{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:55:09Z","timestamp":1790319309990,"version":"4.1.0"},"reference-count":99,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Dengue contributes a significant burden on global public health and economies. In Africa, the burden of dengue virus (DENV) infection is not well described. This review was undertaken to determine the prevalence of dengue and associated risk factors. A literature search was done on PubMed\/MEDLINE, Scopus, Embase, and Google Scholar databases to identify articles published between 1960 and 2020. Meta-analysis was performed using a random-effect model at a 95% confidence interval, followed by subgroup meta-analysis to determine the overall prevalence. Between 1960 and 2020, 45 outbreaks were identified, of which 17 and 16 occurred in East and West Africa, respectively. Dengue virus serotype 1 (DENV-1) and DENV-2 were the dominant serotypes contributing to 60% of the epidemics. Of 2211 cases reported between 2009 and 2020; 1954 (88.4%) were reported during outbreaks. Overall, the prevalence of dengue was 29% (95% CI: 20\u201339%) and 3% (95% CI: 1\u20135%) during the outbreak and non-outbreak periods, respectively. Old age (6\/21 studies), lack of mosquito control (6\/21), urban residence (4\/21), climate change (3\/21), and recent history of travel (3\/21) were the leading risk factors. This review reports a high burden of dengue and increased risk of severe disease in Africa. Our findings provide useful information for clinical practice and health policy decisions to implement effective interventions.<\/jats:p>","DOI":"10.3390\/v13040536","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T21:36:51Z","timestamp":1616621811000},"page":"536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":88,"title":["Dengue Virus Infection and Associated Risk Factors in Africa: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-8393","authenticated-orcid":false,"given":"Gaspary O.","family":"Mwanyika","sequence":"first","affiliation":[{"name":"SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania"},{"name":"Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania"},{"name":"Department of Health Science and Technology, Mbeya University of Science and Technology, P.O. Box 131 Mbeya, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5746-3776","authenticated-orcid":false,"given":"Leonard E. G.","family":"Mboera","sequence":"additional","affiliation":[{"name":"SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1473-3750","authenticated-orcid":false,"given":"Sima","family":"Rugarabamu","sequence":"additional","affiliation":[{"name":"SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania"},{"name":"Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania"},{"name":"Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65595 Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baraka","family":"Ngingo","sequence":"additional","affiliation":[{"name":"SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania"},{"name":"Biology Department, St. John\u2019s University of Tanzania, P.O. Box 47 Dodoma, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Sindato","sequence":"additional","affiliation":[{"name":"SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania"},{"name":"Tabora Research Centre, National Institute for Medical Research, P.O. Box 482 Tabora, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius J.","family":"Lutwama","sequence":"additional","affiliation":[{"name":"Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, P.O. Box 49 Entebbe, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz T.","family":"Paweska","sequence":"additional","affiliation":[{"name":"National Health Laboratory Service, National Institute for Communicable Diseases, Sandringham, 2192 Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1827-6403","authenticated-orcid":false,"given":"Gerald","family":"Misinzo","sequence":"additional","affiliation":[{"name":"SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania"},{"name":"Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lambrechts, L., Scott, T.W., and Gubler, D.J. (2010). Consequences of the expanding global distribution of aedes albopictus for dengue virus transmission. PLoS Negl. Trop. Dis., 4.","DOI":"10.1371\/journal.pntd.0000646"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1038\/s41564-019-0476-8","article-title":"The current and future global distribution and population at risk of dengue","volume":"4","author":"Messina","year":"2019","journal-title":"Nat. