PT  - JOURNAL ARTICLE
AU  - Lukas Baumann
AU  - Manuel Cina
AU  - Dianne Egli-Gany
AU  - Myrofora Goutaki
AU  - Florian Halbeisen
AU  - Gian-Reto Lohrer
AU  - Hammad Ali
AU  - Pippa Scott
AU  - Nicola Low
TI  - Prevalence of <em>Mycoplasma genitalium</em> in different population groups: systematic review and meta-analysis
AID  - 10.1101/180422
DP  - 2017 Jan 01
TA  - bioRxiv
PG  - 180422
4099  - http://biorxiv.org/content/early/2017/08/25/180422.short
4100  - http://biorxiv.org/content/early/2017/08/25/180422.full
AB  - Background Mycoplasma genitalium is a common cause of non-gonococcal non-chlamydial urethritis and cervicitis. Testing of asymptomatic populations has been proposed, but prevalence rates in asymptomatic populations are not well established. We aimed to estimate the prevalence of M. genitalium in adults in the general population, in clinic-based samples, pregnant women, men who have sex with men (MSM) and female sex workers (FSW).Methods We searched Embase, Medline, IndMED, AIM and LILACS from 1 January 1991 to 12 July 2016 without language restrictions. We included studies with 500 participants or more. We screened and selected studies and extracted data in duplicate. We examined eligible studies in forest plots and conducted random effects meta-analysis to estimate prevalence, if appropriate. Between study heterogeneity was examined using the I2 statistic and meta-regression.Results Of 3,316 screened records, 63 were included. In randomly selected samples from the general population, the summary prevalence estimate was 1.3% (95% confidence intervals, CI 1.0 to 1.8%, I2 41.5%, 3 studies) in countries with higher levels of development and 3.9% (95% CI 2.2 to 6.7, I2 89.2%, 3 studies) in countries with lower levels. Prevalence estimates were similar in women and men (p=0.47). In clinic-based samples prevalence estimates were higher, except in asymptomatic patients (0.8%, 95% CI 0.4 to 1.4, I2 0.0%, 3 studies). Summary prevalence estimates were: pregnant women 0.9% (95% CI 0.6 to 1.4%, I2 0%, 4 studies); MSM in the community 3.2% (95% CI 2.1 to 5.1, I2 78.3%, 5 studies); FSW in the community 15.9% (95% CI 13.5 to 18.9, I2 =79.9%, 4 studies).Discussion This systematic review can inform testing guidelines for M. genitalium infection. The low estimated prevalence of M. genitalium in the general population, pregnant women and asymptomatic attenders at clinics does not support expansion of testing to asymptomatic people in these groups.Registration NumbersPROSPERO: CRD42015020420