Table 1.
Full executable search string by database.
Fig 1.
Flow diagram of study selection.
A PRISMA-compliant flow chart documenting the identification, screening, and inclusion process. From 11,583 initial citations, 174 met criteria via database search, with an additional 221 identified through country-specific purposive searching, resulting in a total of 395 included studies.
Table 2.
Characteristics of included studies (N = 395).
Table 3.
Estimates of the Global burden of HEV-Caused Cases and Deaths for data coverage years.
Table 4.
Serological and epidemiological data sources informing IHME’s 2021 Hepatitis E prevalence estimates.
Table 5.
Epidemiology of Hepatitis E virus in WHO South-East Asia Region.
Table 6.
Epidemiology of Hepatitis E virus in WHO Western Pacific Region.
Table 7.
Epidemiology of Hepatitis E virus in WHO Eastern Mediterranean Region.
Table 8.
Epidemiology of Hepatitis E virus in WHO African Region.
Table 9.
Epidemiology of Hepatitis E virus in WHO Europe Region.
Table 10.
Epidemiology of Hepatitis E virus in WHO Americas Region.
Fig 2.
Thematic synthesis of reported risk factors (N = 395).
A conceptual mapping of identified drivers for HEV infection, categorized into environmental sanitation, zoonotic pathways, and socio-cultural practices.
Fig 3.
Global HEV evidence maturity by WHO region.
A visualization of data “maturity” based on the availability of routine surveillance, diagnostic capacity, and peer-reviewed literature density. It highlights the disparity between high-data regions and those with fragmented epidemiological records.
Fig 4.
Global discordance: disease burden vs. evidence maturity.
A comparative analysis illustrating the “Paradox of Data,” where regions with the highest estimated HEV incidence often coincide with the lowest levels of evidence maturity and diagnostic infrastructure.
Fig 5.
Regional virological blind spots and transmission profiles.
Map identifying specific geographic areas lacking genotype-specific (molecular) data. It differentiates regions dominated by waterborne Genotypes 1 and 2 from those primarily characterized by zoonotic Genotypes 3 and 4.