Prevalence of Bartonella spp. infections in Iran: a systematic review and meta-analysis

Despite the public health importance of Bartonella infections, its epidemiology is under-studied, particularly in Iran. The objective of this systematic review and meta-analysis was to determine the pooled prevalence of Bartonella infections in humans, domestic and wild animals, and invertebrates in Iran, respectively. PubMed, Scopus, Web of Science, Google Scholar, Scientific Information Database (SID), MagIran, and IranDoc databases were searched. Title and abstract screening was done by two independent reviewers based on the eligibility criteria. The eligibility criteria were cross-sectional studies investigating the prevalence of Bartonella infections in humans, pets, farm animals, and parasites in Iran. A random-effects model with Freeman-Tukey Double Arcsine transformation was used for data synthesis. Subgroup analysis was done based on the host species. A total number of 220 results were identified by the search, among which 93 were removed as duplicates. Of the 127 remaining results, 19 studies were included. The molecular prevalence of Bartonella spp. infections was 4% with the highest values observed in rats (17%), dogs (10%) and cats (10%), respectively. The seroprevalence of Bartonella spp. among cat owners and hospital patients in Tehran was 18% and 5%, respectively. Also, the seroprevalence of Bartonella spp. among dogs in Hamadan was estimated to be 74.24%. Based on culture methods, in one study among cats in Shahrekord, 12.5% of blood samples were positive. Based on the findings of the current study, the molecular prevalence of Bartonella spp. in Iran was higher in rats, dogs, and cats. However, more investigations, particularly in other hosts, are recommended.