Prevalence estimates of Opisthorchis viverrini and Clonorchis sinensis infection in the Greater Mekong subregion: a systematic review and meta-analysis.

BACKGROUND: Opisthorchiasis and clonorchiasis, caused by Opisthorchis viverrini and Clonorchis sinensis, respectively, are significant yet neglected foodborne trematodiases in the Great Mekong Subregion (GMS). Despite the reporting of the prevalence of these human liver flukes in the region over the past decades, there has been a lack of a comprehensive and systematic consolidation of this data. Therefore, we aimed to conduct a thorough systematic review and meta-analysis to synthesize and analyze time-trend prevalence estimates of both O. viverrini and C. sinensis across the GMS for the past 30 years. METHODS: This study undertakes a systematic review using a comprehensive search for published articles in PubMed, EMBASE, Scopus, Cochrane and Thai Journal Online databases until early 2023. The pooled prevalence of O. viverrini and C. sinensis infection was analyzed through a random-effects meta-analysis, with meta-regression analysis used to quantify associations with study characteristics. Sub-group analysis was conducted, whenever comparison data were available, to assess the risk of O. viverrini and C. sinensis infection in each GMS country. Heterogeneity among studies was assessed using the Q statistic and quantified by using the I 2 Index. RESULTS: From a total of 2997 articles, 155 articles comprising 218 datasets and 751,108 participants were included for review. The GMS prevalence of O. viverrini was 21.11% [45,083/260,237; 95% confidence interval (CI): 17.74-24.47%]. Pooled prevalence estimates were highly observed in Laos (34.06%, 95% CI: 26.85-41.26%), followed by Thailand (18.19%, 95% CI: 13.86-22.51%), and Cambodia (10.48%, 95% CI: 5.52-15.45%). Myanmar and Vietnam had limited data sources for calculation. Clonorchis sinensis infection in GMS was 25.33% (95% CI: 18.32-32.34%), with Guangxi, China, exhibiting the highest prevalence rates at 26.89% (95% CI: 18.34-35.43%), while Vietnam had a prevalence rate of 20.30% (95% CI: 9.13-31.47%). O. viverrini prevalence decreased significantly over time, whereas C. sinensis infection appeared to be stable consistently over time in both China and Vietnam. CONCLUSIONS: This comprehensive study, drawing from the largest datasets to date, offers an in-depth systematic prevalence review of human liver flukes in the Greater Mekong Subregion. It underscores the imperative for systematic surveillance, data collection, and the implementation of intervention and control measures for these infectious diseases of poverty.

Feline leptospirosis prevalence worldwide: A systematic review and meta-analysis of diagnostic approaches.

Background and Aim: Leptospirosis in felids (domestic and wild cats) presents an ongoing challenge in our understanding. Numerous studies have reported the detection of Leptospira spp. in these feline populations, highlighting their potential as zoonotic carriers. This systematic review and meta-analysis aimed to provide insight into the global prevalence of leptospirosis in domestic and wild cats. Materials and Methods: We conducted extensive searches across five databases (PubMed, Scopus, Web of Science, Science Direct, and Google Scholar) following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. Random-effect meta-analyses were performed using R software version 4.3.0 to estimate pooled prevalence rates. Subgroup meta-analyses were conducted based on continents, diagnostic methods, sample types, and wildcat genera. Results: A total of 71 articles on leptospirosis in domestic cats and 23 articles on leptospirosis in wild cats met the eligibility criteria. Our findings indicated a significantly higher pooled seroprevalence of leptospirosis in domestic cats compared with infection prevalence (9.95% [95% confidence interval (CI), 7.60%-12.54%] vs. 4.62% [95% CI, 2.10%-7.83%], p = 0.01). In contrast, no significant difference was observed in pooled seroprevalence and infection prevalence among wild cats (13.38% [95% CI, 6.25%-21.93%] vs. 2.9% [95% CI, 0.00%-18.91%], p = 0.21). A subgroup meta-analysis of domestic cats revealed significant differences in seroprevalence across continents, sample types, and diagnostic methods. On the contrary, wild cats had no significant differences in any of the subgroups. Conclusion: Leptospira spp. have evidently been exposed to both domestic and wild cats, highlighting their potential roles as reservoir hosts for leptospirosis. These findings highlight the importance of considering felids as a possible public health threat.

