Spatiotemporal modeling of Mycoplasma bovis infection and risk factors in cattle across mainland China: Implications for disease control and surveillance.

Mycoplasma bovis is an important pathogen of cattle worldwide; however, comprehensive epidemiological evidence at the national scale in China remains limited. To address this knowledge gap, we conducted the first nationwide synthesis of published evidence to characterize the extent of the variability in its prevalence and spatiotemporal distribution, as well as potential epidemiological correlates of M. bovis infection in cattle across mainland China. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we conducted a systematic review and meta-analysis of 61 studies published between 2000 and 2025, encompassing 50,325 cattle. Animal-level prevalence estimates were pooled using random-effects models, and subgroup analyses, meta-regression, spatial mapping, and time series forecasting were applied to quantify and interpret heterogeneity across studies, regions, and time. Across studies, prevalence estimates varied widely, with a pooled national estimate of 33.0% (95% CI: 29.0%-37.0%) at the animal level, indicating a substantial but highly heterogeneous epidemiological burden. Marked between-study heterogeneity and potential small-study effects warrant cautious interpretation, although sensitivity analyses yielded consistent estimates (∼32%-33%). Temporal analyses suggested an apparent but modest annual decline (-1.5 percentage points), but with variability across study periods and data sources. Prevalence varied markedly across epidemiological contexts, with higher estimates observed in yaks and dairy cattle, in calves and youngstock, and in animals presenting with bovine respiratory disease. Spatiotemporal mapping further highlighted pronounced geographic heterogeneity, identifying persistent high-prevalence clusters in Central (Hubei, Henan), Southwest (Chongqing, Sichuan), Northwest (Xinjiang, Qinghai), and North and Northeast China (Heilongjiang, Inner Mongolia). Exploratory autoregressive integrated moving average forecasts projected a broadly stable national prevalence of ∼27% for the 2026-2028 period, consistent with the apparent temporal pattern, but accompanied by wide reflecting data sparsity and model uncertainty. Regional projections also showed substantial divergence, with Eastern China remaining high (∼60%), Central China being relatively stable (∼32%), and Northeast China showing a projected sharp decline by 2028, although these estimates should be interpreted cautiously because of limited data. The consistently high degree of heterogeneity-across studies, host characteristics, regions, and time-suggests that a single summary estimate may obscure important epidemiological differences. These findings indicate that M. bovis infection remains widespread and heterogeneous across China. Strengthening coordinated surveillance systems and targeted monitoring of high-risk hosts and age groups will be critical for improving disease detection and informing region- and context-specific, evidence-based control strategies.