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Equine piroplasmosis in China, 2000 to 2025: a systematic review and meta-analysis of prevalence and risk factors.
Abstract: Equine piroplasmosis (EP) is a tick-borne disease of equids caused by Theileria equi, Babesia caballi, and Theileria haneyi. We conducted a PRISMA-guided systematic review and meta-analysis to estimate pooled prevalence in China and identify associated risk factors. PubMed, Web of Science, ScienceDirect, CNKI, Wanfang, and VIP were searched through 15 August 2025. Of 2,626 records identified, 80 studies met the inclusion criteria. Random-effects models were used to pool prevalence estimates, and prespecified subgroup analyses and univariate meta-regression were used to explore heterogeneity and temporal trends. Overall pooled prevalence during 2000-2025 was 31%; species-specific estimates were 24.28% for T. equi and 18.37% for B. caballi. Only one eligible study reported T. haneyi, so its prevalence was summarized descriptively rather than pooled. Statistically significant subgroup differences were observed by host species, fever status, climate class, and detection method. Prevalence was higher in horses than in donkeys and mules, although the mule estimate was based on only five studies and 31 positive cases. Febrile equids had a higher prevalence than afebrile equids, prevalence was highest in Dwb and lowest in Cfa climates, and PCR-based studies yielded a higher pooled prevalence than ELISA-based studies (36.40% vs 23.97%). No significant differences were detected by region, age, sex, season, management system, or sampling year, and meta-regression showed no significant temporal trend. These findings support risk-based surveillance, prioritization of testing in febrile equids, and combined serological and molecular testing to distinguish exposure from active infection.
Copyright © 2026. Published by Elsevier Ltd.
Publication Date: 2026-08-31 PubMed ID: 42674103DOI: 10.1016/j.tvjl.2026.106866Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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Overview
- This study comprehensively reviews research from 2000 to 2025 on equine piroplasmosis (EP) in China, summarizing the prevalence of the disease and identifying factors that influence infection rates.
- It uses a systematic review and meta-analysis approach to pool data from multiple studies, helping to clarify how widespread EP is and which animals or conditions carry higher risks.
Introduction to Equine Piroplasmosis (EP)
- EP is a tick-borne disease affecting equids such as horses, donkeys, and mules.
- It is caused by three protozoan parasites: Theileria equi, Babesia caballi, and Theileria haneyi.
- The study aims to determine how common EP is in China and to identify risk factors linked to infection.
Methodology
- The researchers followed PRISMA guidelines for systematic reviews to ensure a transparent and rigorous study selection process.
- Databases searched included PubMed, Web of Science, ScienceDirect, CNKI, Wanfang, and VIP, covering publications up to August 15, 2025.
- From 2,626 identified studies, 80 met inclusion criteria for detailed analysis.
- They used random-effects models for meta-analysis to pool prevalence estimates since study designs and populations varied.
- Subgroup analyses and meta-regressions were conducted to explore heterogeneity and changes over time.
Main Findings
- The overall pooled prevalence of equine piroplasmosis in China from 2000-2025 was estimated to be 31%.
- Species-specific prevalence estimates were:
- Theileria equi: 24.28%
- Babesia caballi: 18.37%
- Theileria haneyi: Only one study reported its prevalence; thus, no pooled estimate was calculated.
- Significant differences in prevalence were observed by several factors:
- Host species: Higher prevalence in horses compared to donkeys and mules; however, mule data was limited.
- Fever status: Febrile (feverish) equids showed higher prevalence than afebrile ones.
- Climate class: Prevalence was highest in Dwb (cold, dry winters, warm summers) climates and lowest in Cfa (humid subtropical) climates.
- Detection method: PCR-based testing detected higher prevalence (36.40%) compared to ELISA-based methods (23.97%), likely reflecting PCR’s higher sensitivity.
- No significant differences in prevalence were found related to:
- Geographic region within China
- Age or sex of the animals
- Season when samples were collected
- Management system (e.g., farm type or practices)
- Sampling year, indicating no clear increasing or decreasing trend over the study period
Implications and Recommendations
- The results highlight the need for risk-based surveillance focusing on higher-risk groups such as febrile horses.
- Testing protocols should combine serological tests (like ELISA) and molecular methods (PCR) to distinguish between animals exposed to EP and those with active infections.
- Awareness of climate-related risk enables targeted control measures depending on regional climatic conditions.
- The absence of temporal trends suggests stable prevalence levels, indicating ongoing endemic transmission rather than outbreaks or declines.
Conclusion
- This comprehensive meta-analysis provides a clearer picture of EP prevalence in China, emphasizing how host species, clinical signs, climate, and detection methods impact infection rates.
- It supports improving surveillance strategies and diagnostic approaches to better manage and control equine piroplasmosis in the region.
Cite This Article
APA
Jiao D, Wei W, Dong X, Shi R, Sa R, Ma C, Bian P, Liu K, Wang L, Wei Z, Jiang H, Wang R.
(2026).
Equine piroplasmosis in China, 2000 to 2025: a systematic review and meta-analysis of prevalence and risk factors.
Vet J, 106866.
https://doi.org/10.1016/j.tvjl.2026.106866 Publication
Researcher Affiliations
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011.
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China, 010011; Key Laboratory of Clinical Diagnosis and Treatment of Animal Diseases, Ministry of Agriculture, National Animal Medicine Experimental Teaching Center, Hohhot, Inner Mongolia, China, 010011. Electronic address: wr2006@163.com.
Conflict of Interest Statement
Declaration of competing interests The authors declare that they have no competing interests. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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