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/nature12060","article-title":"The global distribution and burden of dengue","volume":"496","author":"Bhatt","year":"2013","journal-title":"Nature"},{"key":"ref_4","first-page":"299","article-title":"Epidemiology of dengue: Past, present and future prospects","volume":"5","author":"Murray","year":"2013","journal-title":"Clin. Epidemiol."},{"key":"ref_5","first-page":"1349","article-title":"Dengue virus infection in Africa","volume":"17","author":"Amarasinghe","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Guo, C., Zhou, Z., Wen, Z., Liu, Y., Zeng, C., Xiao, D., Ou, M., Han, Y., Huang, S., and Liu, D. (2017). Global epidemiology of dengue outbreaks in 1990\u20132015: A systematic review and Meta-analysis. Front. Cell. Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00317"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1179\/2046904712Z.00000000048","article-title":"The dengue situation in Africa","volume":"32","author":"Were","year":"2012","journal-title":"Paediatr. Int. Child Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1478-7954-9-1","article-title":"Measuring the burden of arboviral diseases: The spectrum of morbidity and mortality from four prevalent infections","volume":"9","author":"LaBeaud","year":"2011","journal-title":"Popul. Health Metr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Furuya-Kanamori, L., Liang, S., Milinovich, G., Soares Magalhaes, R.J., Clements, A.C.A., Hu, W., Brasil, P., Frentiu, F.D., Dunning, R., and Yakob, L. (2016). Co-distribution and co-infection of chikungunya and dengue viruses. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1417-2"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Halsey, E.S., Baldeviano, G.C., Edgel, K.A., Vilcarromero, S., Sihuincha, M., and Lescano, A.G. (2016). Symptoms and immune markers in plasmodium\/dengue virus co-infection compared with mono-infection with either in peru. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004646"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., and Stewart, L.A. (2015). Preferred reporting items for systematic review and Meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev., 4.","DOI":"10.1186\/2046-4053-4-1"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014A web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1016\/j.jclinepi.2011.11.014","article-title":"Assessing risk of bias in prevalence studies: Modification of an existing tool and evidence of interrater agreement","volume":"65","author":"Hoy","year":"2012","journal-title":"J. Clin. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.3201\/eid1407.071521","article-title":"Outbreak of dengue and chikungunya fevers, toamasina, madagascar, 2006","volume":"14","author":"Ratsitorahina","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"591","DOI":"10.3201\/eid1504.080664","article-title":"Concurrent chikungunya and dengue virus infections during simultaneous outbreaks, gabon, 2007","volume":"15","author":"Leroy","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Nkoghe, D., Kassa, R.F.K., Bisvigou, U., Caron, M., Grard, G., and Leroy, E.M. (2012). No clinical or biological difference between chikungunya and dengue fever during the 2010 gabonese outbreak. Infect. Dis. Rep., 4.","DOI":"10.4081\/idr.2012.e5"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jiph.2010.08.001","article-title":"Dengue hemorrhagic fever outbreak in children in Port Sudan","volume":"4","author":"Malik","year":"2011","journal-title":"J. Infect. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1089\/vbz.2011.0622","article-title":"Dengue virus seroprevalence among febrile patients in Bamako, Mali: Results of a 2006 surveillance study","volume":"11","author":"Phoutrides","year":"2011","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1093\/cid\/cis530","article-title":"Recent introduction and rapid dissemination of chikungunya virus and dengue virus serotype 2 associated with human and mosquito coinfections in Gabon, Central Africa","volume":"55","author":"Caron","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4269\/ajtmh.2012.11-0393","article-title":"Chikungunya and dengue fever among hospitalized febrile patients in Northern Tanzania","volume":"86","author":"Hertz","year":"2012","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1016\/j.ijid.2011.09.018","article-title":"Seroprevalence of dengue infection: A cross-sectional survey in Mainland Tanzania and on Pemba