The Prevalence of Angiostrongylus Cantonensis in Rodent Hosts in China and Several Asian Countries: A Systematic Review and Meta-Analysis

Abstract Background: Angiostrogylus cantonensis (A.cantonensis) is a zoonotic parasitic nematode, with a worldwide distribution, causing eosinophilic meningitis or meningoencephalitis in humans. Although the biology of A.cantonensis is relatively well known, little is understood about the transmission level in different zoogeographical regions, especially in Asia. Here, to evaluate the prevalence of A.cantonensis in rodent hosts in China and several Asian countries, we conducted a systematic review registered with PROSPERO (CRD42020161665). Methods: Records were selected systematically from 7 databases (Medline via to Pubmed, Web of science, Scopus, Google Scholar, CNKI, Wangfang, CBM ). Forest plots and random-effects model were used to display pooled estimates. The Freeman-Tukey double arcsine transformation of R software was used to conduct meta-analysis and statistical significance was set at 0.05.Results: A total of 67 studies met the inclusion criteria and were included in the systematic review and meta-analysis. The pooled prevalence estimates of A.cantonensis infection in rodents was 0.1003 (95%CI: 0.0765, 0.1268). There was significant heterogeneity in reported outcomes (p<0.0001). So we considered that there was no publication bias in the included studies.Conclusion: The A.cantonensis infection rate among rodent hosts was still high in Asia, particularly in China, especially in Rattus norvegicus, and thus comprehensive measures should be taken for rodent hosts control to avoid an angiostrongyliasis outbreak. Due to the wide distribution and movement of rodent hosts, people in all regions of China, even in other Asia area live at risk of an infection. Hence, the development of more reliable diagnostic tests will be key for an effective identification of cases as well as improved patient care. Consequently, further studies are required to updated strategies for controlling A.cantonensis infection among human population.