{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T07:50:38Z","timestamp":1771573838307,"version":"3.50.1"},"reference-count":86,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Human T Lymphotropic Virus type 1 (HTLV-1) is a neglected retrovirus associated with many clinical disorders, most notably Adult T-cell Leukemia\/Lymphoma and HTLV-1-Associated Myelopathy (HAM). Found in endemic clusters across the world, high prevalence has been reported in minoritized groups who suffer from health inequities. This study investigates the association between HTLV-1 prevalence and the following socioeconomic determinants of health: education, income, and employment, which are markers of health inequity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was conducted by searching the following databases: Ovid\/Medline, Embase, Global Health Database, Web of Science, LILACS and SciELO. Primary studies in English, Spanish and Portuguese mentioning HTLV-1 and one of education, income and\/or employment were included. A random-effects meta-analysis was performed, and odds ratios (OR) were calculated to determine the association between these socioeconomic determinants of health and HTLV-1 prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>42 studies were included. The likelihood of having HTLV-1 was higher in individuals with less than completed primary education compared to those who completed primary education (OR 1.86 [95% CI 1.34\u20132.57]; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01). This may be because individuals with low education have reduced access to and understanding of health information, thus increasing the prevalence of risk factors associated with HTLV-1 infection. No other determinants were found to be statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fewer years of schooling are associated with increased likelihood of contracting HTLV-1. Therefore, health promotion materials and public health policies regarding HTLV-1 must consider those with lower educational levels to effectively reduce disease transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=335004<\/jats:ext-link>, identifier (CRD42022335004).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1298308","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T13:00:30Z","timestamp":1706101230000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["How do socioeconomic determinants of health affect the likelihood of living with HTLV-1 globally? A systematic review with meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Nydile","family":"Ramesh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Cockbain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham P.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Rosadas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/S1473-3099(19)30402-5","article-title":"Association between HTLV-1 infection and adverse health outcomes: a systematic review and meta-analysis of epidemiological 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Centres","volume":"32","author":"Slurink","year":"2021","journal-title":"Int J STD AIDS"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1097\/olq.0b013e31813e0c15","article-title":"Education attainment and the risk of HIV-1 infections in rural Kilimanjaro region of Tanzania, 1991\u20132005: a reversed association","volume":"34","author":"Mmbaga","year":"2007","journal-title":"Sex Transm Dis"},{"key":"ref15","year":"2013"},{"key":"ref16","first-page":"79","article-title":"Unemployment as a disease and diseases of the unemployed","volume":"23","author":"Janlert","year":"1997","journal-title":"Scand J Work Environ Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"44","DOI":"10.4178\/epih.e2022032","article-title":"Unemployment and covid-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran","volume":"44","author":"Mirahmadizadeh","year":"2022","journal-title":"Epidemiology and 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Virol"},{"key":"ref39","first-page":"3","article-title":"Epidemiologic study of the association between human T-cell lymphotropic virus type 1 and Strongyloides stercoralis infection in female blood donors (Guadeloupe, French West Indies)","volume":"53","author":"Courouble","year":"2004","journal-title":"West Indian Med J"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1046\/j.0042-9007.2001.00143.x","article-title":"A case-control study of risk factors associated with human T-cell lymphotrophic virus type-I seropositivity in blood donors from Guadeloupe, French West Indies","volume":"82","author":"Rouet","year":"2002","journal-title":"Vox Sang"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1002\/jmv.21010","article-title":"Use of replacement blood donors to study the epidemiology of major blood-borne viruses in the general population of Maputo, Mozambique","volume":"79","author":"Cunha","year":"2007","journal-title":"J Med Virol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1080\/15321819.2019.1636817","article-title":"Prevalence