Prevalence of Avian Influenza H5N6 in Birds: A Systematic Review and Meta-analysis of Other Viral Zoonosis

Abstract

Avian influenza viruses (AIV) are zoonotic pathogens that can potentially affect humans and potentially be epidemic in a region. Birds (such as poultry and wild birds) serve as potential reservoirs for these viruses, highlighting the importance of determining AIV prevalence in the avian population. No systematic reviews have been published on this issue in the world so far. The present systematic literature review following the PRISMA standard, with meta-analysis, used three databases to globally assess the Influenza H5N6 infection in birds (including poultry and wild birds). A model of random-effects meta-analysis was performed to calculate the pooled prevalence and 95% Confidence Interval (95% CI) for the prevalence of Influenza H5N6 infection in birds. A total number of 14,605 articles published from 2015 to 2020 were retrieved. After screening the abstract/title, 37 articles were selected for full-text assessment, and 15 were included for qualitative and quantitative analyses. Of the total number of birds (n = 13,416 birds), the pool prevalence by RT-PCR was 3.5% (95% CI: 2.8-4.3%). From the total, 39.67% of the birds assessed were ducks (family Anatidae), in which pool prevalence was 7.7% (95% CI: 4.4-11.0). In chickens (Gallus gallus domesticus), the pool prevalence was 3.3% (95% CI 1.9-4.8). Vietnam was the country with the highest pool prevalence; 7.9% (95% CI 4.0-11.7%). Bangladesh was the country with the lowest pool prevalence of 0.4% (95% CI 0.2-0.7%). A considerable proportion of infected birds tested positive highlighted the relevance of individual animals as reservoirs of H5N6. Ducks and chickens were found to be positive by RT-PCR in over 3% of the cases. These data suggest their relevance in maintaining zoonotic transmission and their potential implications for epidemics and even pandemics in the near future.