The Lancet regional health. Southeast Asia
Epidemiology of Kyasanur forest disease in India, 2000-2025: a systematic review and meta-analysis
By Areeb Hussain SS, Chaturvedi R, Kathpalia M and 2 others.
Abstract
Background
Kyasanur forest disease (KFD) is a tick-borne viral haemorrhagic fever that has recently expanded beyond its historically endemic focus in Shimoga district, Karnataka, India. Robust estimates of disease burden, distribution and clinical manifestations remain limited. This systematic review and meta-analysis aimed to estimate pooled KFD positivity, case-fatality rates and to characterise the distribution and clinical features of KFD across India.
Methods
Four databases including PubMed, Scopus, Web of Science, Embase along with grey literature (Google Scholar) were searched (January 1, 2000-January 15, 2025). Non-English publications, studies published prior to 2000, reviews, systematic reviews, meta-analyses, seropositivity assessments, and investigations restricted to diagnostic test comparisons were excluded. Eligible studies included those evaluating KFD diagnostic positivity among clinically suspected patients, tick and non-human primate infectivity, outbreak investigations, symptoms, and mortality. Following duplicate removal, study quality was verified utilising NIH Quality Assessment Tool, resulting in exclusion of poor-quality papers. Primary outcomes, diagnostic positivity among clinically suspected KFD patients and case fatality ratio (CFR), were pooled using random-effects meta-analysis with logit transformation. PROSPERO registration: CRD42024621971.
