Search results and scope of evidence
We identified 21,849 publications from four bibliographic databases (PubMed 1,125, Embase 14,243, CNKI 2,387, and Wanfang 4,094). After excluding duplicate references, 20,830 publications remained. Based on the abstract and title screening, 19,643 publications were further excluded. As 16 publications were not retrieved for full text, 1,171 publications entered full-text screening. Of these, an additional 714 publications were excluded, leaving the rest 457 publications that met eligibility criteria. The majority of the studies were conducted in Central Southern China (30.6%), Southeastern (28.7%), and Southwestern China (17.5%).
In total, 429 included publications reported the overall seroprevalence rates (939 stratified measures), 5 reported seroincidence rates, four reported the overall proportions of HSV-2 isolation in GUD (8 stratified proportions), and 24 reported the overall proportions of HSV-2 isolation in genital herpes (59 stratified proportions). The PRISMA flowchart of article selection is summarized in Figure 1 . For study settings, 80.0% of the studies involved more than 200 participants, and 91.2% used non-probability-based methods. About two-thirds of studies had more than 80% response rates.