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

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.