Wang Feng, Yan Min, Liu Aihua, Chen Taigui, Luo Lisha, Li Lianbao, Teng Zhaowei, Li Bingxue, Ji Zhenhua, Jian Miaomiao, Ding Zhe, Wen Shiyuan, Zhang Yu, Yue Peng, Cao Wenjing, Xu Xin, Zhou Guozhong, Bao Fukai
Department of Microbiology and Immunology, School of Basic Medical Sciences, Kunming Medical University, Kunming, China.
Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Kunming Medical University, Kunming, China.
Transbound Emerg Dis. 2020 Sep;67(5):2050-2064. doi: 10.1111/tbed.13548. Epub 2020 Mar 29.
The tick-borne pathogen Anaplasma phagocytophilum is an emerging infectious disease threat, but the overall A. phagocytophilum seroprevalence in humans is unclear. We performed a systematic search of English databases for literature published from 1994 to 2018. Studies reporting serological evidence of A. phagocytophilum infection in humans were included, and the information was extracted by two authors independently. As the study heterogeneity was significant, a random-effects model was used to calculate the overall pooled seroprevalence. Data from 56 studies involving 28,927 individuals from four continents were included. The seroprevalence reported by the studies ranged from 0% to 37.26%. The overall pooled A. phagocytophilum seroprevalence in humans was 8.4% (95% CI: 6.6%-10.4%). The seroprevalence was highest in high-risk population (13.8%) and lowest in healthy population (5.0%). The estimated A. phagocytophilum seroprevalence of febrile patient, tick-bitten and tick-borne diseases populations was 6.4%, 8.0% and 9.0%, respectively. This meta-analysis demonstrated first A. phagocytophilum seroprevalence estimates in different populations (healthy, febrile patient, high-risk, tick-bitten and tick-borne diseases populations); it seems likely that present surveillance efforts are missing mild or asymptomatic infections of humans.
蜱传病原体嗜吞噬细胞无形体是一种新出现的传染病威胁，但人类中嗜吞噬细胞无形体的总体血清阳性率尚不清楚。我们对英文数据库进行了系统检索，以查找1994年至2018年发表的文献。纳入报告人类嗜吞噬细胞无形体感染血清学证据的研究，并由两位作者独立提取信息。由于研究异质性显著，采用随机效应模型计算总体合并血清阳性率。纳入了来自四大洲56项研究的数据，涉及28,927人。这些研究报告的血清阳性率范围为0%至37.26%。人类中嗜吞噬细胞无形体的总体合并血清阳性率为8.4%（95%CI：6.6%-10.4%）。血清阳性率在高危人群中最高（13.8%），在健康人群中最低（5.0%）。发热患者、蜱叮咬者和蜱传疾病人群的嗜吞噬细胞无形体血清阳性率估计分别为6.4%、8.0%和9.0%。这项荟萃分析首次展示了不同人群（健康、发热患者、高危、蜱叮咬者和蜱传疾病人群）中嗜吞噬细胞无形体的血清阳性率估计值；目前的监测工作似乎遗漏了人类的轻度或无症状感染。
