Global prevalence of Human Demodex Mite: A systematic review and meta-analysis

Demodex mites are common ectoparasites in humans that typically reside as commensals in sebaceous glands, but under certain host conditions, they may become opportunistic pathogens. Despite numerous localized studies on the prevalence of human Demodex mites, the global prevalence and associated risk factors remain unclear. This study aims to systematically assess the global prevalence of human Demodex mites and the effects of age, gender, facial sampling region, humidity, World Health Organization (WHO) regions and countries, and population factors on this prevalence. A systematic literature search, following PRISMA guidelines, was conducted in multiple databases from January 2000 to January 2025. Meta-analysis using a random-effects model estimated the global prevalence of Demodex mites and examined associations with demographic, geographic, and climatic factors. Meta-regression, sensitivity analysis, and Egger's test were conducted to assess publication bias and the robustness of the findings. The global pooled prevalence of human Demodex mites was approximately 35 % (based on available studies), with the highest prevalence observed in the South-East Asia Region (SEARO) at 44 %. The highest prevalence among age groups was found in older adults (>60 years), reaching 59 %, while the highest facial region-specific prevalence was observed in the eyelashes at 33 %. Among different population groups, ophthalmology patients showed the highest prevalence (57 %). Additionally, the prevalence was slightly higher in females compared to males. The analysis revealed significant heterogeneity and publication bias. The sensitivity analysis confirmed the stability of the prevalence estimate. Meta-regression identified significant differences in sample size but no associations with humidity or publication year. This meta-analysis highlights a global prevalence of human Demodex mites, especially among older adults and ophthalmology patients, emphasizing the need for clinical awareness and further studies.