Island, Zanzibar","volume":"16","author":"Vairo","year":"2012","journal-title":"Int. J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3201\/eid2003.121885","article-title":"Urban epidemic of dengue virus serotype 3 infection, senegal, 2009","volume":"20","author":"Faye","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.3855\/jidc.4910","article-title":"Angola\u2019s 2013 dengue outbreak: Clinical, laboratory and molecular analyses of cases from four portuguese institutions","volume":"8","author":"Parreira","year":"2014","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chipwaza, B., Mugasa, J.P., Selemani, M., Amuri, M., Mosha, F., Ngatunga, S.D., and Gwakisa, P.S. (2014). Dengue and chikungunya fever among viral diseases in outpatient febrile children in Kilosa District Hospital, Tanzania. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0003335"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Elduma, A.H., and Osman, W.M. (2014). Dengue and hepatitis E virus infection in pregnant women in eastern sudan, a challenge for diagnosis in an endemic area. Pan Afr. Med. J., 19.","DOI":"10.11604\/pamj.2014.19.391.5439"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1093\/trstmh\/trv076","article-title":"Dengue: Etiology of acute febrile illness in Abidjan, C\u00f4te d\u2019Ivoire, in 2011\u20132012","volume":"109","author":"Succo","year":"2015","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ellis, E.M., Neatherlin, J.C., Delorey, M., Ochieng, M., Mohamed, A.H., Mogeni, D.O., Hunsperger, E., Patta, S., Gikunju, S., and Waiboic, L. (2015). A household serosurvey to estimate the magnitude of a dengue outbreak in Mombasa, Kenya, 2013. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003733"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Konongoi, L., Ofula, V., Nyunja, A., Owaka, S., Koka, H., Makio, A., Koskei, E., Eyase, F., Langat, D., and Schoepp, R.J. (2016). Detection of dengue virus serotypes 1, 2 and 3 in selected regions of Kenya: 2011\u20132014. Virol. J., 13.","DOI":"10.1186\/s12985-016-0641-0"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ngoi, C.N., Price, M.A., Fields, B., Bonventure, J., Ochieng, C., Mwashigadi, G., Hassan, A.S., Thiong\u2019o, A.N., Micheni, M., and Mugo, P. (2016). Dengue and chikungunya virus infections among young febrile adults evaluated for acute HIV-1 infection in coastal Kenya. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0167508"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Le Gonidec, E., Maquart, M., Duron, S., Savini, H., Cazajous, G., Vidal, P.-O., Chenilleau, M.-C., Roseau, J.-B., Benois, A., and Dehan, C. (2016). Clinical survey of dengue virus circulation in the republic of djibouti between 2011 and 2014 identifies serotype 3 epidemic and recommends clinical diagnosis guidelines for resource limited settings. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004755"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"895","DOI":"10.3201\/eid2205.151462","article-title":"Clinical, virologic, and epidemiologic characteristics of dengue outbreak, Dar Es Salaam, Tanzania, 2014","volume":"22","author":"Vairo","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1128\/JCM.00521-16","article-title":"Use of a rapid test for diagnosis of dengue during suspected dengue outbreaks in resource-limited regions","volume":"54","author":"Hunsperger","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jcv.2016.04.011","article-title":"Imported dengue from 2013 angola outbreak: Not just serotype 1 was detected","volume":"79","author":"Abreu","year":"2016","journal-title":"J. Clin. Virol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.3201\/eid2311.170807","article-title":"Unrecognized dengue virus infections in children, western Kenya, 2014\u20132015","volume":"23","author":"Vu","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.4269\/ajtmh.17-0317","article-title":"Dengue virus serotype 2 established in northern Mozambique (2015\u20132016)","volume":"97","author":"Oludele","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-019-50135-x","article-title":"Dengue virus infection in people residing in Africa: A systematic review and meta-analysis of prevalence studies","volume":"9","author":"Simo","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"625","DOI":"10.4269\/ajtmh.17-0421","article-title":"A combined syndromic approach to examine viral, bacterial, and parasitic agents among febrile patients: A pilot study in Kilombero, Tanzania","volume":"98","author":"Hercik","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Obonyo, M., Fidhow, A., and Ofula, V. (2018). Investigation of laboratory confirmed dengue outbreak in north-eastern Kenya, 2011. