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These pathogens not only affect humans through single or multiple tick bites but also pose risks to animal hosts, leading to potential coinfections. Despite regional studies indicating significant prevalence, their global coinfection data remain sparse. This study aims to bridge this gap through a systematic review and meta-analysis of <jats:italic>B. burgdorferi<\/jats:italic> and <jats:italic>A. phagocytophilum<\/jats:italic> coinfections in <jats:italic>Ixodes<\/jats:italic> ticks worldwide. Addressing data limitations and study variability, it seeks to provide a nuanced understanding of coinfection patterns, their epidemiological implications and inform targeted prevention strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>Following Preferred Reporting Items for Systematic Review and Meta-analysis Protocols 2015 guidelines and PROSPERO registration, this study will undertake a thorough database search without constraints on language or publication date, using standardised screening and data extraction protocols. The quality and bias of studies will be evaluated using Joanna Briggs Institute tools. In the statistical analysis phase, conducted in R, we will initially determine the use of fixed or random-effects models based on the assessment of data heterogeneity. This choice will guide the framework for subsequent analyses. Within the selected model\u2019s framework, we will perform subgroup analyses and meta-regression to investigate the effects of various factors, ensuring that each step is tailored to the initial model selection to maintain analytical consistency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>As this study does not involve clinical research or data collection from subjects, ethical approval is not required. We will uphold ethical standards in synthesising and reporting data. Study outcomes will be published in peer-reviewed journals, communicating findings to the scientific community and contributing to the understanding of <jats:italic>Ixodes<\/jats:italic> tickborne diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42023449735.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083052","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T22:33:02Z","timestamp":1718058782000},"page":"e083052","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Global prevalence of <i>Borrelia burgdorferi<\/i> and <i>Anaplasma phagocytophilum<\/i> coinfection in <i>Ixodes<\/i> tick populations: protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"14","author":[{"given":"Suyi","family":"Luo","sequence":"first","affiliation":[{"name":"The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan, China"},{"name":"Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University, Kunming, Yunnan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2652-6660","authenticated-orcid":false,"given":"Fukai","family":"Bao","sequence":"additional","affiliation":[{"name":"The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan, China"},{"name":"Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University, Kunming, Yunnan, 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