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. Author manuscript; available in PMC: 2013 Jul 25.
Published in final edited form as: Epidemics. 2010 Sep 15;2(4):173–182. doi: 10.1016/j.epidem.2010.08.003

Table 1.

HSV-2 prevalence in different Middle East and North Africa populations as well as culturally related populations.

Country HSV-2 prevalence Assay Accuracy and reproducibility of measurement2
Bangladesh 12% (women attending primary care clinic) (Bogaerts et al. 2001) HSV-2 specific IgG ELISA (Gull Laboratories Inc, Salt Lake City, USA) Good
Djibouti 2% (general population women), 5% (male blood donors), 49% (luxury bar FSWs1), 81% (street-based FSWs) (Marcelin et al. 2001) Unknown Unknown
Egypt 32% (women, obstetric outpatient clinic) (el-Sayed Zaki et al. 2007) HSV-2 qualitative specific IgM ELISA (Equipar Via G, Ferrari, Saronno, Italy) Poor
Iran 28% (women, primary health care centers) (Kasraeian et al.) HSV-2 specific IgG ELISA (unknown; commercial test) Unknown
8.25% (pregnant women) (Ziyaeyan et al. 2007) Serum neutralization test Poor
23.3% (university students) (Tayyebi et al. 2010) HSV-2 specific IgG ELISA (Dia-pro, Italy) Unknown
Israel 9% (Arab & Jewish non-Soviet immigrants: pregnant women) (Dan et al. 2003) HSV-2 specific IgG ELISA (Savyon Diagnostics Ltd, Ashdod, Israel) (Ohana et al. 2000) Good
2.4% (Arab STD1 clinic attendees) (Feldman et al. 2003) HSV-2 specific IgG ELISA (EIA-gG; Gull, USA) (Ashley et al. 1998) Good
Jordan 53% (male university students), 42% (female university students) (Abuharfeil et al. 2000) HSV-2 IgG ELISA (Ismunit, Italian Institute of Immunology, Rome, Italy) Fair
Lebanon 0.027% (general population women) (Karam et al. 2007) Unknown Unknown
Morocco 16.2% (ANC attendees), 13% (general population women), 10% (general population men), 6.7% (STD clinic attendees) (WHO/EMRO) Unknown Unknown
26% (urban women with a median age of 40 years) (Patnaik et al. 2007) Western blot (reference gold standard) (Ashley 1998; Ashley et al. 1988; Ashley et al. 1999) Excellent
12.9% (ANC1 attendees), 9.2% (male HIV sentinel surveillance), 6.5% (military personnel) (Cowan et al. 2003) HSV-2-specific IgG ELISA (HerpesSelect; Focus Technologies, CA, USA) Good
Pakistan 3.4% (urban men) (Mir et al. 2009) HSV-2 specific IgG ELISA (unknown; commercial test) Unknown
11.0% (IDUs1), 6.0% (IDUs) (Platt et al. 2009) HSV-2-specific IgG ELISA (HerpesSelect; Focus Technologies, Cypress, CA, USA) Good
8% (FSWs), 4.7% (FSWs), 7.4% (MSWs1; bantha†), 2.5% (MSWs; bantha), 14% (MSWs; khotki1), 25% (MSWs; khotki), 54% (MSWs; khusra1), 31.3% (MSWs; khusra) (Hawkes et al. 2009) HSV-2-specific IgG ELISA (HerpesSelect; Focus Technologies, Cypress, CA, USA) Good
Saudi Arabia 27% (pregnant women) (Ghazi et al. 2002) HSV-2-specific IgG ELISA (Wampole Laboratories, New Jersey, USA) Poor.
Sudan 27% (women Sudanese refugees in Ethiopia), 26% (men Sudanese refugees in Ethiopia) (Holt et al. 2003) Glycoprotein G-based immunoblot assays (Centers for Disease Control and Prevention laboratory, Atlanta, USA) (Schmid et al. 1999) Fair
5.5% (household cluster survey; South Sudan),4.5% (household cluster survey; South Sudan),6.1% (household cluster survey; South Sudan) (Kaiser et al. 2006) Glycoprotein G-based immunoblot assays (Centers for Disease Control and Prevention laboratory, Atlanta, USA). Fair
Syria 0% (pregnant women), 0% (general population women), 0.3% (general population men), 0% (neonates), 9.5% (STD clinic attendees), 8.0% (women with cervical cancer), 20% (“bar girls”), 34% FSWs (Ibrahim et al. 2000) HSV-2-specific IgG ELISA (Radim company, Sulzbach, Germany) Good
Turkey 89% (women with pregnancy complication) (Cengiz et al. 1993b) HSV-2 IgG ELISA (Unknown) Unknown
63.1% (pregnant women) (Duran 2004; Duran et al. 2004) IgG antibodies Poor
5.0% (pregnant women) 5.5% (blood donors), 4.8% (sexually active adults), 8.3% (hotel staff), 17.3% (patients with genital warts), 60% (FSWs) (Dolar et al. 2006) HSV-2-specific IgG ELISA (Euroimmun, Germany) (Aksozek et al. 2004; Eing et al. 2002) Good
26% (MSM) (Cengiz et al. 1992; Cengiz et al. 1993a) HSV-2-specific IgG ELISA (Unknown) Unknown
53.5% (rural general population women) (Maral et al. 2009) EIAgen Herpes Simplex 2 IgG Code 08.1007.2 (ADALTIS ItaliaS.p.A. Via Magnanelli, 2-40033 Casalecchio di Reno) Unknown.
80% (FSWs) (Gul et al. 2008) HSV-2-specific IgG ELISA (Euroimmun, Germany) (Aksözek et al. 2004; Eing et al. 2002) Good
United Arab Emirates 17.7% (blood donors including migrant workers), 7.3% (migrant workers), 9.7% (migrant workers) [N.J. Nagelkerke, personal communication] HSV-2-specific IgG ELISA (Kalon Biological, Ltd., Surrey, United Kingdom) Good, but relatively insensitive to new diagnosis.
†

FSW = female sex worker, MSW = male sex workers, MSM = men who have sex with men, ANC = ante-natal clinic, STD = sexually transmitted diseases, IDU = injecting drug user, bantha = biological males with a male gender identity, khotki = biological males who dress as men but have “female soul” and feminized traits, khusra = transgenders who dress as women (also known as hijra).

2

Criteria used to judge the confidence in the serology measurements were the robustness of the serology test used, procedures used to conduct the serology test, and amount of available information on the serology test. We labeled any test with greater than 95% specificity and sensitivity excellent; tests with greater than 90% sensitivity and specificity good; tests with greater than 75% sensitivity and specificity fair; all other tests were considered poor. Poor tests tend to suffer from cross-reactivity with other infections, particularly HSV-1. We also judged a test to be poor if authors used or described tests that have not been validated in the medical literature. In several cases, we were not able to identify the test used from manuscripts and numerous attempts to contact authors: these were labeled unknown.