Mycobacterium avium subsp. paratuberculosis (MAP) is responsible for the persistent infectious illness known as bovine paratuberculosis, which is one of the most easily overlooked diseases in China amid a lack of epidemiological data. In this study, we evaluated the agreement of milk and blood antibody tests for paratuberculosis and showed an overall agreement of 92.0%, with a 95.0% negative coincidence rate and a 78.6% positive coincidence rate. The milk test was then used to examine the prevalence and incidence of dairy cows in Hubei Province, China. We found that, at the individual level, the highest lacto-prevalence reached up to 22.9%; the farm-level prevalence was as high as 92.3% (12/13) and 84.6% (11/13) in January and April 2018, respectively. The total incidence risk of all farms was 6% per three months. We also found that large-scale farms had a significantly lower prevalence and incidence than small-scale farms. Finally, the correlation between paratuberculosis and milk quality was evaluated, and we confirmed that MAP can significantly alter milk quality and raise somatic cell counts in the milk. This study provides valuable information for assessing the prevalence and incidence risk of paratuberculosis in China. It further provides an essential basis for calling for the prevention and control of paratuberculosis in China.

Bovine paratuberculosis is a chronic infectious disease caused by Mycobacterium avium subspecies paratuberculosis (MAP). Here, a systematic literature review was conducted to investigate the bovine paratuberculosis distribution and associated risk factors in China before 2022. The databases CNKI, VIP, WanFang, PubMed, and ScienceDirect were used to search for articles. The random effect model of the \"Meta\" package of \"R\" software was used, and the Arcsine transformation was chosen for the rate conversion analysis. To reveal the factors that led to research heterogeneity, the research data were used for subgroup analysis and univariate meta-regression analysis. Among the 1238 identified articles, 54 met the eligibility criteria. Based on data obtained from the selected articles, the combined positive rate of bovine paratuberculosis was 6.95% in China. In the sampling year subgroup, the positive rate of bovine paratuberculosis before 2013 was 4.94%, which was lower than in other time periods. In the sampling season subgroup, the highest positive rate of bovine paratuberculosis in cattle was 14.60% in the autumn. Furthermore, in the detection method subgroup, the highest positive rate of bovine paratuberculosis was 7.21%, which was detected by using ELISA. In the age subgroup, the positive rate of bovine paratuberculosis was 17.47% in cattle > 12 months old, significantly higher than other age subgroups. The highest positive rate of bovine paratuberculosis was 11.35% for female cattle in the gender subgroup, while in the geographic region subgroup, the highest positive rate was 8.12% for East China, which was significantly higher than in other regions. The highest positive rate of bovine paratuberculosis was for dairy cattle (8.00%), and the highest positive rate by rearing method was 11.03% for non-scale farming. The effects of different geographical and climatic factors on the positive rate of bovine paratuberculosis were evaluated. In summary, we recommend focusing on screening cattle infected with MAP in warm and humid areas.