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198556"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1089\/vbz.2017.2176","article-title":"Identification of dengue and chikungunya cases among suspected cases of yellow fever in the Democratic Republic of the Congo","volume":"18","author":"Abbate","year":"2018","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.3201\/eid2408.180341","article-title":"Detection of dengue virus among children with suspected Malaria, Accra, Ghana","volume":"24","author":"Amoako","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Bonney, J.H.K., Hayashi, T., Dadzie, S., Agbosu, E., Pratt, D., Nyarko, S., Asiedu-Bekoe, F., Ido, E., Sarkodie, B., and Ohta, N. (2018). Molecular detection of dengue virus in patients suspected of ebola virus disease in Ghana. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0208907"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3201\/eid2401.170973","article-title":"Dengue fever in Burkina Faso, 2016","volume":"24","author":"Tarnagda","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Yousseu, F.B.S., Nemg, F.B.S., Ngouanet, S.A., Mekanda, F.M.O., and Demanou, M. (2018). Detection and serotyping of dengue viruses in febrile patients consulting at the new-bell district hospital in Douala, Cameroon. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204143"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"58","DOI":"10.7883\/yoken.JJID.2018.267","article-title":"Molecular investigation of dengue virus serotype 2 circulation in Kassala State, Sudan","volume":"72","author":"Hamid","year":"2019","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Degife, L.H., Worku, Y., Belay, D., Bekele, A., and Hailemariam, Z. (2019). Factors associated with dengue fever outbreak in dire dawa administration City, October, 2015, Ethiopia\u2014Case control study. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7015-7"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1007\/s13337-019-00556-z","article-title":"Relative frequency of acute pancreatitis from dengue outbreaks as a late complication, in Egypt","volume":"30","author":"Ghweil","year":"2019","journal-title":"VirusDis"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ahmed, A., Elduma, A., Magboul, B., Higazi, T., and Ali, Y. (2019). The first outbreak of dengue fever in greater darfur, western Sudan. Trop. Med. Infect. Dis., 4.","DOI":"10.3390\/tropicalmed4010043"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Proesmans, S., Katshongo, F., Milambu, J., Fungula, B., Muhindo Mavoko, H., Ahuka-Mundeke, S., Inoc\u00eancio da Luz, R., Van Esbroeck, M., Ari\u00ebn, K.K., and Cnops, L. (2019). Dengue and chikungunya among outpatients with acute undifferentiated fever in Kinshasa, Democratic Republic of Congo: A cross-sectional study. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007047"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Ayolabi, C.I., Olusola, B.A., Ibemgbo, S.A., and Okonkwo, G.O. (2019). Detection of dengue viruses among febrile patients in Lagos, Nigeria and phylogenetics of circulating dengue serotypes in Africa. Infect. Genet. Evol., 75.","DOI":"10.1016\/j.meegid.2019.103947"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Boyce, R.M., Collins, M., Muhindo, R., Nakakande, R., Ciccone, E.J., Grounds, S., Espinoza, D., Zhu, Y., Matte, M., and Ntaro, M. (2020). Dengue in western Uganda: A prospective cohort of children presenting with undifferentiated febrile illness. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05568-5"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Chipwaza, B., Sumaye, R.D., Weisser, M., Gingo, W., Yeo, N.K.-W., Amrun, S.N., Okumu, F.O., and Ng, L.F.P. (2021). Occurrence of 4 dengue virus serotypes and chikungunya virus in Kilombero Valley, Tanzania, during the dengue outbreak in 2018. Open Forum Infect. Dis., 8.","DOI":"10.1093\/ofid\/ofaa626"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Dieng, I., Hedible, B.G., Diagne, M.M., El Wahed, A.A., Diagne, C.T., Fall, C., Richard, V., Vray, M., Weidmann, M., and Faye, O. (2020). Mobile laboratory reveals the circulation of dengue virus serotype I of Asian Origin in medina gounass (guediawaye), senegal. Diagnostics, 10.","DOI":"10.3390\/diagnostics10060408"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Im, J., Balasubramanian, R., Ouedraogo, M., Wandji Nana, L.R., Mogeni, O.D., Jeon, H.J., van Pomeren, T., Haselbeck, A., Lim, J.K., and Prifti, K. (2020). The epidemiology of dengue outbreaks in 2016 and 2017 in Ouagadougou, Burkina Faso. Heliyon, 6.","DOI":"10.1016\/j.heliyon.2020.e04389"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Eldigail, M.H., Abubaker, H.A., Khalid, F.A., Abdallah, T.M., Adam, I.A., Adam, G.K., Babiker, R.A., Ahmed, M.E., Haroun, E.M., and Aradaib, I.E. (2020). Recent transmission of dengue virus and associated risk facors among residents of Kassala State, Eastern Sudan. