Recapitulation of Peste des Petits Ruminants (PPR) Prevalence in Small Ruminant Populations of Pakistan from 2004 to 2023: A Systematic Review and Meta-Analysis

Abstract

Peste des petits ruminants (PPR) is an extremely transmissible viral disease caused by the PPR virus that impacts domestic small ruminants, namely sheep and goats. This study aimed to employ a methodical approach to evaluate the regional occurrence of PPR in small ruminants in Pakistan and the contributing factors that influence its prevalence. A thorough search was performed in various databases to identify published research articles between January 2004 and August 2023 on PPR in small ruminants in Pakistan. Articles were chosen based on specific inclusion and exclusion criteria. A total of 25 articles were selected from 1275 studies gathered from different databases. The overall pooled prevalence in Pakistan was calculated to be 51% (95% CI: 42-60), with heterogeneity I² = 100%, τ2 = 0.0495, and p = 0. The data were summarized based on the division into five regions: Punjab, Baluchistan, KPK, Sindh, and GB and AJK. Among these, the pooled prevalence of PPR in Sindh was 61% (95% CI: 46-75), I² = 100%, τ2 = 0.0485, and p = 0, while in KPK, it was 44% (95% CI: 26-63), I² = 99%, τ2 = 0.0506, and p < 0.01. However, the prevalence of PPR in Baluchistan and Punjab was almost the same. Raising awareness, proper surveillance, and application of appropriate quarantine measures interprovincially and across borders must be maintained to contain the disease.

Keywords: Baluchistan; KPK; PPR; Punjab; Sindh; peste des petits ruminants; pooled prevalence; small ruminants.

Figure 1

The PRISMA flow diagram depicts the procedure for selecting studies. We conducted a thorough search across multiple globally renowned online databases to identify relevant papers that reported the prevalence of PPR in small ruminants. Subsequently, we employed pre-established search techniques to locate these studies. Once the records were merged and duplicate entries were eliminated, the data underwent a screening process using the pre-established criteria for eligibility before being included in the systematic review and meta-analysis.

Figure 2

Year-wise published studies spanning the period from 2004–2023. The numeric value shows the number of studies published in the respective year.

Figure 3

Funnel plot for the analysis of publication bias of the prevalence estimate of PPR in sheep and goats 2004–2023.

Figure 4

Bubble plot for the univariate meta-regression analysis of PPR in small ruminants [30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54].

Figure 5

Correlation plot showing the correlation of various detection methods with the proportion of PPR prevalence.

Figure 6

Forest plot of prevalence estimates of PPR in sheep and goats (2004–2023) in Pakistan [30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54].

Figure 7

Forest plot for the prevalence estimates of PPR (2004–2023) in Sindh, Punjab, Baluchistan, GB and AJK, and Khyber Pakhtunkhwa. (GB = Gilgit–Baltistan; AJK = Azad Jammu and Kashmir; KPK = Khyber Pakhtunkhwa) [30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54].

Figure 8

Spatial distribution of prevalence of PPR in domesticated small ruminants in Pakistan. (GB = Gilgit–Baltistan; AJK = Azad Jammu and Kashmir; KPK = Khyber Pakhtunkhwa).

Figure 9

Geographical partition of PPR representing the disease burden.