Global prevalence of Asymptomatic Dengue infections - A systematic review and meta-analysis
Abstract
OBJECTIVE
The burden of asymptomatic Dengue infections is understudied. Therefore, we systematically reviewed the literature to estimate the global prevalence of asymptomatic Dengue infections.
METHODS
We searched cross-sectional studies reporting the prevalence of asymptomatic Dengue infections from PubMed, Scopus, and Embase. Prevalence of asymptomatic dengue infections was pooled and reported as proportions with a 95% confidence interval. This systematic review protocol was a priori registered in PROSPERO (Reg: No. CRD42020218446).
RESULTS
We included 41 studies with 131,953 cases in our analysis. The overall pooled prevalence of asymptomatic Dengue infections was 59.26% (95% CI: 43.76 - 74.75, I2 = 99.93%), with 65.52% (95% CI: 38.73 - 92.32, I2 = 99.95%) during outbreaks and 30.78% (95% CI: 21.39 - 40.16, I2 = 98.78%) during non-outbreak periods. The pooled prevalence among the acutely infected individuals was 54.52% (95% CI: 17.73 - 46.76, I2 = 99.91%), whereas among primary and secondary asymptomatic Dengue infections, it was 65.36% (95% CI: 45.76 - 84.96, I2 = 98.82) and 48.99% (95% CI: 27.85 - 70.13, I2 = 99.08%) respectively.
CONCLUSION
The majority of Dengue cases are asymptomatic and may play a significant role in disease transmission. Public health strategies aimed at Dengue outbreak response and mitigation of disease burden should include early detection of asymptomatic cases.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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