Division of Epidemiology, Department of Public Health, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey.
Zoonoses Public Health. 2024 Nov;71(7):844-854. doi: 10.1111/zph.13166. Epub 2024 Jul 8.
Brucellosis remains a common zoonotic disease, in developing countries, as well as in Turkey where it is endemic, underdiagnosed, and underreported. The aim of this meta-analysis was to provide a comprehensive estimate of seroprevalence with a large sample size, covering all regions of Turkey, including both grey literature and published studies.
A systematic search was performed in MEDLINE (via PubMed), TürkMedline (National Health Sciences-Periodicals Database), and YÖKSİS database (Higher Education Council Information System) until May 5th, 2023. The quality of the studies was evaluated independently using Joanna Briggs Institute (JBI) critical assessment tool for prevalence studies. A random-effects model (DerSimion and Laird) was utilized to estimate the overall pooled prevalence. A sensitivity analysis was performed, excluding studies with a high risk of bias. The subgroup analyses and meta-regression were conducted to explore sources of heterogeneity. Egger test and funnel plot were used to assess publication bias. The meta-analysis included 30 studies in total published between 1999 and 2021 with 51,560 individuals. In Turkey, the pooled seroprevalence of human brucellosis was estimated to be 4.5% (95% confidence interval [CI]: 3.8%-5.3%). According to the subgroup analysis, a higher seroprevalence was found in rural areas (8.0%, 95% CI: 5.4%-10.7%), high-risk occupational groups (9.9%, 95% CI: 5.3%-14.6%), and the Central East Anatolia Region (13%, 95% CI: 3.2%-22.8%). The meta-regression analysis identified living in rural areas and certain geographic regions as significant risk factors associated with higher seroprevalence.
This meta-analysis revealed a significant burden of human brucellosis in Turkey. The findings highlight the need for public health measures and targeted interventions to reduce the burden of this zoonotic disease, especially in rural areas, high-risk occupational groups, and the East Anatolia Region.
布鲁氏菌病仍然是一种常见的人畜共患疾病，在发展中国家以及布鲁氏菌病流行的土耳其，该病漏诊和漏报情况严重。本荟萃分析的目的是使用大样本量提供全面的血清流行率估计值，涵盖土耳其所有地区，包括灰色文献和已发表的研究。
我们在 MEDLINE（通过 PubMed）、TürkMedline（国家卫生科学-期刊数据库）和 YÖKSİS 数据库（高等教育委员会信息系统）中进行了系统搜索，截至 2023 年 5 月 5 日。使用 Joanna Briggs Institute（JBI）流行率研究的临界评估工具独立评估研究的质量。使用随机效应模型（DerSimion 和 Laird）来估计总体汇总流行率。进行敏感性分析，排除偏倚风险高的研究。进行亚组分析和荟萃回归以探索异质性的来源。使用 Egger 检验和漏斗图评估发表偏倚。荟萃分析共纳入了 1999 年至 2021 年间发表的 30 项研究，共涉及 51560 人。在土耳其，人类布鲁氏菌病的血清流行率估计为 4.5%（95%置信区间 [CI]：3.8%-5.3%）。根据亚组分析，在农村地区（8.0%，95%CI：5.4%-10.7%）、高风险职业群体（9.9%，95%CI：5.3%-14.6%）和东安纳托利亚地区（13%，95%CI：3.2%-22.8%）发现了更高的血清流行率。荟萃回归分析确定生活在农村地区和某些地理区域是与更高血清流行率相关的显著危险因素。
本荟萃分析显示土耳其存在严重的人类布鲁氏菌病负担。这些发现强调了采取公共卫生措施和有针对性的干预措施的必要性，以降低这种人畜共患疾病的负担，特别是在农村地区、高风险职业群体和东安纳托利亚地区。