of human T-cell lymphotropic virus and the socio-demographic and risk factors associated with the infection among post-natal clinics women in Zaria, Nigeria","volume":"40","author":"Hananiya","year":"2019","journal-title":"J Immunoass Immunochem"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3109\/00365549009037896","article-title":"Seroepidemiology of human retroviruses in Ogun state of Nigeria","volume":"22","author":"Olusanya","year":"1990","journal-title":"Scand J Infect Dis"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1089\/aid.2011.0248","article-title":"Human T-lymphotropic virus type 1 prevalence in northeastern Iran, Sabzevar: an epidemiologic-based study and phylogenetic analysis","volume":"28","author":"Azarpazhooh","year":"2012","journal-title":"AIDS Res Hum Retrovir"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"103132","DOI":"10.1016\/j.transci.2021.103132","article-title":"Seroprevalence and trends of transfusion transmissible infections among retrospective blood donors in Western Azerbaijan regional blood transfusion center, Iran: a ten-years evaluation","volume":"60","author":"Emadi","year":"2021","journal-title":"Transfus Apher Sci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"10752","DOI":"10.5897\/AJB11.177","article-title":"Seroprevalence of human T-cell lymphotropic virus type 1 infection (HTLV1) in different patients in the north of Iran","volume":"10","author":"Ghaffari","year":"2011","journal-title":"Afr J Biotechnol"},{"key":"ref47","first-page":"424","article-title":"Epidemiology of HTLV-1 in Neyshabour, northeast of Iran","volume":"13","author":"Hedayati-Moghaddam","year":"2011","journal-title":"Iran Red Crescent Med J"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"5736","DOI":"10.3390\/v7112904","article-title":"Human T-Lymphotropic virus type I (HTLV-1) infection among Iranian blood donors: first case-control study on the risk factors","volume":"7","author":"Hedayati-Moghaddam","year":"2015","journal-title":"Viruses-Basel"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"203","DOI":"10.4103\/0973-6247.154255","article-title":"Seroepidemiology of human T-cell lymphotropic virus type-I in blood donors of northeastern Iran, Sabzevar","volume":"9","author":"Maghsudlu","year":"2015","journal-title":"Asian J Transfus Sci"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jcv.2011.07.004","article-title":"High prevalence of HTLV-I infection in Mashhad, Northeast Iran: a population-based seroepidemiology survey","volume":"52","author":"Rafatpanah","year":"2011","journal-title":"J Clin Virol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1093\/ije\/25.5.1083","article-title":"A case-control study of risk factors for seropositivity to human T-lymphotropic virus type I (HTLV-I) in Jamaica","volume":"25","author":"Murphy","year":"1996","journal-title":"Int J Epidemiol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1186\/s12884-017-1362-0","article-title":"Non-malarial infectious diseases of antenatal care in pregnant women in Franceville, Gabon","volume":"17","author":"Pegha Moukandja","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1093\/oxfordjournals.aje.a114828","article-title":"Human T-cell lymphotropic virus type I (HTLV-I) seroepidemiology and risk factors in metropolitan Panam\u00e1","volume":"127","author":"Reeves","year":"1988","journal-title":"Am J Epidemiol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1097\/01.olq.0000194598.47821.b6","article-title":"Human T lymphotropic virus type I\/II infection: prevalence and risk factors in individuals testing for HIV in counseling centers from southern Brazil","volume":"33","author":"Barcellos","year":"2006","journal-title":"Sex Transm Dis"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1002\/jmv.1890420312","article-title":"Seroepidemiology of human T-Lymphotropic virus type-I infection among intravenous drug-abusers in Taiwan","volume":"42","author":"Cj","year":"1994","journal-title":"J Med Virol"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"9 19","DOI":"10.1186\/1471-2288-9-19","article-title":"Determinants of subject visit participation in a prospective cohort study of HTLV infection","volume":"9","author":"De Vita","year":"2009","journal-title":"BMC Med Res Methodol"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1097\/00042560-199804010-00007","article-title":"Laboratory test differences associated with HTLV-I and HTLV-II infection. Retrovirus epidemiology donor study investigators","volume":"17","author":"Murphy","year":"1998","journal-title":"J Acquir Immune Defic Syndr Hum Retrovirol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/00042560-199703010-00011","article-title":"Risk factors for human T-cell lymphotropic virus types I and II (HTLV-I and -II) in blood donors: the retrovirus epidemiology donor study","volume":"14","author":"Schreiber","year":"1997","journal-title":"J Acquir Immune Defic Syndr Hum