temporal, phylogenetic and evolutionary data suggest that these outbreaks were likely associated with the introduction of the ECSA genotype of CHIKV to Indonesia.ConclusionsAlthough no deaths have been recorded, the seroprevalence of anti-CHIKV IgM and IgG in the Indonesian population have been relatively high in recent years following re-emergence in early 2001. There is sufficient evidence to suggest that the introduction of ECSA into Indonesia was likelyassociated with massive chikungunya outbreaks during 2009-2010.",
keywords = "Chikungunya, Chikungunya virus, ECSA genotype, Indonesia, Systematic review, ARBOVIRAL DISEASES, NATIONAL ARBOVIRUS, SOUTHEAST-ASIA, PHYLOGENETIC ANALYSES, HUMAN-POPULATIONS, REUNION ISLAND, BORNE VIRUSES, AUSTRALIA, OUTBREAK, MALARIA",
author = "Harapan Harapan and Alice Michie and Mudatsir Mudatsir and Roy Nusa and Benediktus Yohan and Wagner, {Abram Luther} and Sasmono, {R. Tedjo} and Allison Imrie",
year = "2019",
month = "3",
day = "12",
doi = "10.1186/s12879-019-3857-y",
language = "English",
volume = "19",
journal = "BMC Infectious Diseases",
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Chikungunya virus infection in Indonesia : a systematic review and evolutionary analysis. / Harapan, Harapan; Michie, Alice; Mudatsir, Mudatsir; Nusa, Roy; Yohan, Benediktus; Wagner, Abram Luther; Sasmono, R. Tedjo; Imrie, Allison.

In: BMC Infectious Diseases, Vol. 19, 243, 12.03.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Chikungunya virus infection in Indonesia

T2 - a systematic review and evolutionary analysis

AU - Harapan, Harapan

AU - Michie, Alice

AU - Mudatsir, Mudatsir

AU - Nusa, Roy

AU - Yohan, Benediktus

AU - Wagner, Abram Luther

AU - Sasmono, R. Tedjo

AU - Imrie, Allison

PY - 2019/3/12

Y1 - 2019/3/12

N2 - BackgroundDespite the high number of chikungunya cases in Indonesia in recent years, comprehensive epidemiological data are lacking. The systematic review was undertaken to provide data on incidence, the seroprevalence of anti-Chikungunya virus (CHIKV) IgM and IgG antibodies, mortality, the genotypes of circulating CHIKV and travel-related cases of chikungunya in the country. In addition, a phylogenetic and evolutionary analysis of Indonesian CHIKV was conducted.MethodsA systematic review was conducted to identify eligible studies from EMBASE, MEDLINE, PubMed and Web of Science as of October 16th 2017. Studies describing the incidence,seroprevalence of IgM and IgG, mortality, genotypes and travel-associated chikungunya were systematically reviewed. The maximum likelihood phylogenetic and evolutionary rate was estimated using Randomized Axelerated Maximum Likelihood (RAxML), and the Bayesian Markov chain Monte Carlo (MCMC) method identified the Time to Most Recent Common Ancestors (TMRCA) of Indonesian CHIKV. The systematic review was registered in the PROSPERO database (CRD42017078205).ResultsChikungunya incidence ranged between 0.16-36.2 cases per 100,000 person-year.Overall, the median seroprevalence of anti-CHIKV IgM antibodies in both outbreak and non-outbreak scenarios was 13.3% (17.7 and 7.3% for outbreak and non-outbreak events, respectively). The median seroprevalence of IgG antibodies in both outbreak and non-outbreak settings was 18.5% (range 0.0-73.1%). There were 130 Indonesian CHIKV sequences available, of which 120 (92.3%) were of the Asian genotype and 10 (7.7%) belonged to the East/Central/South African (ECSA) genotype. The ECSA genotype was first isolated in Indonesia in 2008 and was continually sampled until 2011. All ECSA viruses sampled in Indonesia appear to be closely related to viruses that caused massive outbreaks in Southeast Asia countries during the same period. Massive nationwide chikungunya outbreaks in Indonesia were reported during 2009-2010 with a total of 137,655 cases. Our spatio-temporal, phylogenetic and evolutionary data suggest that these outbreaks were likely associated with the introduction of the ECSA genotype of CHIKV to Indonesia.ConclusionsAlthough no deaths have been recorded, the seroprevalence of anti-CHIKV IgM and IgG in the Indonesian population have been relatively high in recent years following re-emergence in early 2001. There is sufficient evidence to suggest that the introduction of ECSA into Indonesia was likelyassociated with massive chikungunya outbreaks during 2009-2010.