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-08656-y"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Masika, M.M., Korhonen, E.M., Smura, T., Uusitalo, R., Vapalahti, K., Mwaengo, D., J\u00e4\u00e4skel\u00e4inen, A.J., Anzala, O., Vapalahti, O., and Huhtamo, E. (2020). Detection of dengue virus type 2 of indian origin in acute febrile patients in Rural Kenya. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008099"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2638","DOI":"10.3201\/eid2611.200960","article-title":"High dengue burden and circulation of 4 virus serotypes among children with undifferentiated fever, Kenya, 2014\u20132017","volume":"26","author":"Shah","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0140-6736(71)90840-3","article-title":"Dengue viruses from febrile patients in Nigeria, 1964\u201368","volume":"297","author":"Carey","year":"1971","journal-title":"The Lancet"},{"key":"ref_58","first-page":"937","article-title":"An outbreak of type 2 dengue fever in the seychelles, probably transmitted by aedes albopictus (skuse)","volume":"58","author":"Metselaar","year":"1980","journal-title":"Bull. World Health Organ."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/0035-9203(86)90182-3","article-title":"Isolation of dengue 2 and dengue 4 viruses from patients in senegal","volume":"80","author":"Saluzzo","year":"1986","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/jmv.1890290202","article-title":"Serological evidence of dengue fever among Refugees, Hargeysa, Somalia","volume":"29","author":"Botros","year":"1989","journal-title":"J. Med. Virol."},{"key":"ref_61","unstructured":"(2020, December 03). Home\u2014ProMED. Available online: https:\/\/promedmail.org\/."},{"key":"ref_62","unstructured":"WHO (2020, December 03). Disease Outbreak News (DONs). Available online: http:\/\/www.who.int\/csr\/don\/en\/."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"716","DOI":"10.3201\/eid1604.091582","article-title":"Reemergence of dengue in mauritius","volume":"16","author":"Issack","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.26719\/2012.18.12.1217","article-title":"Dengue vector control and surveillance during a major outbreak in a coastal red sea area in Sudan","volume":"18","author":"Seidahmed","year":"2012","journal-title":"East. Mediterr. Health J."},{"key":"ref_65","first-page":"155","article-title":"The first acute febrile illness investigation associated with dengue fever in Ethiopia, 2013: A descriptive analysis","volume":"28","author":"Woyessa","year":"2020","journal-title":"Ethiop. J. Health Dev."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Vincent, M., Larrieu, S., Vilain, P., Etienne, A., Solet, J.-L., Fran\u00e7ois, C., Roquebert, B., Jaffar Bandjee, M.-C., Filleul, L., and Menudier, L. (2019). From the threat to the large outbreak: Dengue on reunion Island, 2015 to 2018. Euro Surv, 24.","DOI":"10.2807\/1560-7917.ES.2019.24.47.1900346"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Demanou, M., Pouillot, R., Grandadam, M., Boisier, P., Kamgang, B., Herv\u00e9, J.P., Rogier, C., Rousset, D., and Paupy, C. (2014). Evidence of dengue virus transmission and factors associated with the presence of anti-dengue virus antibodies in humans in three major towns in cameroon. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0002950"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.virusres.2016.12.011","article-title":"Dengue Virus Non-Structural Protein-1 Expression and Associated Risk Factors among Febrile Patients Attending University of Abuja Teaching Hospital, Nigeria","volume":"230","author":"Nasir","year":"2016","journal-title":"Virus Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/tme.12646","article-title":"Seroprevalence and factors associated with IgG Anti-DENV positivity in blood donors in burkina faso during the 2016 dengue outbreak and implications for blood supply","volume":"30","author":"Sawadogo","year":"2020","journal-title":"Transfus. Med."