Douglas Hospital Research Centre, McGill University, Montreal, QC, Canada.
Hôpital de la Cité-de-la-Santé, affiliated to the University of Montreal, Laval, QC, Canada.
Trop Med Int Health. 2019 Nov;24(11):1277-1290. doi: 10.1111/tmi.13305. Epub 2019 Sep 30.
Human T-cell lymphotropic virus type 1 (HTLV-1), the causative agent of adult T-cell leukaemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), is endemic in sub-Saharan Africa (SSA) and poses a high morbidity and mortality risk. Its prevalence in the general population is poorly understood. The potential for prevention motivated us to do a systematic review and meta-analysis of population-based studies to estimate the prevalence of HTLV-1 in SSA.
A comprehensive, no-limit search was conducted in EMBASE, PubMed, Web of Science and the Cochrane Library from their inception dates to March 2019. Population-based studies presenting data on HTLV-1 in sub-Saharan Africa were included. Pooled prevalence was estimated using a random-effects meta-analysis.
A total of 21 studies were included, representing 42 297 participants. The pooled HTLV-1 seroprevalence was 3.19% (95% CI 2.36-4.12%) with variations across year of study. Prevalence of HTLV-1 positively correlated with year of study (β = 0.0036, P = 0.007). Participants from Central, Western and Southern Africa had a seroprevalence of 4.16% (95% CI 2.43-6.31%), 2.66% (95% CI 1.80-3.68%) and 1.56% (95% CI 0.48-3.15%), respectively.
Our findings suggest that HTLV-1 infection is a public health concern in SSA and highlight the need to implement effective preventive programmes and interventions aimed at reducing the burden of this common yet neglected infection.
人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）是成人 T 细胞白血病/淋巴瘤（ATL）和 HTLV-1 相关脊髓病/热带痉挛性截瘫（HAM/TSP）的病原体，在撒哈拉以南非洲（SSA）流行，具有较高的发病率和死亡率。人们对其在普通人群中的流行情况了解甚少。由于存在潜在的预防需求，我们进行了系统评价和荟萃分析，以评估 HTLV-1 在 SSA 的流行情况。
从各数据库的创建日期起至 2019 年 3 月，我们对 EMBASE、PubMed、Web of Science 和 Cochrane Library 进行了全面的、无限制的检索。纳入了在撒哈拉以南非洲地区开展的有关 HTLV-1 的人群研究。采用随机效应荟萃分析来估计 HTLV-1 的总体流行率。
共纳入 21 项研究，共计 42297 名参与者。总的 HTLV-1 血清流行率为 3.19%（95%CI 2.36-4.12%），不同研究年份的流行率有所不同。HTLV-1 的流行率与研究年份呈正相关（β=0.0036，P=0.007）。来自中部、西部和南部非洲的参与者的血清流行率分别为 4.16%（95%CI 2.43-6.31%）、2.66%（95%CI 1.80-3.68%）和 1.56%（95%CI 0.48-3.15%）。
我们的研究结果表明，HTLV-1 感染是撒哈拉以南非洲地区的一个公共卫生问题，强调需要实施有效的预防计划和干预措施，以降低这种常见但被忽视的感染的负担。
