Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Surg. 2018 Mar;51:39-48. doi: 10.1016/j.ijsu.2018.01.025. Epub 2018 Feb 3.
Cystic echinococcosis (CE) represents an increasing public health concern in many parts of the world, including the Middle East. The present study is the first systematic review and meta-analysis to assess the seroprevalence rate and population genetic structure of human CE in the eastern Mediterranean region. To estimate the population genetic structure, Echinococcus sequences of the cytochrome oxidase subunit 1 (cox1) gene isolated from countries from this geographical area were retrieved from the GenBank database. An electronic search for articles from 1990 until 2015 was performed using databases PubMed, ScienceDirect, and Scopus. A total of 53 articles reporting on CE seroprevalence and genotyping data met our eligibility criteria and were included in a meta-analysis. The overall CE seroprevalence rates in the general population and in individuals at high risk of infection were estimated using the random-effect model at 7.4% (95% CI = 4.8-10.6) and 10.7% (95% CI = 7.6-14.3), respectively. Risk factors including age group (P < 0.001), dog ownership (P = 0.03), residence area (P < 0.001), and educational level (P = 0.04) showed a statistically significant association with CE seroprevalence. A pairwise fixation index (Fst), used as an estimation of gene flow, suggested a moderate level of genetic differentiation between members of the E. granulosus sensu stricto (G1-G3) complex from Iranian and Turkish metapopulations (Fst = 0.171). The finding of common haplotypes may represent an ancestral transfer of alleles among populations probably during the early stages of animal domestication. The high CE seroprevalence rates found highlight the necessity of implementing appropriate public education for preventive and control strategies, particularly in individuals at high risk of infection; furthermore, our genetic findings reveal novel molecular data concerning microevolutionary events of Echinococcus isolates among Middle East countries.
包虫病（CE）在世界许多地区，包括中东地区，都是一个日益严重的公共卫生问题。本研究是首次对东地中海地区人类包虫病的血清流行率和种群遗传结构进行系统评价和荟萃分析。为了评估种群遗传结构，从该地理区域的国家中提取细胞色素氧化酶亚单位 1（cox1）基因的棘球蚴序列，并从 GenBank 数据库中检索。使用数据库 PubMed、ScienceDirect 和 Scopus 对 1990 年至 2015 年的文章进行电子检索。共有 53 篇报道 CE 血清流行率和基因分型数据的文章符合入选标准，并纳入荟萃分析。使用随机效应模型估计一般人群和感染高风险人群的总体 CE 血清流行率分别为 7.4%（95%CI=4.8-10.6）和 10.7%（95%CI=7.6-14.3）。年龄组（P<0.001）、狗的拥有情况（P=0.03）、居住地区（P<0.001）和教育水平（P=0.04）等危险因素与 CE 血清流行率呈统计学显著关联。作为基因流动估计的成对固定指数（Fst）表明，伊朗和土耳其种群中棘球蚴感观严格（G1-G3）复合体成员之间存在中度遗传分化（Fst=0.171）。常见单倍型的发现可能代表了在动物驯化的早期阶段，等位基因在种群之间的祖先转移。发现的高包虫病血清流行率突出表明，需要实施适当的公众教育，以制定预防和控制策略，特别是针对感染高风险人群；此外，我们的遗传研究结果揭示了中东国家棘球蚴分离株微进化事件的新分子数据。
Zotero 插件