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Ferede, G., Tiruneh, M., Abate, E., Wondimeneh, Y., Damtie, D., Gadisa, E., Howe, R., Aseffa, A., and Tessema, B. (2018). A serologic study of dengue in northwest Ethiopia: Suggesting preventive and control measures. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006430"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Omatola, C.A., Onoja, A.B., Moses, E., Mahmud, M., and Mofolorunsho, C.K. (2020). Dengue in parts of the guinea savannah region of nigeria and the risk of increased transmission. Int. Health, 1\u20135. Online Ahead of Print.","DOI":"10.1093\/inthealth\/ihaa033"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Elaagip, A., Alsedig, K., Altahir, O., Ageep, T., Ahmed, A., Siam, H.A., Samy, A.M., Mohamed, W., Khalid, F., and Gumaa, S. (2020). Seroprevalence and associated risk factors of dengue fever in Kassala State, Eastern Sudan. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008918"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"465","DOI":"10.3201\/eid2003.130150","article-title":"IgG against dengue virus in healthy blood donors, Zanzibar, Tanzania","volume":"20","author":"Vairo","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Mweya, C.N., Kimera, S.I., Stanley, G., Misinzo, G., and Mboera, L.E.G. (2016). Climate change influences potential distribution of infected aedes aegypti co-occurrence with dengue epidemics risk areas in Tanzania. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0162649"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/1743-422X-11-135","article-title":"First sero-prevalence of dengue fever specific immunoglobulin G antibodies in western and north-western provinces of Zambia: A population based cross sectional study","volume":"11","author":"Siziya","year":"2014","journal-title":"Virol. J."},{"key":"ref_76","first-page":"145","article-title":"Survey of malaria and anti-dengue virus IgG among febrile HIV-infected patients attending a tertiary hospital in Abuja, Nigeria","volume":"9","author":"Mustapha","year":"2017","journal-title":"HIVAIDS Auckl. NZ"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Ochieng, C., Ahenda, P., Vittor, A.Y., Nyoka, R., Gikunju, S., Wachira, C., Waiboci, L., Umuro, M., Kim, A.A., and Nderitu, L. (2015). Seroprevalence of infections with dengue, rift valley fever and chikungunya viruses in Kenya, 2007. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0132645"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Boillat-Blanco, N., Klaassen, B., Mbarack, Z., Samaka, J., Mlaganile, T., Masimba, J., Franco Narvaez, L., Mamin, A., Genton, B., and Kaiser, L. (2018). Dengue fever in Dar Es Salaam, Tanzania: Clinical features and outcome in populations of black and non-black racial category. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-3549-z"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Sondo, K.A., Ouattara, A., Diend\u00e9r\u00e9, E.A., Diallo, I., Zoungrana, J., Z\u00e9man\u00e9, G., Da, L., Gnamou, A., Meda, B., and Poda, A. (2019). Dengue infection during pregnancy in Burkina Faso: A cross-sectional study. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4587-x"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.medmal.2014.08.002","article-title":"Seven native cases of dengue in Abidjan, Ivory Coast","volume":"44","author":"Aoussi","year":"2014","journal-title":"M\u00e9decine Mal. Infect."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1080\/20469047.2020.1756106","article-title":"An outbreak of dengue fever in children in the national capital district of papua new guinea in 2016","volume":"40","author":"Pulsan","year":"2020","journal-title":"Paediatr. Int. Child Health"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1126\/science.aan6836","article-title":"Antibody-dependent enhancement of severe dengue disease in humans","volume":"358","author":"Katzelnick","year":"2017","journal-title":"Science"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Dieng, I., Cunha, M. dos P., Diagne, M.M., Semb\u00e8ne, P.M., Zanotto, P.M. de A., Faye, O., Faye, O., and Sall, A.A. (2021). Origin and spread of the dengue virus type 1, genotype V in senegal, 2015\u20132019. Viruses, 13.","DOI":"10.3390\/v13010057"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"800","DOI":"10.3201\/eid0907.030038","article-title":"Emergence and global spread of a dengue serotype 3, subtype III virus","volume":"9","author":"Messer","year":"2003","journal-title":"Emerg. Infect. