Exploring adenovirus in water environments: a systematic review and meta-analysis

Figures & data

Figure 1. PRISMA flow diagrams.

Figure 2. Adenovirus prevalence in water matrices.

Table 1. Summary of global meta-analysis results for prevalence of Adenovirus in different water matrices divided by risk of bias and process control.

Water matrix	Prevalence (%) [95%CI]	95% Prediction interval	N° of Studies	N° of samples	^¶ H [95%CI]	^§ I^2 [95%CI]	P heterogeneity
Untreated wastewater
Overall	83.2 [74.6–90.4]	[4.1–100]	81	3690	5.9 [5.6–6.3]	97.2 [96.8–97.5]	<0.001
Low risk of bias	65.5 [22.2–97.5]	[0–100]	7	429	8.8 [7.5–10.3]	98.7 [98.2–99.1]	<0.001
Process controlled	86.3 [74.2–95.3]	[10.2–100]	31	1245	5.1 [4.6–5.6]	96.1 [95.2–96.8]	<0.001
Treated wastewater
Overall	75.4 [64.7–84.8]	[1.9–100]	57	2657	5.9 [5.5–6.3]	97.1 [96.7–97.5]	<0.001
Low risk of bias	86.6 [53.5–100]	[0–100]	3	87	3.4 [2.1–5.5]	91.5 [78.2–96.7]	<0.001
Process controlled	86.3 [76.3–94.1]	[28.8–100]	22	1035	4 [3.5–4.6]	93.7 [91.6–95.2]	<0.001
Surface water
Overall	49.5 [42.9–56.1]	[0–100]	135	10920	6.7 [6.4–7]	97.8 [97.6–97.9]	<0.001
Low risk of bias	30.4 [3.2–68.8]	[0–100]	6	683	9.8 [8.4–11.5]	99 [98.6–99.2]	<0.001
Process controlled	56.4 [47–65.5]	[0.4–100]	64	5099	6.2 [5.9–6.6]	97.4 [97.1–97.7]	<0.001
Drinking water
Overall	22.7 [12.6–34.5]	[0–81.9]	22	1511	4.6 [4.1–5.2]	95.3 [93.9–96.4]	<0.001
Process controlled	44.3 [16.3–74.3]	[0–100]	7	236	4.6 [3.7–5.9]	95.3 [92.5–97.1]	<0.001
Groundwater
Overall	18.5 [11.3–26.8]	[0–58.9]	19	2525	4 [3.5–4.7]	93.9 [91.7–95.5]	<0.001
Low risk of bias	2.5 [1.6–3.6]	[NA-NA]	1	964	NA [NA-NA]	NA [NA-NA]	1
Process controlled	26.4 [0.2–68.9]	[0–100]	4	179	4.2 [3–6]	94.4 [88.9–97.2]	<0.001
Others
Overall	53.4 [35.3–71]	[0–100]	29	1379	6.5 [6–7.1]	97.6 [97.2–98]	<0.001
Process controlled	50.2 [23.7–76.6]	[0–100]	16	650	6.7 [6–7.6]	97.8 [97.2–98.2]	<0.001

95% CI: 95% Confidence Interval.

NA: not applicable.

¶ H is a measure of the extent of heterogeneity; a value of H > 1 indicates a potential heterogeneity of the prevalence of adenovirus.

§ I² describes the proportion of total variation in prevalence of adenovirus that is due to heterogeneity; a value > 50% indicates presence of heterogeneity.

Figure 3. Global prevalence of adenovirus in water matrices.