Population‐based prevalence of human T‐lymphotropic virus type 1 in sub‐Saharan Africa: a systematic review and meta‐analysis

摘要

Abstract Background Human T‐cell lymphotropic virus type 1 (HTLV‐1), the causative agent of adult T‐cell leukaemia/lymphoma (ATL) and HTLV‐1‐associated myelopathy/tropical spastic paraparesis (HAM/TSP), is endemic in sub‐Saharan Africa (SSA) and poses a high morbidity and mortality risk. Its prevalence in the general population is poorly understood. The potential for prevention motivated us to do a systematic review and meta‐analysis of population‐based studies to estimate the prevalence of HTLV‐1 in SSA. Methods A comprehensive, no‐limit search was conducted in EMBASE, PubMed, Web of Science and the Cochrane Library from their inception dates to March 2019. Population‐based studies presenting data on HTLV‐1 in sub‐Saharan Africa were included. Pooled prevalence was estimated using a random‐effects meta‐analysis. Results A total of 21 studies were included, representing 42?297 participants. The pooled HTLV‐1 seroprevalence was 3.19% (95% CI 2.36–4.12%) with variations across year of study. Prevalence of HTLV‐1 positively correlated with year of study (β?=?0.0036, P ?=?0.007). Participants from Central, Western and Southern Africa had a seroprevalence of 4.16% (95% CI 2.43–6.31%), 2.66% (95% CI 1.80–3.68%) and 1.56% (95% CI 0.48–3.15%), respectively. Conclusions Our findings suggest that HTLV‐1 infection is a public health concern in SSA and highlight the need to implement effective preventive programmes and interventions aimed at reducing the burden of this common yet neglected infection.