Department of Public Health, University of Otago, Wellington, New Zealand.
Epidemiology and Laboratory Capacity Program, Commonwealth of the Northern Mariana Islands, Saipan, Commonwealth of the Northern Mariana Islands, USA.
Sci Rep. 2020 Apr 30;10(1):7337. doi: 10.1038/s41598-020-63740-y.
Legionella is a ubiquitous pathogen yet the global occurrence of legionellosis is poorly understood. To address this deficit, this paper summarises the available evidence on the seroprevalence of Legionella antibodies and explores factors that may influence seroprevalence estimates. Through a systematic review, a total of 3979 studies were identified with seroprevalence results published after 1 January 1990. We tabulated findings by World Health Organization (WHO) region, location, study period and design, composition of study population(s) for all ages in terms of exposure, sex, detection methods, IFA titre, Legionella species measured, and present seroprevalence point estimates and 95% confidence intervals. Sampled populations were classified according to income, WHO region, gender, age, occupation and publication date. We conducted a meta-analysis on these subgroups using Comprehensive Meta-Analysis 3.0 software. Heterogeneity across studies was evaluated by the Q test in conjunction with I statistics. Publication bias was evaluated via funnel plot and Egger's test. Fifty-seven studies met our inclusion criteria, giving an overall estimate of seroprevalence for Legionella of 13.7% (95% CI 11.3-16.5), but with substantial heterogeneity across studies.
军团菌是一种无处不在的病原体，但全球军团病的发生情况仍了解甚少。为了解决这一不足，本文总结了现有关于军团菌抗体血清流行率的证据，并探讨了可能影响血清流行率估计的因素。通过系统评价，共确定了 3979 项研究，这些研究均在 1990 年 1 月 1 日之后发表了血清流行率结果。我们按照世界卫生组织（WHO）区域、地点、研究期间和设计、所有年龄段的研究人群（根据暴露情况、性别、检测方法、IFA 滴度、检测的军团菌种类等）的组成情况，对发现的结果进行了列表，并列出了当前的血清流行率点估计值和 95%置信区间。抽样人群根据收入、WHO 区域、性别、年龄、职业和发表日期进行了分类。我们使用 Comprehensive Meta-Analysis 3.0 软件对这些亚组进行了荟萃分析。通过 Q 检验结合 I 统计量评估了研究之间的异质性。通过漏斗图和 Egger 检验评估了发表偏倚。有 57 项研究符合我们的纳入标准，总体估计军团菌的血清流行率为 13.7%（95%CI 11.3-16.5），但研究之间存在很大的异质性。
