title: Prevalence of scoliosis among primary and middle school students in Mainland China: a systematic review and meta-analysis.
abstract: METHODS
  Systematic review and meta-analysis of published prevalence of scoliosis among primary and middle school students in Mainland China.
  
  
  OBJECTIVE
  To evaluate the prevalence of scoliosis among primary and middle school students in Mainland China.
  
  
  BACKGROUND
  There is substantial uncertainty regarding the prevalence of scoliosis in Mainland China among the primary and middle school students. We conducted a systematic review aiming to describe the prevalence of scoliosis in Mainland China.
  
  
  METHODS
  We systematically reviewed the published epidemiological studies or reports on the prevalence of scoliosis in Chinese cities. Scopus, PubMed, WanFang Database, CNKI, China National Science and Technology Digital Library, and WeiPu Database were searched for studies reporting a prevalence estimate for scoliosis in primary and middle school students. Meta-analyses were performed to estimate the pooled prevalence of scoliosis by STATA 12.0. Subgroup analyses were conducted according to the sex, age, and geographical area.
  
  
  RESULTS
  A total of 38 articles, including 697,043 patients, were eligible for inclusion in this review. Meta-analyses revealed the prevalence of scoliosis to be 1.02% (95% [confidence interval] CI, 0.85-1.18) among the primary and middle school students in Mainland China. The female to male ratio was 1.54 (95% CI, 1.35-1.74; P < 0.001). According to the subgroup analysis by different ages, the prevalence of scoliosis increased from 0.73% (95% CI, 0.55-0.90) to 1.14% (95% CI, 0.86-1.42).
  
  
  CONCLUSIONS
  Meta-analyses showed that the prevalence of scoliosis in Mainland China was 1.02% among the primary and middle school students. The prevalence of scoliosis in females was higher than in males and the ratio was 1.54. As they grew older, the prevalence of scoliosis increased in the students.
authors.affiliation: *Department of Spine Surgery, Xiangya Hospital †Department of Orthopedics, The Third Xiangya Hospital ‡School of Public Health; and §Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Hongqi
authors.initials: H
authors.lastname: Zhang
authors.forename: Chaofeng
authors.initials: C
authors.lastname: Guo
authors.forename: Mingxing
authors.initials: M
authors.lastname: Tang
authors.forename: Shaohua
authors.initials: S
authors.lastname: Liu
authors.forename: Jinsong
authors.initials: J
authors.lastname: Li
authors.forename: Qiang
authors.initials: Q
authors.lastname: Guo
authors.forename: Lizhang
authors.initials: L
authors.lastname: Chen
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhu
authors.forename: Shushan
authors.initials: S
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012600:Scoliosis / Q000453:epidemiology*; D012737:Sex Factors; D055815:Young Adult