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The Prevalence of Borrelia miyamotoi in Ixodes Ticks and Humans in the Northern Hemisphere: A Systematic Review and Meta-Analysis
39 Pages Posted: 14 Jan 2022More...
Background: Various studies have evaluated infection of Ixodes ticks and humans with the relapsing fever spirochete Borrelia miyamotoi. However, it has never been assessed systematically. This systematic review and meta-analysis examines B. miyamotoi prevalence in Ixodes ticks and humans, and the disease it can cause in the Northern hemisphere.
Methods: PubMed and Web of Science were searched up to March 1th, 2021. Publications assessing Ixodes tick infection using data from 2011 onwards were eligible, whereas no time limitation was placed on human reports. B. miyamotoi test positivity ratios were extracted. A random effects-model was used to calculate estimated proportions (ES) with 95% confidence interval (CI).
Findings: Included articles reported on 165 637 questing ticks, 45 608 unique individuals, and 504 well-described human cases. In ticks, the highest prevalence was observed in Ixodes persulcatus (2·8%, 95%CI 2·4-3·1%) and the lowest in I. pacificus ticks (0·7, 95%CI 0·6-0·8%). The overall seroprevalence in humans was 4·4% (95%CI 2·8-6·3%), with a significantly (p<0·001) higher seroprevalence in the high risk group (4·6%, 95%CI 2·6-7·1%), participants with confirmed or suspected Lyme borreliosis (4·8%, 95%CI 1·8-8·8%), and individuals suspected of another tick-borne disease (11·9%, 95%CI 5·6-19·9%), as compared to healthy controls (1·3%, 95%CI 0·4-2·8%). Individuals suspected of another tick-borne disease were significantly more often B. miyamotoi-PCR positive than the high risk group (p=0·0246), with individuals in Asia more likely to be positive than those in the United States of America (OR 14·63, 95%CI 2·80-76·41).
Interpretation: Our findings demonstrate Borrelia miyamotoi disease should be considered an emerging infectious disease, especially in North America and Asia. Prospective studies and increased awareness are required to obtain further insights into the burden of disease.
Registration Details: This study was registered at PROSPERO (CRD42021268996) and followed PRISMA guidelines.
Funding Information: ZonMW (project no. 52200-30-07) and the European Regional Development Fund (Interreg).
Declaration of Interests: All involved authors declare to have no competing interests.
Keywords: Borrelia miyamotoi, Relapsing fever Borrelia, Borrelia miyamotoi Disease, Hard tick-borne relapsing fever
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