Seroprevalence of severe fever with thrombocytopenia syndrome virus in China: A systematic review and meta-analysis

Peng Li; Zhen-Dong Tong; Ke-Feng Li; An Tang; Ya-Xin Dai; Jian-Bo Yan

doi:10.1371/journal.pone.0175592

Seroprevalence of severe fever with thrombocytopenia syndrome virus in China: A systematic review and meta-analysis

PLoS One. 2017 Apr 11;12(4):e0175592. doi: 10.1371/journal.pone.0175592. eCollection 2017.

Authors

Peng Li^{1

2}, Zhen-Dong Tong^{1

2}, Ke-Feng Li^{1

2}, An Tang^{1

2}, Ya-Xin Dai^{1

2}, Jian-Bo Yan^{1

2}

Affiliations

¹ Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China.
² Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China.

Abstract

Objective: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus-SFTSV. The seroprevalence of anti-SFTSV antibodies including immunoglobulin G (IgG) and immunoglobulin M (IgM), specific to SFTSV in the general population has been investigated in various epidemiological studies with inconsistent results. Here, we clarify this discrepancy and reach a more comprehensive result by mean of a meta-analysis.

Methods: All relevant articles were searched in the electronic databases (PubMed, Web of science, Embase, Chinese National Knowledge Infrastructure database, Chinese Wanfang database) up to November 2016. The pooled seroprevalence and 95% confidence intervals (95% CIs) were calculated by random- or fixed- model on the basis of heterogeneity.

Results: In total, 21 studies containing 23,848 blood samples from 7 provinces were included in this meta-analysis. The minimum and maximum reported seroprevalences of SFTSV among humans in China were 0.23% and 9.17%, respectively. The overall pooled seroprevalence of SFTSV antibodies was 4.3% (95%CI: 3.2%-5.5%). The pooled prevalence was 5.9% (95%CI: 4.7%-7.0%) in Zhejiang province, 4.9% (95%CI: 4.1-5.8%) in Anhui province, 3.9% (95%CI: 1.3%-6.4%) in Shandong province, and 0.7% (95%CI: 0.2%-1.1%) in Jiangsu province. Stratified by occupation, the pooled prevalence of farmer was 6.1% (95%CI: 3.4%-8.9%) and others (mainly are students) was 3.3% (95%CI: 2.4%-4.2%). Additionally, seroprevalence of SFTSV in people who lived in the same village with the patient were higher than that of people who lived in a different village. Seropositive rates in sampling years after 2012 were higher than that before 2012. The prevalence of SFTSV did not differ by age or gender. Sensitive analysis by omitting one study at a time indicated the results of the pooled seroprevalence were robust.

Conclusions: Seroprevalence of SFTSV among healthy population in central and eastern China is high. Surveillance efforts on mild or asymptomatic infections among endemic persons are needed.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Bunyaviridae Infections / epidemiology*
China / epidemiology
Fever / complications*
Humans
Immunoglobulin G / immunology
Immunoglobulin M / immunology
Orthobunyavirus / immunology*
Seroepidemiologic Studies
Thrombocytopenia / complications
Thrombocytopenia / epidemiology*

Substances

Immunoglobulin G
Immunoglobulin M

Grants and funding

This work was supported by the science and technology program of Zhoushan City (2014C31075) and the medical and health projects of Zhoushan City (2016A12). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.