In this study, we conducted a meta-analysis (MA) and systematic review to evaluate the effectiveness of vaccines against post-weaning diarrhea (PWD), caused by enterotoxigenic Escherichia coli (ETEC), in piglets. A Bayesian network meta-analysis (NMA) was also performed to compare the effects of combining different target antigens on vaccine efficacy. Relevant electronic databases were searched using pre-specified search terms, and 17 studies were selected based on three outcomes: diarrhea, mortality, and average daily weight gain (ADWG). In pairwise MA, the vaccinated group showed a significant decrease in diarrhea (OR = 0.124 [0.056, 0.275]) and mortality (OR = 0.273 [0.165, 0.451]), and a significant increase in ADWG (SMD = 0.699 [0.107, 1.290]) compared with those in controls. Furthermore, NMA results showed that all vaccine groups, except for group D (LT enterotoxin), were effective against PWD. Rank probabilities indicated that the F4 + F18 + LT combination was the best regimen for preventing diarrhea (SUCRA score = 0.92) and mortality (SUCRA score = 0.89). NMA also demonstrated that, among the vaccine groups, those inducing simultaneous anti-adhesion and antitoxin immunity had the highest efficacy. Our results provide evidence-based information on the efficacy of vaccines in reducing PWD incidence in pigs and may serve as guidelines for antigen selection for commercial vaccine development in the future.

The past and current burden of swine influenza A viruses (swIAV) must be estimated since pigs act as mixing vessels and are considered a potential source of newly emerging IAV variants. The objective of this systematic review and meta-analysis was to integrate data on the prevalence and seroprevalence of swIAV in South Korean domestic pigs and evaluate important risk factors that influence these outcomes. Eight databases were searched for studies that evaluated the prevalence and seroprevalence of swIAV in South Korean pigs using a specified search string; twenty-seven eligible studies were identified after application of a set of pre-determined inclusion criteria by three authors. The reported prevalence and seroprevalence were pooled separately in proportions between 0 and 1, using a random-effect meta-analysis. To identify and quantify potential sources of heterogeneity, subgroup, and meta-regression analyses were conducted using covariates (publication type, swIAV subtype, growth stage of pigs, sampling region, publication year, sampling season, facility, detection method, sample type, and sample size). The overall prevalence and seroprevalence in domestic pigs were 0.05 [95% confidence intervals (CIs): 0.05–0.12] and 0.35 (95% CIs: 0.14–0.63), respectively. To identify the impact of covariates on effect size, a suitable meta-regression model was determined using predictor importance estimates with corrected Akaike information criterion values. Consequently, the best-fit model included two covariates, publication year and sample size, which were significantly associated with high heterogeneity in the subgroup analysis. Furthermore, data visualization depicted a significant non-linear association between swIAV prevalence and seroprevalence and specific growth stages of pigs. These findings suggest that the periodic monitoring of pigs at different growth stages in large farms may help to establish the status of swIAV-spread across species in the region, and thereby minimize pandemic risk.

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