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Prevalence of sapovirus infection among hospitalized pediatric patients in Asia: A systematic review and meta-analysis
Mudra Sikenis, Bhavna Prajapati, Ashutosh Kumar Singh, Tarun Patil, Vikas Yadav, Surya Singh, Mayank Gangwar, Vishal Diwan, Uday Kumar Mandal, Debasis Biswas, Shashwati Nema, Rajnarayan R Tiwari, Pradyumna Kumar Mishra, Pushpendra Singh, Irfan F Corovic, Ram Kumar Nema
Mudra Sikenis, Department of Life Science, Sharda School of Bio-science and Technology, Sharda University, Greater Noida, Noida 201310, Uttar Pradesh, India
Bhavna Prajapati, Tarun Patil, Pradyumna Kumar Mishra, Ram Kumar Nema, Division of Environmental Biotechnology, Genetics and Molecular Biology, ICMR - National Institute for Research in Environmental Health, Bhopal 462030, Madhya Pradesh, India
Ashutosh Kumar Singh, School of Biosciences, Engineering and Technology, VIT Bhopal University, Bhopal 466114, Madhya Pradesh, India
Vikas Yadav, Uday Kumar Mandal, Department of Environmental Health and Epidemiology, ICMR - National Institute for Research in Environmental Health, Bhopal 462030, Madhya Pradesh, India
Surya Singh, Vishal Diwan, Division of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR - National Institute for Research in Environmental Health, Bhopal 462030, Madhya Pradesh, India
Mayank Gangwar, Division of Development Research, ICMR Head Quarter, New Delhi 110029, Delhi, India
Debasis Biswas, Shashwati Nema, Department of Microbiology, All India Institute of Medical Sciences, Bhopal 462020, Madhya Pradesh, India
Rajnarayan R Tiwari, ICMR - National Institute for Research in Environmental Health, Bhopal 462030, Madhya Pradesh, India
Pushpendra Singh, Division of Virology and Zoonoses, ICMR - National Institute of Research in Tribal Health, Jabalpur 482003, Madhya Pradesh, India
Irfan F Corovic, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Co-first authors: Mudra Sikenis and Bhavna Prajapati.
Co-corresponding authors: Ashutosh Kumar Singh and Ram Kumar Nema.
Author contributions: Sikenis M, Prajapati B, and Patil T were involved in data curation; Sikenis M and Prajapati B contributed equally to this manuscript as co-first authors; Singh AK and Nema RK contributed equally to this manuscript as co-corresponding authors; Sikenis M, Prajapati B, Patil T, and Mandal UK participated in the investigation; Singh AK, Yadav V, and Singh S contributed to visualization; Singh AK, Singh S, Gangwar M, and Diwan V reviewed and edited the manuscript; Singh AK and Nema RK contributed to and writing the first draft of the manuscript; Sikenis M, Prajapati B, Patil T, Yadav V, Singh S, Gangwar M, Diwan V, and Nema RK contributed to methodology; Yadav V contributed to software development; Biswas D, Nema S, Tiwari RR, Mishra PK, Singh P, and Corovic IF was responsible for writing, review, and editing; Tiwari RR and Nema RK contributed to project administration; Tiwari RR contributed to, provided resources; Mishra PK, Singh P, Corovic IF, and Nema RK was involved in conceptualization; Mishra PK, Singh P, and Corovic IF was involved in supervision. All authors commented on previous versions of the manuscript, read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Ram Kumar Nema, Division of Environmental Biotechnology, Genetics and Molecular Biology, ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhopal 462030, Madhya Pradesh, India.
ramkumarnema@gmail.com
Received: January 2, 2026
Revised: January 30, 2026
Accepted: March 9, 2026
Published online: March 25, 2026
Processing time: 71 Days and 21.5 Hours
BACKGROUND
Acute gastroenteritis significantly affects children under five, with viral agents causing over 75% of cases. Sapovirus, from the Caliciviridae family, is increasingly recognized as a major cause of childhood diarrhea, especially in low and middle-income countries with high morbidity, hospitalization, and mortality rates.
AIM
To determine the prevalence of sapovirus infection among hospitalized pediatric patients in Asia.
METHODS
This study conducted a systematic review to investigate the presence of sapovirus in hospitalised pediatric patients suffering from acute gastroenteritis across Asian countries. The articles were retrieved from Scopus, PubMed, and Web of Science. The review followed PRISMA guidelines and was registered with PROSPERO (No. CRD420251029792). The quality of individual studies was assessed using Joanna Briggs Institute guidelines.
RESULTS
A total of 39 studies with 30800 observations and 567 sapovirus-positive cases were analyzed. The pooled prevalence of sapovirus in hospitalized pediatric patients was 1.73% (95% confidence interval: 1.33%-2.25%). Substantial heterogeneity was observed (I2 = 84.9%), supporting the use of a random-effects model. Sensitivity analysis using 32 high-quality studies yielded a consistent prevalence of 1.74% (95% confidence interval: 1.31%-2.31%), reinforcing the robustness of the findings.
CONCLUSION
In Asian countries, sapovirus has been detected in hospitalized pediatric patients with a pooled prevalence rate of 1.73%, indicating its ongoing circulation and potential public health relevance in the region. Despite variability, consistent findings from sensitivity analysis underscore the need for enhanced surveillance and water quality monitoring to reduce public health risks.
Core Tip: Sapovirus is an underrecognized viral cause of acute gastroenteritis in hospitalized children across Asia. This systematic review and meta-analysis synthesizes evidence from 39 studies and demonstrates a pooled prevalence of approximately 1.7%, with consistent estimates across high-quality studies despite marked heterogeneity. The findings confirm ongoing sapovirus circulation in pediatric hospital settings and support the need for strengthened surveillance systems and preventive measures, particularly in regions with high enteric disease burden.