Prevalence of mastitis in dairy animals in Indonesia: A systematic review and meta-analysis.

Background and Aim: Mastitis is an important disease that can reduce milk production and farmer income as well as negatively affect human health. This study aimed to summarize dairy mastitis in Indonesia, both subclinical mastitis (SCM) and clinical mastitis (CM), and its prevalence in different provinces, the diagnostic methods, and the animal species. Materials and Methods: Relevant studies on mastitis in dairy animals in Indonesia were obtained from PubMed, Scopus, ProQuest, Google Scholar, and Garuda. The title and abstract were screened for the eligibility of the studies. The full text of the selected studies was assessed and the data were extracted for analysis. To determine the pooled estimate of the prevalence of mastitis, a random-effects model was performed using the "Meta" and "Metaphor" packages in the R software version 4.2.2. The heterogeneity of several characteristics (mastitis type, provinces, animal species, and diagnostic methods) was evaluated through subgroup meta-analysis. Meta-regression analysis was conducted to assess the trend of mastitis prevalence reports over time. Publication bias was evaluated using Egger's test and a funnel plot. Results: A total of 735 studies were retrieved for the title and abstract screening, which resulted in the final selection of 37 studies with a total of 6050 samples for meta-analysis. The pooled estimate of mastitis prevalence in dairy animals in Indonesia was 59.44% (95% confidence interval [CI], 52.39%-66.49%). Based on mastitis type, SCM had a significantly higher prevalence than CM (58.24% [95% CI, 51.26%-65.23%] vs. 3.31% [95% CI, 1.42%-5.19%]). No significant difference was observed in the analysis of other subgroups. Among provinces, Central Java had the highest prevalence (66.62% [95% CI, 49.37%-83.87%]), whereas Yogyakarta had the lowest (41.77% [95% CI, 14.96%-68.58%]). Based on animal species, cow and goat had a prevalence of 63.42% (95% CI, 55.97%-70.86%) and 44.96% (95% CI, 28.26%-61.66%), respectively. Based on the diagnostic method, the California mastitis test resulted in 60.08% (95% CI, 52.11%-68.06%) and the Institut Pertanian Bogor test, 56.00% (95% CI, 41.20%-70.81%). No significant change in the prevalence of mastitis in Indonesia was observed from 2003 to 2022. Conclusion: This study demonstrates that the pooled estimate of mastitis prevalence in dairy animals in Indonesia is >50%. Based on subgroup analysis, SCM had a higher prevalence than CM; however, the prevalence between provinces, detection methods, and animal species in the 2003-2022 periods was not significantly different. A mastitis control strategy needs to be developed to reduce the prevalence of mastitis and further loss in milk production.

Effectiveness of public health interventions in reducing the prevalence of Opisthorchis viverrini: a protocol for systematic review and network meta-analysis.

INTRODUCTION: The carcinogenic liver fluke Opisthorchis viverrini is a major public health problem in the Mekong basin region. The liver flukes can induce cholangiocarcinoma, a bile duct cancer that causes a significant burden of mortality and economic loss. Various public health interventions have been conducted to reduce opisthorchiasis but the prevalence of O. viverrini remains high in endemic regions. The aim is to quantify the effectiveness of public health interventions in reducing the prevalence of O. viverrini infection. METHODS AND ANALYSIS: Seven databases (including PubMed, SCOPUS, Web of Science, EMBASE, ScienceDirect, Thai thesis database and TCI (Thai journals online)) will be searched from initiation through to 2022 to identify studies of interventions to reduce the prevalence of O. viverrini infection. The prevalence, incidence or number of O. viverrini-infected people will be used as the source of O. viverrini prevalence data. A conventional meta-analysis and a Bayesian network meta-analysis will be conducted to undertake direct and indirect comparisons of different interventions. Meta-regression will be used to determine the effect of each intervention. The risk of bias will be assessed using the Cochrane Collaboration's risk of bias tool. Heterogeneity between studies will be determined by forest plots and I2 and publication bias investigated with funnel plots and the Egger's test. ETHICS AND DISSEMINATION: Ethical approval will not be required because this study will only use published data. The final report of this review will be disseminated through publication in a peer-reviewed scientific journal and will also be presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42022323066.