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Abstract：
BACKGROUND: Reports of natural infections of Schistosoma mansoni in a number of species of nonhuman primates (NHPs) in Africa, coupled with the substantial overlap of NHP habitats and human schistosomiasis endemic areas, has led to concerns about the role of NHPs in the transmission of human schistosomiasis. We conducted a systematic review of the literature to describe the current scope of knowledge for Africa, for the NHP species implicated, their geographical distribution, infection rates with S. mansoni, and to discuss the implications for public health and conservation.
METHODS: A systematic search of the literature was performed using PubMed, Web of Science, Google Scholar, the World Health Organization (WHO) library database, World Cat, and ScienceDirect without any language restriction. Studies examining S. mansoni infection of any African NHP species were included. Study types, primate species, their geographical distribution, and parasite diagnostic techniques reported in the studies were qualitatively summarized. Data for species with sample sizes ≥10 were included in the meta-analysis. We assessed the reported infection rate, and used a random-effects model to estimate the summary infection rates and 95% confidence intervals (CIs). We assessed heterogeneity among studies using the I2 statistics. Twenty-nine publications, from 1960 to 2018, were identified and included in the review. The studies examined a total of 2962 primates belonging to 22 species in 11 genera across ten countries (Cameroon, Eritrea, Ethiopia, Gabon, Kenya, Nigeria, Senegal, Tanzania, Uganda, and Zimbabwe), and S. mansoni infections were found in nine species of five genera in all countries. When we excluded studies with sample sizes < 10, data from 24 studies on 11 species of primates in three genera in ten countries remained in the meta-analysis. The overall pooled estimate of infection rate was 10% (95% CI: 6-16%) with high heterogeneity (I2 = 94.77%) across countries and species/genera. Among the three genera, Pan had the highest infection rate of 15% (95% CI: 0-55%), followed by Papio at 11% (95% CI: 6-18%), and Cercopithecus at 5% (95% CI: 0-14%). The association between NHP and human infections was positive, but not significant, due to low study sample matches and high variation.
CONCLUSIONS: Our findings suggest that S. mansoni infection rate is high in African NHPs, with substantial heterogeneities across species/genera and countries in Africa. Given the evidence for potential spillover and spillback of S. mansoni between African NHPs and humans, further research is urgently needed to understand ecology and mechanisms of transmission of the parasite between NHP and human hosts, in order to inform control strategies of this important neglected tropical disease.
METHODS: A systematic search of the literature was performed using PubMed, Web of Science, Google Scholar, the World Health Organization (WHO) library database, World Cat, and ScienceDirect without any language restriction. Studies examining S. mansoni infection of any African NHP species were included. Study types, primate species, their geographical distribution, and parasite diagnostic techniques reported in the studies were qualitatively summarized. Data for species with sample sizes ≥10 were included in the meta-analysis. We assessed the reported infection rate, and used a random-effects model to estimate the summary infection rates and 95% confidence intervals (CIs). We assessed heterogeneity among studies using the I2 statistics. Twenty-nine publications, from 1960 to 2018, were identified and included in the review. The studies examined a total of 2962 primates belonging to 22 species in 11 genera across ten countries (Cameroon, Eritrea, Ethiopia, Gabon, Kenya, Nigeria, Senegal, Tanzania, Uganda, and Zimbabwe), and S. mansoni infections were found in nine species of five genera in all countries. When we excluded studies with sample sizes < 10, data from 24 studies on 11 species of primates in three genera in ten countries remained in the meta-analysis. The overall pooled estimate of infection rate was 10% (95% CI: 6-16%) with high heterogeneity (I2 = 94.77%) across countries and species/genera. Among the three genera, Pan had the highest infection rate of 15% (95% CI: 0-55%), followed by Papio at 11% (95% CI: 6-18%), and Cercopithecus at 5% (95% CI: 0-14%). The association between NHP and human infections was positive, but not significant, due to low study sample matches and high variation.
CONCLUSIONS: Our findings suggest that S. mansoni infection rate is high in African NHPs, with substantial heterogeneities across species/genera and countries in Africa. Given the evidence for potential spillover and spillback of S. mansoni between African NHPs and humans, further research is urgently needed to understand ecology and mechanisms of transmission of the parasite between NHP and human hosts, in order to inform control strategies of this important neglected tropical disease.
