Epidemiology, seroprevalence, and circulation of Chikungunya virus in Southern Africa (SADC region): A systematic review

Chikungunya virus (CHIKV) is an emerging arbovirus that causes major morbidity in tropical regions, but its epidemiology in Southern Africa is poorly defined. This study compiles research on CHIKV circulation, clinical characteristics, and surveillance strategies in the region, specifically in the Southern African Developing Community (SADC) block. A systematic search of peer-reviewed publications published between January 2012 and October 2025 that reported CHIKV detection, seroprevalence, or clinical symptoms in eight Southern African countries was conducted. Eligible studies included human studies, outbreak investigations, population-based surveys, diagnostic evaluations, and case reports. Whilst, zoonotic studies, animal studies, letters to editors, comments, and studies not clearly define in terms of country, number participants and method of investigation were considered ineligible. Twenty studies met inclusion criteria, representing data from Madagascar, Mozambique, the Democratic Republic of the Congo (DRC), Angola, Tanzania, Malawi, South Africa (SA), and Mauritius. CHIKV circulation was confirmed in both urban and rural settings, often co-occurring with dengue, Zika, and Rift Valley fever viruses. Seroprevalence estimates varied widely, from sporadic detection in Angola to sustained immunoglobulin G (IgG) positivity in Madagascar and Tanzania, indicating ongoing endemic transmission. Women of reproductive and working age were disproportionately affected. Clinical presentations were dominated by acute febrile illness with arthralgia, though severe neurological outcomes and long-term rheumatologic sequelae were reported. Diagnostic practices relied primarily on serology, with molecular confirmation limited to outbreak contexts. Vector surveillance detected CHIKV in mosquitoes even in the absence of human cases. CHIKV is a common virus in Southern Africa that is not well known. Effective response and early detection depend on strengthened integrated surveillance that combines entomological, molecular, and serological approaches. The findings highlight the necessity of investigating the long-term effects of Chikungunya infection and conducting coordinated regional monitoring.