Amoebiasis in Iran: a systematic review and meta-analysis

Area of Science:

• Medical Parasitology
• Infectious Disease Epidemiology
• Molecular Diagnostics

Background:

• Amoebiasis remains a significant public health concern globally.
• Understanding the prevalence and molecular epidemiology of amoebiasis is crucial for effective control strategies.
• Iran, with diverse geographical and socioeconomic factors, requires specific data on amoebiasis burden.

Purpose of the Study:

• To conduct a comprehensive meta-analysis to determine the national prevalence of amoebiasis in Iran.
• To investigate the molecular epidemiology, specifically the species distribution of Entamoeba, in the Iranian population.
• To explore correlations between prevalence and socioeconomic factors like Human Development Index (HDI).

Main Methods:

• A systematic search of nine English and Persian databases was conducted.
• Meta-analysis and meta-regression techniques were employed to pool data from 71 eligible studies.
• Molecular analysis of 462 polymerase chain reaction (PCR)-positive isolates was performed for inter-species differentiation.

Main Results:

• The pooled prevalence of Entamoeba infection in Iran was estimated at 1% (95% CI 0.8-2.0%).
• Entamoeba dispar was the predominant species (91% overall, 75% in GI patients), while Entamoeba histolytica prevalence was lower (7% overall, 18% in GI patients).
• Higher amoebiasis prevalence was observed in provinces with lower Human Development Index (HDI).

Conclusions:

• Amoebiasis poses a low overall burden in Iran, largely due to the prevalence of the non-pathogenic Entamoeba dispar.
• The higher proportion of Entamoeba histolytica in patients with gastrointestinal disorders warrants attention.
• Targeted public health interventions in less developed regions are recommended to mitigate potential risks.