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

Abstract

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 confidence interval (CI) was calculated using random effect method. Results: In this review, 27 papers were identified. The pooled seroprevalence of Q fever in animals was 27 (CI 95: 23-32). The prevalence was 33 (CI 95: 22-45) in goats, 27 (CI 95: 21-32) in sheep, and 17 (CI 95: 5-28) in cattle. The 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). Conclusion: 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.