Global animal melioidosis prevalence: a systematic review and meta-analysis

BACKGROUND: Burkholderia pseudomallei, the causative agent of melioidosis, infects both humans and a broad range of animal species. While human disease has been well characterized, animal data are dispersed across studies and lack a comprehensive global synthesis. This systematic review and meta-analysis estimated the pooled global prevalence of animal melioidosis and examined regional and diagnostic influences. METHODS: Following PRISMA 2020 guidelines, studies reporting B. pseudomallei detection in animals were retrieved from PubMed, Scopus, and Embase up to April 2025. Pooled prevalence was calculated using a random-effects model. Subgroup and meta-regression analyses explored moderators of heterogeneity. RESULTS: Twenty-eight studies from 11 countries, encompassing 98,885 animal samples, were included. The global pooled prevalence was 7.3% (95% CI: 0.039-0.117), with high heterogeneity (I² = 98.8%). Southeast Asia, particularly Thailand, showed consistently higher prevalence across livestock, wildlife, and companion animals. Diagnostic methods and study period contributed to variability but were not statistically significant. CONCLUSIONS: Animal melioidosis is globally distributed, with Thailand serving as a key endemic region and research hub. Strengthening One Health surveillance, standardizing diagnostic tools, and expanding genomic monitoring are essential for improved detection and control of B. pseudomallei across animal populations.