Khalkhali H R, Foroutan M, Khademvatan S, Majidiani H, Aryamand S, Khezri P, Aminpour A
Department of Biostatistics and Epidemiology,Inpatient's Safety Research Center, Urmia University of Medical Sciences,Urmia,Iran.
Department of Parasitology,Faculty of Medical Sciences,Tarbiat Modares University,Tehran,Iran.
J Helminthol. 2018 May;92(3):260-268. doi: 10.1017/S0022149X17000463. Epub 2017 Jun 7.
As a significant zoonosis, cystic echinococcosis (CE) is endemic in some parts of the world, such as the Middle East. There are studies on the prevalence of this infection in animal and human reservoirs in Iran; hence, we conducted this meta-analysis to elucidate the prevalence of CE in Iran. English (PubMed, Scopus, Web of Science, Science Direct and Google Scholar) and Persian (Magiran, Iran Medex, Iran Doc and SID) databases were explored. In the case of definitive, animal and human intermediate hosts, 37, 90 and 33 studies, respectively, have been included in the current review from January 1990 to December 2015. According to outcomes of the heterogeneity test, either Der Simonian and Laird's random-effects method or Mantel-Haenszel's fixed-effects method were employed to pool the estimations. The pooled prevalence of Echinococcus granulosus infection in definitive hosts was calculated as 23.6% (95% confidence interval (CI) = 17.6-30.1%). The weighted prevalence of animal and human hydatidosis was calculated as 15.6% (95% CI = 14.2-17.1%) and 4.2% (95% CI = 3.0-5.5%), respectively. Meanwhile, most cases of human hydatidosis were in southern Iran, with a prevalence of 5.8% (3.2-9.2%). In terms of human hydatidosis, more infections were found in rural regions, and mostly in female individuals. Egger's regression test revealed publication bias, with a remarkable impact on total prevalence of the infection in animal intermediate hosts (P < 0.001), while it was not significant in human hosts (P = 0.4) and definitive hosts (P = 0.3). According to the weighted estimated prevalence of cystic echinococcosis and its financial burden, implementing appropriate control programmes should be compulsory to decrease the burden of the disease in Iran.
作为一种重要的人畜共患病，囊型包虫病（CE）在世界某些地区呈地方性流行，如中东地区。伊朗有关于该感染在动物和人类宿主中流行情况的研究；因此，我们开展了这项荟萃分析以阐明伊朗囊型包虫病的流行情况。我们检索了英文数据库（PubMed、Scopus、Web of Science、Science Direct和Google Scholar）以及波斯文数据库（Magiran、Iran Medex、Iran Doc和SID）。对于终末宿主、动物中间宿主和人类中间宿主，分别纳入了1990年1月至2015年12月期间的37项、90项和33项研究进行本次综述。根据异质性检验结果，采用Der Simonian和Laird随机效应法或Mantel-Haenszel固定效应法合并估计值。终末宿主中细粒棘球绦虫感染的合并患病率计算为23.6%（95%置信区间（CI）=17.6 - 30.1%）。动物和人类包虫病的加权患病率分别计算为15.6%（95%CI = 14.2 - 17.1%）和4.2%（95%CI = 3.0 - 5.5%）。同时，大多数人类包虫病病例发生在伊朗南部，患病率为5.8%（3.2 - 9.2%）。就人类包虫病而言，农村地区感染更为常见，且大多发生在女性个体。Egger回归检验显示存在发表偏倚，对动物中间宿主中感染的总患病率有显著影响（P < 0.001），而在人类宿主（P = 0.4）和终末宿主（P = 0.3）中不显著。根据囊型包虫病的加权估计患病率及其经济负担，应强制实施适当的控制计划以减轻伊朗的疾病负担。
