Epidemiology of Q fever in Iran: A systematic review and meta?analysis for estimating serological and molecular prevalence

Zary Nokhodian, Awat Feizi, Behrooz Ataei, Shervin Ghaffari Hoseini, Ehsan Mostafavi


Background: Q fever is endemic in Iran, thus, we conducted a systematic review and meta?analysis on epidemiology of Coxiella
burnetii among humans and animals in Iran. Materials and Methods: A systematic search was performed to identify all articles
reporting C. burnetii prevalence in Iranian humans or animals, published from January 2000 to January 2015. Data from articles were extracted, and a pooled estimate of prevalence with corresponding 95% confdence interval (CI) was calculated using random e?ect method. Results: In this review, 27 papers were identifed. Te pooled seroprevalence of Q fever in animals was 27% (CI 95%: 23%–32%). Te prevalence was 33% (CI 95%: 22%–45%) in goats, 27% (CI 95%: 21%–32%) in sheep, and 17% (CI 95%: 5%–28%) in cattle. Te bacterial DNA was detected in 5% (95% CI: 3%–9%) of milk samples, and it was higher in cattle (10%; 95% CI: 6%–16%) than sheep (2%; 95% CI: 0–7%) and goats (4%; 95% CI:  0–12%). Conclusions: C. burnetii DNA or its antibody has been frequently detected among ruminants. Since these animals can transmit the infection to humans, Q fever could be a potential health problem in Iran.


Iran, meta?analysis, molecular, Q fever, serology

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