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Systematic review The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis
Mozhgan Ahmadinezhad2,4orcid , leila mounesan5orcid , Amin Doostiirani3orcid , Manijeh Yousefi Behzadi1,2orcid
Epidemiol Health 2022;e2022097
DOI: https://doi.org/10.4178/epih.e2022097 [Accepted]
Published online: October 28, 2022
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1National Reference Laboratory of Plague, Tularemia and Q fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, KabudarAhang, Hamadan, Iran, Tehran, Iran
2Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran, Tehran, Iran
3Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran, Hamedan, Iran
4Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Tehran, Iran
5Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran, Tehran, Iran
Corresponding author:  Amin Doostiirani,
Email: yousefibehzadim@yahoo.fr
Manijeh Yousefi Behzadi,
Email: yousefibehzadim@yahoo.fr
Received: 7 June 2022   • Revised: 25 October 2022   • Accepted: 28 October 2022

Objectives
Q fever is a main zoonotic disease around the world. This disease is common in the eastern mediterranean region, so we conducted for the first time a systematic review and meta-analysis between humans and animals and ticks in the Eastern Mediterranean region.
Methods
Major national and international databases were searched from 2000 up to 2021. We extracted the prevalence of Q fever in blood sample in animal, milk sample in animal, tick and human as the main outcome. We reported the prevalence of the seropositivity as point and 95% confidence intervals.
Results
In this review, 112 papers were identified. The overall seroprevalence Q fever was 23.42 (95% CI 20.3–26.21).The pooled seroprevalence of Q fever in tick was 42.44% ( 95% CI: 21.13- 63.75%). The prevalence was 25.54%( 95% CI: 16.15-34.92%) in human. The prevalence of Q fever in animal blood samples such as goat, sheep, camel, cattle, dog, cat, buffalo and horse were 28.05%, 25.10%, 25.04%, 19.52 %, 8.45%, 9.80%, 6.33%, 6.51% respectively. Also, the prevalence of Q fever in milk samples of animals was higher in cattle 21.41% than sheep 18.69% and goat 13.85% and camel 3.38%.
Conclusions
Coxiella burnetii infections are common in human and in a wide range of animal populations but they are still not recognized in many countries in the eastern mediterranean region, thus presenting a significant threat to human and animal health in the region.


Epidemiol Health : Epidemiology and Health