Zoonotic brugian filariasis past and present trends in malaysia: A systematic review and proportionate meta-analysis

Lymphatic filariasis is a neglected tropical disease of public health concern targeted for elimination globally. Malaysia is endemic to filariasis caused mainly by the filarial parasite Brugia malayi, with decades of continues elimination efforts. Despite recorded success, the disease is yet to be eliminated. Recently, reinfection in regions following mass drug administration programs and resurgence in some parts of the country raises concern as the country geared towards the 2030 filariasis elimination target. This study aims to provide pool prevalence estimates of the disease in animals and humans in Malaysia using a proportionate meta-analysis. Recent epidemiolocal data, potential filaria hotspots and the role of human induced environmental degradation on zoonotic filariasis transmission are also discussed. A Generalized Linear Mixed Model (GLMM) was used for the proportionate meta-analysis of prevalence data from 12 included studies. The result reveals overall human zoonotic filariasis estimated pool prevalence of 3% [95% CI: 0.01–0.09] and 5% [95% CI=0.01–0.17] among animals in Malaysia, with a significant between study heterogeneity (I² = 97%; I² = 94%, p<0.001, respectively). A subgroup meta-analysis of animal prevalence reveals high common effect estimated prevalence among monkeys 50% [95% CI=0.43–0.58] with a random effect of 9% [0.00-0.94], with no observed between study heterogeneity (I² = 0%, p=1). This study provides insight into zoonotic brugian filariasis that can be useful for the development of effective and su