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Meta-Analysis
. 2020 Feb 24;18(1):100.
doi: 10.1186/s12967-020-02269-0.

Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)

Eun-Jin Lim  1 , Yo-Chan Ahn  2 , Eun-Su Jang  1 , Si-Woo Lee  3 , Su-Hwa Lee  4 , Chang-Gue Son  5
Affiliations
Meta-Analysis

Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)

Eun-Jin Lim et al. J Transl Med. .

Abstract

Background: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) has been emerging as a significant health issue worldwide. This study aimed to systemically assess the prevalence of CFS/ME in various aspects of analyses for precise assessment.

Methods: We systematically searched prevalence of CFS/ME from public databases from 1980 to December 2018. Data were extracted according to 7 categories for analysis: study participants, gender and age of the participants, case definition, diagnostic method, publication year, and country of the study conducted. Prevalence data were collected and counted individually for studies adopted various case definitions. We analyzed and estimated prevalence rates in various angles: average prevalence, pooled prevalence and meta-analysis of all studies.

Results: A total of 1291 articles were initially identified, and 45 articles (46 studies, 56 prevalence data) were selected for this study. Total 1085,976 participants were enrolled from community-based survey (540,901) and primary care sites (545,075). The total average prevalence was 1.40 ± 1.57%, pooled prevalence 0.39%, and meta-analysis 0.68% [95% CI 0.48-0.97]. The prevalence rates were varied by enrolled participants (gender, study participants, and population group), case definitions and diagnostic methods. For example, in the meta-analysis; women (1.36% [95% CI 0.48-0.97]) vs. men (0.86% [95% CI 0.48-0.97]), community-based samples (0.76% [95% CI 0.53-1.10]) vs. primary care sites (0.63% [95% CI 0.37-1.10]), adults ≥ 18 years (0.65% [95% CI 0.43-0.99]) vs. children and adolescents < 18 years (0.55% [95% CI 0.22-1.35]), CDC-1994 (0.89% [95% CI 0.60-1.33]) vs. Holmes (0.17% [95% CI 0.06-0.49]), and interviews (1.14% [95% CI 0.76-1.72]) vs. physician diagnosis (0.09% [95% CI 0.05-0.13]), respectively.

Conclusions: This study comprehensively estimated the prevalence of CFS/ME; 0.89% according to the most commonly used case definition CDC-1994, with women approximately 1.5 to 2 folds higher than men in all categories. However, we observed the prevalence rates are widely varied particularly by case definitions and diagnostic methods. An objective diagnostic tool is urgently required for rigorous assessment of the prevalence of CFS/ME.

Keywords: CFS; Chronic fatigue syndrome; ME/CFS; Meta-analysis; Prevalence; Systematic review.

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Conflict of interest statement

There are no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
PRISMA flowchart. Study flowchart of the articles included in the analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. CFS chronic fatigue syndrome, ME myalgic encephalitis
Fig. 2
Fig. 2
Meta-analysis of the total CFS/ME prevalance. CFS chronic fatigue syndrome. ME myalgic encephalitis
Fig. 3
Fig. 3
Meta-analysis of the CFS/ME prevalence in adults (≥ 18 years). CFS chronic fatigue syndrome, ME myalgic encephalitis
Fig. 4
Fig. 4
Meta-analysis of the CFS/ME prevalence in males a, females b. CFS chronic fatigue syndrome, ME myalgic encephalitis
Fig. 5
Fig. 5
Key symptoms of CFS/ME by case definitions. CFS chronic fatigue syndrome, ME myalgic encephalitis, PEM postexertion malaise, IOM Institute of Medicine, SEID systemic exertion intolerance disease, NICE National Institute for Health and Care Excellence, PVES Post viral exhaustion syndrome. Holmes. ECD epidemiology case definition, CCC Canadian Consensus Criteria, ICC International Consensus Criteria
See this image and copyright information in PMC

References

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