Background Mycoplasma genitalium is a common cause of non-gonococcal non-chlamydial urethritis and cervicitis. Testing of asymptomatic populations has been proposed, but prevalence in asymptomatic populations is not well established. We aimed to estimate the prevalence of M. genitalium in the general population, pregnant women, men who have sex with men (MSM), commercial sex workers (CSWs) and clinic-based samples,
Methods We searched Embase, Medline, IndMED, African Index Medicus and LILACS from 1 January 1991 to 12 July 2016 without language restrictions. We included studies with 500 participants or more. Two reviewers independently screened and selected studies and extracted data. We examined 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 3316 screened records, 63 were included. In randomly selected samples from the general population, the summary prevalence was 1.3% (95% CI 1.0% to 1.8%, I2 41.5%, three studies, 9091 people) in countries with higher levels of development and 3.9% (95% CI 2.2 to 6.7, I2 89.2%, three studies, 3809 people) in countries with lower levels. Prevalence was 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%, three studies, 2889 people). Summary prevalence estimates were, in the following groups: pregnant women 0.9% (95% CI 0.6% to 1.4%, I2 0%, four studies, 3472 people), MSM in the community 3.2% (95% CI 2.1 to 5.1, I2 78.3%, five studies, 3012 people) and female CSWs in the community 15.9% (95% CI 13.5 to 18.9, I2 79.9%, four studies, 4006 people).
Discussion This systematic review can inform testing guidelines for M. genitalium. 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 these groups.
Registration numbers PROSPERO: CRD42015020420
- systematic rreviews
- epidemiology (general)
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Handling editor Joseph D Tucker
Contributors Conceived and designed the review: NL, LB, MC, PS, DE-G. Screened titles, abstracts and full texts: LB, MC, DE-G, HA, G-RL, NL. Extracted the data: LB, MC, DE-G, HA, G-RL. Analysed the data: LB, MC, FH, MG. Wrote the first draft: LB, MC. Revised the paper before submission: NL, MG, DE-G, FH, PS, HA. Approved the final version: LB, MC, DE-G, MG, FH, PS, HA, NL.
Funding This study received funding from the Swiss National Science Foundation (grant numbers 320030_173044 and 320030_135654) and Swiss Programme for Research on Global Issues for Development (r4d): Grant number IZ07Z0_160909.
Competing interests NL is deputy editor of Sexually Transmitted Infections.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data from included and excluded studies are provided in a supplementary document.
Correction notice The paper has been corrected since it was published Online First. An error at the production stage meant the references were not in the correct order. We have since amended them and would like to apologise to the authors for this error.
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