Abstract
Lyme disease (LD) is a common arthropod-borne inflammatory disorder prevalent in the northern hemisphere. LD is caused by a spirochete named Borrelia burgdorferi s.l., which is transmitted to humans by ticks. Climate, environment, and other factors affect land use; recreational-behavior changes affect human contact with infected ticks. Studies in Europe and North America have looked at these aspects, but studies in Asia have not. We searched databases to identify all relevant abstracts published until March 2021. A meta-analysis was undertaken using the standard methods and procedures established by the Cochrane Collaboration. Ninety-one articles were included in our meta-analysis. The literature search identified data from nine countries (China, Japan, Malaysia, Mongolia, Pakistan, Russia Siberia region, South Korea, Thailand and Turkey). Furthermore, 53,003 ticks from six genera (Amblyomma, Dermacentor, Haemaphysalis, Hyalomma, Ixodes and Rhipicephalus) were inspected for infection with B. burgdorferi. The pooled prevalence was 11.1% (95% CI = 8.3–14.2%). Among the nine countries, China had the most studies (56) and Malaysia had the highest infection rate (46.2%). Most infected ticks were from the genera Ixodes and Haemaphysalis. Ticks of the genus Ixodes had the highest infection rate (16.9%). Obvious heterogeneity was noted in our meta-analysis. We analyzed the heterogeneity with regard to countries, genera, time points, and detection methods. This study suggests that Ixodes, Haemaphysalis and Dermacentor may be the most common tike of B. burgdorferi-positive in Asia. The highest proportion of ticks infected by B. burgdorferi were from the genus Ixodes. This meta-analysis is the first attempt to explain the B. burgdorferi infection of hard-body ticks in Asia. The infection rate for each country and infection rate of different tick genera were analyzed: there were large differences between them. The literature is concentrates mainly on East Asia, and data are limited. Our study can provide a reference for a more comprehensive and in-depth investigation of ticks in Asia infected by B. burgdorferi spirochetes.
Highlights
Lyme disease (LD) is a tick-borne inflammatory disease caused by infection with Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) complex
Several weeks to months after the tick bite, followed by early dissemination and development, B. burgdorferi s.l. can spread to other tissues and organs, and untreated infections can progress to neurologic abnormalities or heart dysfunction [2,3]
Pooling and Heterogeneity of Selected Studies The pooled prevalence was calculated based on a random-effects model, with all studies being included in our meta-analysis
Summary
Lyme disease (LD) is a tick-borne inflammatory disease caused by infection with Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) complex. LD is of public-health importance in moderate-climate regions of the northern hemisphere, such as North America, Europe, North Africa, and Northern Asia. The number of reported cases have revealed obvious differences in many regions such as Ixodes ricinus, Ixodes persulcatus, etc. Erythema migrans (the most common clinical manifestation) is a typical sign of early acute infection [1]. It is an expanding skin redness that usually develops at the site of a tick bite. Several weeks to months after the tick bite, followed by early dissemination and development, B. burgdorferi s.l. can spread to other tissues and organs, and untreated infections can progress to neurologic abnormalities or heart dysfunction [2,3].
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