Spatial patterns of rodent-borne pathogens and ecological suitability of rodent-borne diseases in China.

BACKGROUND: Rodent-borne pathogens pose important global health risks, yet national-scale assessments linking host-pathogen ecology with disease dynamics remain limited, particularly in China. METHODS: We compiled global (>29,000 records) and China-specific (2,235 records; 1950-2023) rodent-pathogen datasets to characterize host-pathogen networks, identify hyperreservoirs, and quantify prevalence heterogeneity using hierarchical meta-regression. We applied a two-layer framework integrating 1-km host suitability surfaces (stacking ensemble of boosted regression trees and random forest models) with province-level disease inference using generalized linear models for hemorrhagic fever with renal syndrome (HFRS), leptospirosis, and plague. Human exposure was estimated by overlaying suitability with gridded population data. RESULTS: Globally, 116 pathogens of concern were identified across 206 host species, including 30 spillover-risk viruses and 34 hyperreservoirs. Meta-regression identified sample source as the only consistently robust moderator of prevalence heterogeneity; other moderators (e.g., rodent family, region, and habitat type) showed inconsistent or non-robust associations. Host suitability was positively associated with HFRS incidence (incidence rate ratio = 1.36, P < 0.01) but negatively or not significantly associated with leptospirosis and plague. In China, the three diseases showed contrasting suitability patterns, with approximately 404 million people (29.3%) exposed to at least one high-suitability area. CONCLUSIONS: Our analysis elucidates disease-specific ecological drivers and identifies spatial priorities to inform targeted One Health surveillance and integrated interventions.