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Franco, L., Palacios, G., Martinez, J.A., Sanchez-Seco, M.P., Mart\u0131n, D., Lipkin, W.I., and Tenorio, A. (2011). First report of sylvatic DENV-2-associated dengue hemorrhagic fever in West Africa. PLoS Negl. Trop Dis., 5.","DOI":"10.1371\/journal.pntd.0001251"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"502","DOI":"10.3201\/eid1403.070843","article-title":"Sylvatic dengue virus type 2 activity in humans, Nigeria, 1966","volume":"14","author":"Vasilakis","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.cmi.2018.02.011","article-title":"The epidemiology of febrile illness in sub-saharan Africa: Implications for diagnosis and management","volume":"24","author":"Maze","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Jaenisch, T., Junghanss, T., Wills, B., Brady, O.J., Eckerle, I., Farlow, A., Hay, S.I., McCall, P.J., Messina, J.P., and Ofula, V. (2014). Dengue expansion in Africa\u2014Not recognized or not happening?. Emerg. Infect. Dis., 20.","DOI":"10.3201\/eid2010.140487"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Elduma, A.H., LaBeaud, A.D., A. Plante, J., Plante, K.S., and Ahmed, A. (2020). High seroprevalence of dengue virus infection in Sudan: Systematic review and meta-analysis. Trop. Med. Infect. Dis., 5.","DOI":"10.3390\/tropicalmed5030120"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Werneck, G.L., Macias, A.E., Mascarenas, C., Coudeville, L., Morley, D., Recamier, V., Guergova-Kuras, M., Puentes-Rosas, E., Baurin, N., and Toh, M.-L. (2018). Comorbidities increase in-hospital mortality in dengue patients in Brazil. Mem. Inst. Oswaldo Cruz, 113.","DOI":"10.1590\/0074-02760180082"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Saqib, M.A.N., Rafique, I., Bashir, S., and Salam, A.A. (2014). A retrospective analysis of dengue fever case management and frequency of co-morbidities associated with deaths. BMC Res. Notes, 7.","DOI":"10.1186\/1756-0500-7-205"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.virusres.2014.07.023","article-title":"High dengue NS1 antigenemia in febrile patients in Ibadan, Nigeria","volume":"191","author":"Oyero","year":"2014","journal-title":"Virus Res."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.4269\/ajtmh.16-0798","article-title":"Surveillance of vector-borne infections (Chikungunya, Dengue, and Malaria) in Bo, Sierra Leone, 2012\u20132013","volume":"97","author":"Dariano","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1002\/jmv.24788","article-title":"Dengue virus and malaria concurrent infection among febrile subjects within Ilorin Metropolis, Nigeria","volume":"89","author":"Kolawole","year":"2017","journal-title":"J. Med. Virol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"276","DOI":"10.4314\/mmj.v30i4.11","article-title":"A cross sectional study of dengue virus infection in febrile patients presumptively diagnosed of malaria in Maiduguri and Jos Plateau, Nigeria","volume":"30","author":"Onyedibe","year":"2018","journal-title":"Malawi Med. J."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Salam, N., Mustafa, S., Hafiz, A., Chaudhary, A.A., Deeba, F., and Parveen, S. (2018). Global prevalence and distribution of coinfection of malaria, dengue and chikungunya: A systematic review. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5626-z"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1086\/499363","article-title":"Laboratory medicine in Africa: A barrier to effective health care","volume":"42","author":"Petti","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Msellemu, D., Gavana, T., Ngonyani, H., Mlacha, Y.P., Chaki, P., and Moore, S.J. (2020). Knowledge, attitudes and bite prevention practices and estimation of productivity of vector breeding sites using a Habitat Suitability Score (HSS) among households with confirmed dengue in the 2014 outbreak in Dar Es Salaam, Tanzania. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0007278"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2149\/tmh.2014-29","article-title":"Abundant aedes (stegomyia) aegypti aegypti mosquitoes in the 2014 dengue outbreak area of Mozambique","volume":"43","author":"Higa","year":"2015","journal-title":"Trop. Med. Health"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/4\/536\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:40:05Z","timestamp":1760161205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/4\/536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,24]]},"references-count":99,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["v13040536"],"URL":"https:\/\/doi.org\/10.3390\/v13040536","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,24]]}}}