Meta-analysis of epidemiological characteristics of plague cases in high altitude areas

FU Bang, LIANG Ying, FANG Xin-yue, YUE Yu-juan, REN Dong-sheng, SONG Xiuping, LU Liang, LIU Xiao-bo, LIU Qi-yong

doi:10.11853/j.issn.1003.8280.2025.01.013

Chinese Journal of Vector Biology and Control >

2025 , Vol. 36 >Issue 1: 66 - 75

DOI: https://doi.org/10.11853/j.issn.1003.8280.2025.01.013

Vector-borne Disease

Meta-analysis of epidemiological characteristics of plague cases in high altitude areas

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1. Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China;
2. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, WHO Collaborating Centre for Vector Surveillance and Management, Department of Vector Biology and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
3. Xinjiang Key Laboratory of Vector-borne Infectious Diseases, Urumqi, Xinjiang 830002, China

Received date: 2024-08-07

Online published: 2025-03-05

Supported by

National Natural Science Foundation of China (No. 81703280);Vector Surveillance and Control Project (No. 102393220020020000012)

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Abstract

Objective The epidemiological characteristics of plague cases in high altitude areas were evaluated by meta-analysis, so as to provide a reference for plague prevention and control. Methods Use the Chinese and English key words such as altitude, altitudes, highland, plateau, tableland, plateaus, high altitude, altiplano, mountain, high plateau, elevation, height, plague, Yersinia pestis infection, black death, black plague, pneumonic plague, pulmonic plague, bubonic plague, septicemic plague, inguinal plague and meningeal plague to systematically search Web of Science, Embase, PubMed, Cochrane Library, SinoMed, CNKI, Wanfang Data Service platform, VIP Chinese scientific journals and other databases. The time range of the search is from the establishment of the database to March 14, 2024. Excel 2019 was used to extract literature data, and R 4.3.3 software was used for meta analysis. Results Finally, 72 literatures were included, all of which were descriptive studies. Heterogeneity test found that there was heterogeneity in the included studies (I²>90.00%, P<0.01), so random-effects model was used to merge the studies, and the combined annual reported incidence of plague was 0.08/100 000 people [95% confidence interval (CI): 0.06/100 000-0.11/100 000]. Sensitivity analysis showed that the results were stable, and Egger test and Begg test showed all P<0.05, indicating possible publication bias in included studies. Subgroup analysis of regional distribution showed that the average annual reported incidence of plague was 0.17/100 000 (95%CI: 0.11/100 000-0.23/100 000) in high altitude areas of Tibet, 0.08/100 000 (95%CI: 0.05/100 000-0.11/100 000) in the high altitude area of Qinghai Province, 0.01/100 000 (95%CI: 0.00/100 000-0.02/100 000) in the high altitude area of Gansu Province, 0.33/100 000 (95%CI: 0.20/100 000-0.48/100 000) in high altitude areas of Mongolia, and 0.02/100 000 (95%CI: 0.01/100 000 to 0.04/100 000) in high altitude areas of Peru. The analysis of disease subgroups showed that the proportion of cases with glandular type of plague was 27.26%, lung type was 43.91%, rancidity type was 5.32%, and other types of cases accounted for 10.88%. Conclusions This study synthesizes 72 descriptive studies and reveals significant regional differences in plague incidence at high altitude areas. The analysis showed that Mongolia had the highest incidence at high altitudes, while Peru had the lowest. In addition, pneumonic plague accounts for the highest proportion of cases. The findings highlight the endemic characteristics of different regions and types of plague and suggest that these differences be taken into account when developing public health strategies.

Key words： Plague; The Black Death; Epidemiology; Meta-analysis

Cite this article

FU Bang, LIANG Ying, FANG Xin-yue, YUE Yu-juan, REN Dong-sheng, SONG Xiuping, LU Liang, LIU Xiao-bo, LIU Qi-yong . Meta-analysis of epidemiological characteristics of plague cases in high altitude areas[J]. Chinese Journal of Vector Biology and Control, 2025 , 36(1) : 66 -75 . DOI: 10.11853/j.issn.1003.8280.2025.01.013

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