Global prevalence and risk factors of human trichinellosis: A systematic review and meta-analysis

Trichinellosis is a food-borne zoonosis caused by Trichinella spp., typically acquired through consumption of raw or undercooked meat. Given its broad geographic distribution and persistent gaps in surveillance and reporting, we conducted a global systematic review and meta-analysis to estimate the prevalence of human Trichinella infection and identify major sources of heterogeneity. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), PubMed, Web of Science, ScienceDirect, Scopus, and Google Scholar were searched from inception to 15 May 2025. Eligible studies reported human Trichinella infection with extractable numerator/denominator data. Random-effects meta-analysis was performed in R. A total of 127 studies were included. Across these studies, 425,225 individuals were examined and 31,401 cases were identified, yielding an overall pooled prevalence of 18 %. Pooled prevalence differed significantly by continent (ranging from 6.30 % in South America to 24.42 % in Oceania, p = 0.0279) and sampling period (20.59 % after 2000 vs. 10.02 % in 2000 or before, p = 0.0290). At the country level, the highest pooled prevalences were observed in Thailand, Germany, and Türkiye. Occupation also differed significantly (p = 0.0145), with the highest prevalence observed in military personnel (41.47 %). Clinical manifestations differed significantly (p < 0.0001), and the most frequently reported symptoms were myalgia (63.19 %), fever (60.77 %), and facial edema (58.98 %). Temporal meta-regression showed no significant trend. Human Trichinella infection remains a global public health concern, with higher prevalence observed in Asia and Europe. Individuals with risk exposure who develop symptoms such as myalgia, fever, or facial edema should undergo prompt medical examination. A One Health approach integrating human, animal, and food-safety surveillance is essential for effective prevention and control of Trichinella infection.