Global Prevalence and Distribution of H9 Subtype of Avian Influenza Viruses in Wild Birds: Literature Review with Meta-Analysis.

Background: As a natural accelerator of highly pathogenic avian influenza in wild birds, the H9 subtype of avian influenza poses a substantial threat to both humans and the poultry industry. A comprehensive meta-analysis is necessary to assess the current status of the global H9 outbreak. In this research, a literature review and meta-analysis are presented on the surveillance studies of the H9 subtype of avian influenza in wild birds worldwide up to 2024. Methods: A comprehensive search strategy was employed, utilizing the China Science and Technology Journal Database, China National Knowledge Infrastructure, PubMed, Google Scholar, and Scientific Direct databases. The exclusion criteria for this study included duplicate studies, reviews, other host studies, as well as research with inconsistent or insufficient data. An analysis was conducted on data obtained from a total of 31 publications. The rate-conversion analyses were conducted using a random-effects model in the "meta" package of the "R" software, with the PFT method implemented. Results: In the meta-analysis, the prevalence of wild bird H9 avian influenza virus (AIV) was found to be 0.02% (193 out of 365,972). Statistically significant higher prevalences of wild bird influenza A virus were observed in Norway and South Africa (0.87%, 21/2417 and 0.44%, 10/1155, respectively) in comparison with other regions. Within the Anseriformes family, the prevalence rate was much greater (0.17%, 80 out of 90,014) compared with other species. In addition, we performed subgroup analyses that included geographical variables. These assessments showed a higher prevalence of H9 in wild birds in cold regions (0.08%, 30/100,691). Conclusion: In summary, our results suggest that the occurrence of H9 AIV in avian populations differs among different geographical areas and species. Therefore, it is necessary to conduct further surveillance on the prevalence of AIV in wild birds to guide the creation of strong and efficient regulatory strategies targeted at eradicating the transmission of AIV across different species.