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.