{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:58:43Z","timestamp":1773003523648,"version":"3.50.1"},"reference-count":204,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000853","name":"University of Glasgow","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Equine trypanosomiasis is a neglected protozoal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To perform a systematic search of literature to explore: (1) In equines what is the global geographical distribution and prevalence of trypanosomiasis? In low and middle\u2010income countries (LMICs) is trypanosomiasis more prevalent than in higher\u2010income countries (HICs)? (2) Is trypanosomiasis infection a significant contributor to global morbidity and mortality?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Studies were identified that described naturally occurring equine trypanosomiasis worldwide following \u2018Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses\u2019 using eight international databases (1980\u20132022). Equine population data for each country were extracted. Meta\u2010analyses were used to estimate point prevalence and disease characteristics. Country exposure risk to equines (negligible\/low\/medium\/high) and clinical data (\n                      <jats:italic>Trypanosoma<\/jats:italic>\n                      sp.; outbreak (O) vs. endemic (E) disease) were categorised.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Study quality was assessed (Question 1 prevalence:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009147 manuscripts, median grade \u2018medium\u2019 (4\/8 (range 2\u20136)); Question 2 morbidity and mortality:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946 \u2018moderate\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), \u2018low\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) or \u2018very low\u2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925)). Heterogeneity was high. LMICs were more likely to report disease (41\/125; 33% vs. 7\/80, 9%; (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; OR 5.1 (2.1\u201314.2))). Fifty\u2010six percent of the world's equines reside in a \u2018medium\u2019\/\u2018high\u2019 risk country (61,507,601). Disease characteristics were summated. For\n                      <jats:italic>Trypanosoma evansi<\/jats:italic>\n                      : (O) Infection rate (IR) (42%; 95% CI 14\u201376), morbidity (47%; (13\u201385)), mortality (23%; 7\u201354) and death to case ratio (DCR) (45%; 20\u201373).\n                      <jats:italic>Trypanosoma equiperdum<\/jats:italic>\n                      : (O) IR 12% (7\u201318), morbidity 25% (9\u201349).\n                      <jats:italic>Tsetse transmitted trypanosomiasis<\/jats:italic>\n                      (O): IR 46% (29\u201363), morbidity 46% (29%\u201363%), mortality 6% (1\u201319), DCR 12% (2\u201338). (E) IR 50% (20\u201360), morbidity (no data), mortality 11% (7\u201314), DCR 9% (5\u201316).\n                      <jats:italic>Trypanosoma vivax<\/jats:italic>\n                      (O) IR 43% (10\u201383), morbidity 43% (10\u201383), mortality 15% (0\u2013100), DCR 32% (0\u2013100).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Limitations<\/jats:title>\n                    <jats:p>Publication bias, heterogeneity, descriptive data, missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Equine trypanosomiasis predominates in LMICs. Conservatively, globally more than eight million equines are estimated to be affected, with substantial morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/evj.70101","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T04:55:41Z","timestamp":1761281741000},"page":"291-319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Equine trypanosomiasis, a systematic review and meta\u2010analyses: Prevalence, morbidity and mortality"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4365-7654","authenticated-orcid":false,"given":"Alexandra G.","family":"Raftery","sequence":"first","affiliation":[{"name":"School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7667-9572","authenticated-orcid":false,"given":"Lauren","family":"Gummery","sequence":"additional","affiliation":[{"name":"Three Counties Equine Hospital, Stratford Bridge  Gloucestershire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3382-0929","authenticated-orcid":false,"given":"Karelhia","family":"Garcia","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine, Veterinary Medical Sciences University of Calgary  Calgary Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8236-2109","authenticated-orcid":false,"given":"Dinesh","family":"Mohite","sequence":"additional","affiliation":[{"name":"Federation of Indian Animal Protection Organisations  New Dehli India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8803-5034","authenticated-orcid":false,"given":"Paul","family":"Capewell","sequence":"additional","affiliation":[{"name":"School of Molecular Biosciences, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7241-8444","authenticated-orcid":false,"given":"David G. 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