Global seroprevalence and epidemiological patterns of equine viral arteritis from 1968 to 2025: A systematic review and meta-analysis.

Abstract

BACKGROUND: Equine viral arteritis (EVA) is a globally widespread infectious disease affecting equids, with significant consequences for reproductive efficiency and the regulation of international equine trade. Nevertheless, despite the accumulation of numerous region-specific investigations, an integrated synthesis of global seroprevalence estimates and overarching epidemiological patterns remains insufficiently developed. AIMS/OBJECTIVES: To calculate the pooled global seroprevalence of EVA and to explore sources of epidemiological heterogeneity. METHODS: A systematic review and meta-analysis were undertaken in accordance with the PRISMA 2020 guidelines. Five independent reviewers conducted study screening for publications from 1968 to 2025 across multiple electronic databases, including PubMed, Scopus, ScienceDirect, Springer Nature, the Cochrane Library, ProQuest, the CABI Digital Library, and Google Scholar. Data extraction and mapping were performed using Microsoft Excel and QGIS v3.22.8. Meta-analysis, subgroup analysis, and meta-regression were conducted in RStudio v4.4.2 under a random-effects model. RESULTS: A total of 57 studies were included in the analysis, yielding a pooled EVA seroprevalence of 13.98% (95% CI: 9.45-19.21) with a prediction interval of 0.00-63.90%, indicating substantial variability across studies. The analysis revealed considerable heterogeneity among the included studies (I² = 99.4%). Seroprevalence varied by species, region, diagnostics, and period, declined significantly over time, and showed potential publication bias. CONCLUSION: EVA remains globally significant, with heterogeneous seroprevalence driven by regional, host, and methodological factors, necessitating harmonized surveillance and targeted control strategies.