What is the clinical evidence from this study?

Study design: Systematic Review. Population: Acute gastroenteritis (AGE). Intervention: Human adenovirus (pan-HAdV) infection. Primary outcome: Overall pooled prevalence of any species of HAdV (pan-HAdV) among AGE case-patients (95% CI 4.9-6.8).

May 2, 2025Journal of Infection and Public Health10 citationsOpen Access

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

MWMary E. WikswoCenters for Disease Control and Prevention AKAnita KambhampatiCenters for Disease Control and Prevention CMClaire P. MattisonCenters for Disease Control and Prevention

Key Result

The overall pooled prevalence of human adenovirus among patients with acute gastroenteritis was 5.8% for any species and 6.0% for species F, with significantly higher rates in children under 5 years.

Study Design

Type

Systematic Review

Structured PICO

Population

A systematic review and meta-analysis of 147 studies across 75 countries assessing the global prevalence of human adenovirus in patients of all ages with acute gastroenteritis.

Outcome

Global pooled prevalence of any species of human adenovirus (pan-HAdV) and HAdV species F (HAdV-F) among AGE case-patients.

Human adenovirus, particularly species F, is a significant global cause of acute gastroenteritis, with the highest prevalence observed in children under 5 years of age and in high-mortality developing countries.

Limitations

High between-study variance with wide prediction intervals
Evidence of slight publication bias
Inconsistent definition of age groups across included studies
Many countries represented by only a single study, with underrepresentation of the African continent
Broad country development classifications do not capture within-country socioeconomic variations
Lack of genotyping data in many studies testing for pan-HAdV

Abstract

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.

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