Studies on prevalence of Hantavirus in small mammals in Southeast Asia: A systematic review and meta-analysis

Background: This study systematically analyzed the prevalence of Hantavirus (HVs) in small mammals across Southeast Asia to evaluate the risks of this zoonotic disease. Methods: We searched the Web of Science, PubMed, Embase, Scopus, and Cochrane Library for studies published up to 6 February 2025, extracted data from 28 eligible studies. Results: Meta-analysis revealed a pooled prevalence of HVs was 6.07% (986/11,806) in small mammals in Southeast Asia, with the highest prevalence in Indonesia (17.49%) and Singapore (10.53%). The prevalence was higher in samples detected by Enzyme-Linked Immunosorbent Assay (10.68%) and in rodents (8.07%). Conclusions: The results of our study highlight the urgency of strengthening surveillance in trade networks with Southeast Asia, particularly in high-risk areas such as Indonesia and Singapore, to mitigate the threat of imported zoonotic diseases. Author summary: Hantaviruses (HVs) are zoonotic pathogens that can cause severe diseases in humans, such as Hantavirus pulmonary syndrome (HPS) and Hemorrhagic Fever with Renal Syndrome (HFRS). Understanding the prevalence of HVs in small mammals is critical for assessing public health risks, especially in regions with high biodiversity and frequent international trade. In this study, we conducted a systematic review and meta-analysis of 28 studies to estimate the prevalence of HVs in small mammals across Southeast Asia. We found an overall prevalence of 6.07%, with higher rates in Indonesia and Singapore. Certain species, such as Rattus norvegicus showed particularly high infection rates. Detection methods also influenced prevalence estimates, with immunofluorescence assays reporting higher rates than molecular methods. Our findings underscore the need for enhanced surveillance in high-risk areas and trade networks to prevent the cross-border spread of Hantaviruses.