METHODS: All included studies were identified through a systematic search of online databases, including Scopus, PubMed, Web of Science, and EMBASE, through July 26, 2022, using keywords and suitable combinations. We focused on cross-sectional studies investigating the prevalence of F. tularensis. The weighted pooled prevalence was calculated using a random-effects model.
RESULTS: A total of 206 studies were identified, of which 20 were finally included in the analysis. The human seroprevalence of tularemia in WHO-EMRO countries was 6.2% (95% CI, 4.2 9.2). In the subgroup analysis, anti-F. tularensis antibodies were found in 6.92% and 5.5% of the high-risk individuals and Iran, respectively. The pooled prevalence of F. tularensis in environmental samples (water and soil) from the WHO-EMRO countries was 5.8% (9.4% by PCR and 0.5% by culture). In addition, 2.5% (95% CI, 0.2 0.22.7) of ticks in WHO-EMRO countries were positive for F. tularensis. The pooled prevalence of F. tularensis in rodents is 2.0% (1.1% by PCR and 3.7% by serology). In addition, 0.6% of domestic ruminants (0.4% by PCR and 2.4% by serology) were positive for F. tularensis in WHO-EMRO countries.
CONCLUSIONS: According to the results of the present study, tularemia is an endemic but neglected disease in the WHO-EMRO region. However, most studies on tularemia are limited to a few countries in this region. Studies on tularemia in human populations, reservoirs, and vectors have been conducted in all countries in the WHO-EMRO region to obtain more detailed information about the epidemiology of tularemia in these regions.
方法:所有纳入的研究都是通过对在线数据库的系统搜索来确定的,包括Scopus,PubMed,WebofScience,和EMBASE,到2022年7月26日,使用关键词和合适的组合。我们专注于横断面研究,调查了土拉灵的患病率。使用随机效应模型计算加权合并患病率。
结果:共确定了206项研究,其中20人最终被纳入分析。在WHO-EMRO国家中,人的tularemia血清阳性率为6.2%(95%CI,4.29.2)。在亚组分析中,反F在6.92%和5.5%的高危人群和伊朗发现了tularensis抗体,分别。来自WHO-EMRO国家的环境样品(水和土壤)中的土拉特氏菌的合并患病率为5.8%(PCR为9.4%,培养为0.5%)。此外,在WHO-EMRO国家,2.5%(95%CI,0.20.22.7)的蜱体为土拉热杆菌阳性。在啮齿类动物中,土拉特氏菌的合并患病率为2.0%(PCR为1.1%,血清学为3.7%)。此外,在WHO-EMRO国家中,0.6%的国内反刍动物(PCR检测为0.4%,血清学检测为2.4%)为土拉特氏菌阳性。
结论:根据本研究的结果,在WHO-EMRO地区,Tularemia是一种地方性但被忽视的疾病。然而,大多数关于tularemia的研究仅限于该地区的少数国家。对人群中的塔拉热症的研究,水库,世卫组织-EMRO区域的所有国家都开展了病媒传播活动,以获得有关这些区域的兔热病流行病学的更详细信息。