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Cryptococcus and cryptococcosis in Iran during 1969-2019: A systematic review and meta-analysis
Z Bandalizadeh1, J Javidnia1, S A Hosseini2
1Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Journal De Mycologie Medicale
|December 23, 2019
Summary
Cryptococcus species are prevalent in Iranian environments, particularly bird guano (20.4%) and trees (4.7%). This highlights the need for preventive strategies against cryptococcosis, especially for immunocompromised individuals.
Area of Science:
- Environmental microbiology
- Medical mycology
- Epidemiology
Background:
- Cryptococcal infections pose a significant health risk, particularly to immunocompromised individuals.
- Limited epidemiological data exists for Cryptococcus species in the Middle East, specifically Iran.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of Cryptococcus species in various environmental sources in Iran.
- To summarize reported cases of cryptococcosis in humans and animals within Iran.
Main Methods:
- A comprehensive search of twelve major databases and gray literature was conducted from 1969 to 2019.
- Keywords included "Cryptococcus", "Cryptococcosis", "invasive fungal infection", "Humans", "Birds", "Animals", "Tree", and "Iran" in English and Persian.
- Thirty-six studies met the eligibility criteria for the meta-analysis.
Main Results:
- The overall prevalence of Cryptococcus species was 4.7% in trees and 20.4% in bird guano.
- Prevalence in animals was 1.7% and in humans was 2.8%.
- Highest prevalence rates were observed in Khorasan (trees, bird guano), Chaharmahal and Bakhtiari (animals), and Mazandaran (humans) provinces.
Conclusions:
- Cryptococcus species are environmentally widespread in Iran, posing a significant risk to susceptible populations, including HIV-infected patients.
- Concrete preventive strategies are necessary to identify and mitigate risks associated with environmental habitats of Cryptococcus.
- Further research into the specific ecological niches and transmission routes is warranted.
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