Retrovirol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1080\/15321819.2018.1500374","article-title":"Serological detection of human T-cell lymphotropic virus types I and II among pregnant women in Ilorin, Nigeria","volume":"39","author":"Udeze","year":"2018","journal-title":"J Immunoass Immunochem"},{"key":"ref60","first-page":"5042","article-title":"Seroepidemiology of human T-cell lymphotropic virus type I infection in Taiwan","volume":"48","author":"Wang","year":"1988","journal-title":"Cancer Res"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"672","DOI":"10.34172\/aim.2020.85","article-title":"Prevalence and associated risk factors of htlv-1 and co-infections of blood-borne viruses in Birjand, iran's eastern border","volume":"23","author":"Yousefi","year":"2020","journal-title":"Arch Iran Med"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1001\/archinte.159.13.1485","article-title":"Increased incidence of infectious diseases during prospective follow-up of human T-lymphotropic virus type II- and I-infected blood donors","volume":"159","author":"Murphy","year":"1999","journal-title":"Arch Intern Med"},{"key":"ref63","first-page":"89","article-title":"Seroprevalence of human T-cell lymphotropic virus type I in Cura\u00e7ao and predictive variables for that infection","volume":"142","author":"Kamphuis","year":"1998","journal-title":"Ned Tijdschr Geneeskd"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/s1201-9712(03)90009-9","article-title":"Seroprevalence and risk factors for human T-cell lymphotropic virus (HTLV 1) infection among ethnically and geographically diverse Peruvian women","volume":"7","author":"Sanchez-Palacios","year":"2003","journal-title":"Int J Infect Dis"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"3903","DOI":"10.1128\/jcm.38.10.3903-3904.2000","article-title":"Human T-cell lymphotropic virus type I association with strongylo\u00efdes stercoralis: a case control study among Caribbean blood donors from Guadeloupe (French west indies)","volume":"38","author":"Courouble","year":"2000","journal-title":"J Clin Microbiol"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"e0218138","DOI":"10.1371\/journal.pone.0218138","article-title":"\u201cI can\u2019t read and don\u2019t understand\u201d: health literacy and health messaging about folic acid for neural tube defect prevention in a migrant population on the Myanmar-Thailand border","volume":"14","author":"Gilder","year":"2019","journal-title":"PLoS One"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"1979","DOI":"10.1681\/asn.2009111163","article-title":"Low health literacy associates with increased mortality in ESRD","volume":"21","author":"Cavanaugh","year":"2010","journal-title":"J Am Soc Nephrol"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1007\/s11606-008-0699-5","article-title":"The demographic assessment for health literacy (dahl): a new tool for estimating associations between health literacy and outcomes in national surveys","volume":"23","author":"Hanchate","year":"2008","journal-title":"J Gen Intern Med"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1080\/08858190902910871","article-title":"Literacy and cancer anxiety as predictors of health status: an exploratory study","volume":"24","author":"Hoffman-Goetz","year":"2009","journal-title":"J Cancer Educ"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"e112","DOI":"10.2196\/jmir.4018","article-title":"Low health literacy and evaluation of online health information: a systematic review of the literature","volume":"17","author":"Diviani","year":"2015","journal-title":"J Med Internet Res"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1007\/s11606-009-1105-7","article-title":"Developing predictive models of health literacy","volume":"24","author":"Martin","year":"2009","journal-title":"J Gen Intern Med"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"2468","DOI":"10.1056\/nejmsa0707519","article-title":"Socioeconomic inequalities in health in 22 European countries","volume":"358","author":"Mackenbach","year":"2008","journal-title":"N Engl J Med"},{"key":"ref73","volume-title":"NHS digital service manual","year":"2022"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1007\/s00038-017-0972-7","article-title":"The impact of low education and poor health on unemployment varies by work life stage","volume":"62","author":"van Zon","year":"2017","journal-title":"Int J Public Health"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1086\/429410","article-title":"A prospective study of sexual transmission of human T lymphotropic virus (HTLV)-I and HTLV-II","volume":"191","author":"Roucoux","year":"2005","journal-title":"J Infect Dis"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"e003680","DOI":"10.1136\/bmjopen-2013-003680","article-title":"Determinants of concurrent sexual partnerships within stable relationships: a qualitative study in Tanzania","volume":"4","author":"Cox","year":"2014","journal-title":"BMJ 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