A systematic review and meta-analysis of the global prevalence of human enteric adenovirus infections.

Human adenovirus (HAdV), especially HAdV species F (HAdV-F) is recognized as a cause of acute gastroenteritis (AGE) worldwide. To assess the global prevalence of HAdV in case-patients of all ages with AGE, we conducted a systematic literature search for studies published in English during 2015-2022. We generated pooled prevalence estimates using generalized linear mixed models. Using data from 147 included articles, the overall pooled prevalence among AGE case-patients of any species of HAdV (pan-HAdV) was 5.8 % and 6.0 % for HAdV-F. The prevalence of HAdV was significantly higher among case-patients < 5 years of age compared with case-patients ≥ 5 years of age (pan-HAdV: 6.6 % vs. 2.0 %, p < 0.0001; HAdV-F: 8.7 % vs. 2.3 %, p = 0.04). Prevalence was significantly higher in high mortality developing countries and lowest in developed countries (pan-HAdV: 9.4 % vs. 4.0 %, p < 0.0001; HAdV-F: 11.6 % vs. 3.2 %, p = 0.0003). Understanding the burden of HAdV-associated AGE may be useful for targeted interventions, including future vaccine development.