AB - BackgroundDespite the high number of chikungunya cases in Indonesia in recent years, comprehensive epidemiological data are lacking. The systematic review was undertaken to provide data on incidence, the seroprevalence of anti-Chikungunya virus (CHIKV) IgM and IgG antibodies, mortality, the genotypes of circulating CHIKV and travel-related cases of chikungunya in the country. In addition, a phylogenetic and evolutionary analysis of Indonesian CHIKV was conducted.MethodsA systematic review was conducted to identify eligible studies from EMBASE, MEDLINE, PubMed and Web of Science as of October 16th 2017. Studies describing the incidence,seroprevalence of IgM and IgG, mortality, genotypes and travel-associated chikungunya were systematically reviewed. The maximum likelihood phylogenetic and evolutionary rate was estimated using Randomized Axelerated Maximum Likelihood (RAxML), and the Bayesian Markov chain Monte Carlo (MCMC) method identified the Time to Most Recent Common Ancestors (TMRCA) of Indonesian CHIKV. The systematic review was registered in the PROSPERO database (CRD42017078205).ResultsChikungunya incidence ranged between 0.16-36.2 cases per 100,000 person-year.Overall, the median seroprevalence of anti-CHIKV IgM antibodies in both outbreak and non-outbreak scenarios was 13.3% (17.7 and 7.3% for outbreak and non-outbreak events, respectively). The median seroprevalence of IgG antibodies in both outbreak and non-outbreak settings was 18.5% (range 0.0-73.1%). There were 130 Indonesian CHIKV sequences available, of which 120 (92.3%) were of the Asian genotype and 10 (7.7%) belonged to the East/Central/South African (ECSA) genotype. The ECSA genotype was first isolated in Indonesia in 2008 and was continually sampled until 2011. All ECSA viruses sampled in Indonesia appear to be closely related to viruses that caused massive outbreaks in Southeast Asia countries during the same period. Massive nationwide chikungunya outbreaks in Indonesia were reported during 2009-2010 with a total of 137,655 cases. Our spatio-temporal, phylogenetic and evolutionary data suggest that these outbreaks were likely associated with the introduction of the ECSA genotype of CHIKV to Indonesia.ConclusionsAlthough no deaths have been recorded, the seroprevalence of anti-CHIKV IgM and IgG in the Indonesian population have been relatively high in recent years following re-emergence in early 2001. There is sufficient evidence to suggest that the introduction of ECSA into Indonesia was likelyassociated with massive chikungunya outbreaks during 2009-2010.

KW - Chikungunya

KW - Chikungunya virus

KW - ECSA genotype

KW - Indonesia

KW - Systematic review

KW - ARBOVIRAL DISEASES

KW - NATIONAL ARBOVIRUS

KW - SOUTHEAST-ASIA

KW - PHYLOGENETIC ANALYSES

KW - HUMAN-POPULATIONS

KW - REUNION ISLAND

KW - BORNE VIRUSES

KW - AUSTRALIA

KW - OUTBREAK

KW - MALARIA

U2 - 10.1186/s12879-019-3857-y

DO - 10.1186/s12879-019-3857-y

M3 - Review article

VL - 19

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

M1 - 243

ER -