Prevalence Trend of Ketosis in Dairy Cows in Asia: A Systematic Review and Meta-Analysis

This research aims to determine the prevalence of ketosis, both subclinical ketosis (SCK) and clinical ketosis (CK), in dairy cows in Asia.This study involves a meta-analysis of studies investigating ketosis detection or prevalence trends using cross-sectional or survey designs.Only articles published in English were included.PubMed, Scopus, ScienceDirect, Agricola, and ProQuest were searched for relevant studies published from inception until February 9, 2025.Guided by the PRISMA guidelines, we carefully selected relevant studies and analyzed the collected data using a random-effects model to determine the overall prevalence of ketosis in Asia.Considering the differences between studies, we used Cochran's Q and I² stats, along with sensitivity analysis and meta-regression, to determine the influence of different factors, such as region, diagnostic tools, or study design, on ketosis prevalence.A total of 25 studies, investigating 35 study groups from seven countries, were analyzed.Approximately 29% of dairy cows in Asia had ketosis (95% CI: 23-35%), with subclinical cases slightly more common (32%) than clinical or unclear cases (30%).West Asia had the highest prevalence rate (39%), possibly due to harsher climates or feed-related challenges, followed by East Asia (25%) and then South Asia (19%).Moreover, our analysis reveals an upward trend in ketosis prevalence.The results were stable, as no single study substantially affected the findings.The results show that the prevalence trend of ketosis is increased in Asia, and thus is an urgent health concern in dairy farms in the region.