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Microsporidiosis in Iran: A systematic review and meta-analysis
Roghayeh Ghoyounchi1, Ehsan Ahmadpour2, Adel Spotin3
1Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Objective:
To examine all evidence about Microsporidia infection in vertebrate/invertebrate hosts and Iranian populations distributed in different regions of the country.
Methods:
All published articles up to December 2015, including descriptive and cross-sectional studies related to the prevalence and genotyping of Microsporidia infection in Iran, was considered in this systematic review. The meta-analysis was done using the random-effects model and Stats Direct statistical software. MEGA 5.05 software and maximum likelihood algorithm with Kimura 2-parameter model were used for phylogenetic analysis.
Results:
Of the 1152 investigated studies, 33 eligible studies reported a prevalence of Microsporidia infection in vertebrate and invertebrate hosts. According to this systematic review, the overall prevalence rate of Microsporidia infection in immunocompromised patients in Iran was 8.18%. Furthermore, the overall prevalence rate of Microsporidia infection in immunocompromised patients with chronic diarrhoea, patients with non-diarrhoea, gastroenteritis, and patients with CD4 (<200 cells/μL) was 15.4%, 4.1%, 0.5%, and 12.9% respectively. The highest prevalence rate of human and animal Microsporidia was estimated in Kerman (29%) and Khuzestan (26.5%). The overall prevalence rate of Microsporidia infection in honeybees using the random-effects model was 40%. Furthermore, the highest prevalence rate of nosemosis was described in East Azerbaijan (48.2%). The most Microsporidia isolates from immunocompromised patients and pigeons in Iran belonged to genotypes D (n = 16; 50%) and E (n = 6; 20.6%) of Enterocytozoon bieneusi.
Conclusions:
This study may be the first systematic review and meta-analysis that provides a broad outlook on the prevalence of microsporidiosis in Iran. It is necessary to investigate Microsporidia infection in vertebrate and invertebrate hosts and environmental resources in Iran.
Insights
This systematic review reveals Microsporidia infection prevalence in Iran, with immunocompromised patients showing an 8.18% infection rate. Further research is needed to understand its impact on hosts and the environment.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Public Health
Background:
- Microsporidia are opportunistic pathogens causing microsporidiosis.
- Prevalence data in Iran, particularly across diverse hosts and regions, requires comprehensive synthesis.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on Microsporidia infection prevalence.
- To investigate Microsporidia infection in vertebrate and invertebrate hosts and Iranian populations.
Main Methods:
- Systematic review and meta-analysis of published articles up to December 2015.
- Inclusion of descriptive and cross-sectional studies on Microsporidia prevalence and genotyping in Iran.
- Phylogenetic analysis using MEGA 5.05 software.
Main Results:
- Overall prevalence of Microsporidia infection in immunocompromised patients in Iran was 8.18%.
- Specific prevalence rates were noted in patients with chronic diarrhea (15.4%), non-diarrhea (4.1%), gastroenteritis (0.5%), and low CD4 counts (12.9%).
- High prevalence rates were observed in honeybees (40%) and specific regions for human and animal infections (Kerman 29%, Khuzestan 26.5%, East Azerbaijan 48.2% for nosemosis).
- Genotypes D and E of Enterocytozoon bieneusi were most common in Iranian isolates.
Conclusions:
- This study provides a broad overview of microsporidiosis prevalence in Iran.
- Further investigation into Microsporidia infection in various hosts, including environmental sources, is essential.
