A Systematic Review and Meta-Analysis of Practices Exposing Humans to Avian Influenza Viruses, Their Prevalence, and...

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• Avian influenza viruses (AIVs) pose a significant zoonotic threat, with most human infections originating from poultry.
• Understanding the practices and rationales behind human exposure to AIVs is critical for effective prevention.

Purpose of the Study:

• To systematically review practices associated with human avian influenza virus infections.
• To determine the prevalence of these practices and explore the rationale for their adoption.

Main Methods:

• A systematic review of observational studies was conducted.
• Database searches identified relevant literature, and meta-analysis was used to estimate combined odds ratios.
• Prevalence of practices and rationales were reported based on included articles.

Main Results:

• Direct and indirect poultry exposure was linked to AIV infection across subtypes and settings.
• Infection risk was higher with practices in markets versus households, involving sick/dead poultry, and with H7N9 compared to H5N1.
• Practice descriptions lacked detail on frequency and intensity; reasons for adoption were not comprehensively studied.

Conclusions:

• Poultry-related practices are consistently associated with human AIV infections.
• Further research combining epidemiological and anthropological approaches is needed to understand practice rationales.
• Insights into rationales can inform the design of more effective and acceptable public health interventions.