tetano
Editor, Senior Moderator
Int J Infect Dis
. 2026 Feb 3:108456.
doi: 10.1016/j.ijid.2026.108456. Online ahead of print.
Epidemiology and genomic features of MERS coronavirus in Africa: a systematic and meta-analysis review
Brian Ogoti[SUP] 1 [/SUP], Victor Riitho[SUP] 2 [/SUP], Johanna Wildemann[SUP] 3 [/SUP], Nyamai Mutono[SUP] 4 [/SUP], Marianne Mureithi[SUP] 5 [/SUP], Prof Julius Oyugi[SUP] 6 [/SUP], Jordi Rodon[SUP] 3 [/SUP], Victor M Corman[SUP] 7 [/SUP], Prof Christian Drosten[SUP] 7 [/SUP], Prof S M Thumbi[SUP] 8 [/SUP], Prof Marcel A Müller[SUP] 9 [/SUP]
Affiliations
Objective: We explored factors contributing to the low human MERS-CoV prevalence in Africa by assessing MERS-CoV epidemiological and genomic features.
Methods: We followed the PRISMA guidelines. We searched for articles on epidemiological and virological MERS-CoV characteristics in humans and camels in Africa until August 2025. We used a generalised linear mixed-effects model to calculate pooled proportions. We identified relevant polymorphisms in African MERS-CoV lineages compared with the prototypic EMC/2012 and contemporary Arabian MERS-CoV (clade B5).
Results: We included 53 articles, with 31 used in the meta-analysis. Kenya, Egypt, and Ethiopia contributed to 66.03% of all included studies. Pooled MERS-CoV RNA positivity in African dromedaries was 6.09%, with juveniles (15.29%) having a higher incidence than adults (4.51%). The pooled MERS-CoV seroprevalence was 73.67%, with adults (80.96%) higher than juveniles (36.02%). In human-focused studies, only nine PCR-confirmed MERS cases were reported, six travel-associated and three autochthonous cases, despite a pooled seroprevalence of 2.4%. Genomic analyses identified MERS-CoV clade C-specific polymorphisms in the Spike and accessory genes with putative phenotypic impact.
Conclusion: We found the highest MERS-CoV RNA positivity in young dromedaries. Elevated MERS-CoV seroprevalence in mainly asymptomatic camel-exposed humans suggests an underestimation of MERS-CoV infections in Africa. The ongoing MERS-CoV evolution emphasises the need for active genomic surveillance to monitor signatures of human adaptation.
Keywords: Africa; MERS, coronavirus; MERS-CoV; dromedary camel; epidemiology; genotype; meta-analysis; phenotype; systematic review; zoonosis.
. 2026 Feb 3:108456.
doi: 10.1016/j.ijid.2026.108456. Online ahead of print.
Epidemiology and genomic features of MERS coronavirus in Africa: a systematic and meta-analysis review
Brian Ogoti[SUP] 1 [/SUP], Victor Riitho[SUP] 2 [/SUP], Johanna Wildemann[SUP] 3 [/SUP], Nyamai Mutono[SUP] 4 [/SUP], Marianne Mureithi[SUP] 5 [/SUP], Prof Julius Oyugi[SUP] 6 [/SUP], Jordi Rodon[SUP] 3 [/SUP], Victor M Corman[SUP] 7 [/SUP], Prof Christian Drosten[SUP] 7 [/SUP], Prof S M Thumbi[SUP] 8 [/SUP], Prof Marcel A Müller[SUP] 9 [/SUP]
Affiliations
- PMID: 41644038
- DOI: 10.1016/j.ijid.2026.108456
Objective: We explored factors contributing to the low human MERS-CoV prevalence in Africa by assessing MERS-CoV epidemiological and genomic features.
Methods: We followed the PRISMA guidelines. We searched for articles on epidemiological and virological MERS-CoV characteristics in humans and camels in Africa until August 2025. We used a generalised linear mixed-effects model to calculate pooled proportions. We identified relevant polymorphisms in African MERS-CoV lineages compared with the prototypic EMC/2012 and contemporary Arabian MERS-CoV (clade B5).
Results: We included 53 articles, with 31 used in the meta-analysis. Kenya, Egypt, and Ethiopia contributed to 66.03% of all included studies. Pooled MERS-CoV RNA positivity in African dromedaries was 6.09%, with juveniles (15.29%) having a higher incidence than adults (4.51%). The pooled MERS-CoV seroprevalence was 73.67%, with adults (80.96%) higher than juveniles (36.02%). In human-focused studies, only nine PCR-confirmed MERS cases were reported, six travel-associated and three autochthonous cases, despite a pooled seroprevalence of 2.4%. Genomic analyses identified MERS-CoV clade C-specific polymorphisms in the Spike and accessory genes with putative phenotypic impact.
Conclusion: We found the highest MERS-CoV RNA positivity in young dromedaries. Elevated MERS-CoV seroprevalence in mainly asymptomatic camel-exposed humans suggests an underestimation of MERS-CoV infections in Africa. The ongoing MERS-CoV evolution emphasises the need for active genomic surveillance to monitor signatures of human adaptation.
Keywords: Africa; MERS, coronavirus; MERS-CoV; dromedary camel; epidemiology; genotype; meta-analysis; phenotype; systematic review; zoonosis.