Global prevalence of equine piroplasmosis: A systematic review and meta-analysis of evidence from 2020 to 2025.

Equine piroplasmosis remains a major constraint to equine health, productivity, and international movement. In compliance with PRISMA 2020 criteria, a systematic review and meta-analysis were carried out to estimate the pooled global prevalence of equine piroplasmosis and identify possible sources of risk variables. Databases including PubMed, Scopus, Web of Science, ScienceDirect, Springer Nature, Europe PMC, Cochrane Library, ProQuest, CABI Digital Library, and Google Scholar were searched between 2020 and 2025. Random-effects meta-analyses were performed to calculate pooled prevalence estimates. Subgroup analyses, meta-regression, and publication bias assessments were conducted using RStudio software version 4.6.0. Among the 95 studies included in the analysis, the pooled prevalence of active T. equi infection was 25.21%, while the corresponding seroprevalence was 30.96%. For active B. caballi infection, the pooled prevalence was 4.60%, compared with a seroprevalence of 10.90%. The pooled prevalence of active T. haneyi infection was 12.18%. Substantial heterogeneity (I² > 90%) was identified across all pooled estimates, likely reflecting differences in sampling periods and sample sizes, geographic regions, diagnostic approaches, and host demographics. Meta-regression revealed a significant increasing temporal trend in T. equi prevalence (p < 0.05), whereas no significant trends were detected for B. caballi or T. haneyi (p > 0.05). Equine piroplasmosis remains highly prevalent worldwide, particularly T. equi, with marked heterogeneity driven by methodological factors, geographic region, and host characteristics. These findings underscore the need for standardized surveillance, harmonized diagnostics, and integrated vector control strategies to mitigate the global impact of equine piroplasmosis.