摘要：
背景：报道了非洲许多非人类灵长类动物（NHP）物种中曼氏血吸虫的自然感染，再加上NHP栖息地和人类血吸虫病流行区的大量重叠，引起了人们对NHP在人类血吸虫病传播中的作用的担忧。我们对文献进行了系统的回顾，以描述非洲当前的知识范围，对于涉及的NHP物种，它们的地理分布,曼索尼链球菌的感染率，并讨论对公共卫生和保护的影响。
方法：使用PubMed对文献进行了系统搜索，WebofScience,谷歌学者，世界卫生组织（WHO）图书馆数据库，世界猫和ScienceDirect，没有任何语言限制。包括检查任何非洲NHP物种的曼氏链球菌感染的研究。研究类型,灵长类物种，它们的地理分布,对研究中报道的寄生虫诊断技术进行了定性总结。荟萃分析中包括样本量≥10的物种数据。我们评估了报告的感染率，并使用随机效应模型来估计总感染率和95％置信区间（CI）。我们使用I2统计量评估了研究之间的异质性。29种出版物，从1960年到2018年，被确定并纳入审查。这些研究共检查了10个国家11属22种的2962只灵长类动物(喀麦隆，厄立特里亚,埃塞俄比亚,加蓬,肯尼亚,尼日利亚,塞内加尔,坦桑尼亚,乌干达，和津巴布韦)，在所有国家中，在五个属的九个物种中都发现了曼氏链球菌感染。当我们排除样本量<10的研究时，来自10个国家三个属的11种灵长类动物的24项研究数据仍保留在荟萃分析中。感染率的总体汇总估计为10％（95％CI：6-16％），在国家和物种/属之间具有高度异质性（I2=94.77％）。在三个属中，Pan的感染率最高，为15％（95％CI：0-55％），其次是Papio，占11％（95％CI：6-18％），5％（95％CI：0-14％）。NHP和人类感染之间的关联是阳性的，但并不重要，由于低研究样本匹配和高变异。
结论：我们的研究结果表明，非洲NHPs的曼氏链球菌感染率很高，在非洲的物种/属和国家之间具有大量异质性。鉴于S.mansoni在非洲NHP和人类之间的潜在溢出和溢出的证据，迫切需要进一步的研究，以了解NHP和人类宿主之间的寄生虫传播的生态学和机制，以便为这种重要的被忽视的热带病提供控制策略。
方法：使用PubMed对文献进行了系统搜索，WebofScience,谷歌学者，世界卫生组织（WHO）图书馆数据库，世界猫和ScienceDirect，没有任何语言限制。包括检查任何非洲NHP物种的曼氏链球菌感染的研究。研究类型,灵长类物种，它们的地理分布,对研究中报道的寄生虫诊断技术进行了定性总结。荟萃分析中包括样本量≥10的物种数据。我们评估了报告的感染率，并使用随机效应模型来估计总感染率和95％置信区间（CI）。我们使用I2统计量评估了研究之间的异质性。29种出版物，从1960年到2018年，被确定并纳入审查。这些研究共检查了10个国家11属22种的2962只灵长类动物(喀麦隆，厄立特里亚,埃塞俄比亚,加蓬,肯尼亚,尼日利亚,塞内加尔,坦桑尼亚,乌干达，和津巴布韦)，在所有国家中，在五个属的九个物种中都发现了曼氏链球菌感染。当我们排除样本量<10的研究时，来自10个国家三个属的11种灵长类动物的24项研究数据仍保留在荟萃分析中。感染率的总体汇总估计为10％（95％CI：6-16％），在国家和物种/属之间具有高度异质性（I2=94.77％）。在三个属中，Pan的感染率最高，为15％（95％CI：0-55％），其次是Papio，占11％（95％CI：6-18％），5％（95％CI：0-14％）。NHP和人类感染之间的关联是阳性的，但并不重要，由于低研究样本匹配和高变异。
结论：我们的研究结果表明，非洲NHPs的曼氏链球菌感染率很高，在非洲的物种/属和国家之间具有大量异质性。鉴于S.mansoni在非洲NHP和人类之间的潜在溢出和溢出的证据，迫切需要进一步的研究，以了解NHP和人类宿主之间的寄生虫传播的生态学和机制，以便为这种重要的被忽视的热带病提供控制策略。
