Prevalence and Genotype Distribution of Sapovirus in China: A Systematic Review and Meta-Analysis

Sapovirus is gaining recognition as a significant non-bacterial causative agent of acute gastroenteritis globally, contributing to both sporadic cases and outbreaks across all age groups. In China, it is identified as the second most prevalent pathogen responsible for acute gastroenteritis outbreaks, following norovirus, which underscores its public health importance. Consequently, an extensive systematic review and meta-analysis are undertaken to evaluate the prevalence and genotype distribution of sapovirus among patients presenting with acute gastroenteritis. This analysis incorporated 159 eligible studies spanning 32 provinces in China. The estimated overall prevalence of sapovirus is 1.9% (95% CI: 1.7-2.2), with an asymptomatic prevalence of 0.8% (95% CI: 0-2.5). Notably, in outbreak settings, the respective prevalence rates increase substantially to 16.4% (95% CI: 10.1-23.8) and 14.4% (95% CI: 8.9-20.7). Furthermore, these findings reveal that sapovirus GI genomes predominated in both sporadic and outbreak contexts, with genotypes GI.1, GI.2, and GII.1 being most frequently identified. These insights are crucial for enabling governments to accurately assess disease burden, inform the development of targeted vaccines, and establish evidence-based public health policies and emergency response strategies to mitigate sapovirus outbreaks.