Figure 1Literature search and review flowchart for selection of primary studies.
Figure 2Pooled estimate of brucellosis prevalence in Iranian men.
Figure 3Pooled estimate of brucellosis prevalence in Iranian women.
Table 1Distribution of characteristics of primary studies included in meta-analysis.
Id |
First author (Ref) |
Publication year |
Sample size |
Gender
|
Area residence
|
Job
|
High Risk behavior
|
Clinical sign
|
Age
|
Male |
Female |
Sex ratio |
Urban |
Rural |
Ranchers and farmers |
Student |
Housewife |
Animal contact |
Unpasteurized dairy |
Fever |
Joint pain |
Sweating |
Average |
least |
high |
1 |
Hasanzadeh [20]
|
2013 |
139 |
68.0 |
32.0 |
2.09 |
49.6 |
50.4 |
|
|
|
59.71 |
69.06 |
|
|
|
|
|
11–20 |
2 |
Almasi-Hashiani [21]
|
2011 |
907 |
61.0 |
39.0 |
1.56 |
21.3 |
78.7 |
36.30 |
12.80 |
34.60 |
|
|
|
|
|
37.20 |
|
|
3 |
Haddadi [22]
|
2006 |
415 |
47.7 |
52.5 |
0.91 |
84.3 |
15.7 |
|
|
35.66 |
17.10 |
76.38 |
67.22 |
61.44 |
73.25 |
35.50 |
<20 |
20–40 |
4 |
Sharifi-Mood [23]
|
2007 |
181 |
53.0 |
47.0 |
1.13 |
24.6 |
75.4 |
38.0 |
|
4.00 |
|
29.0 |
50.00 |
43.0 |
|
39.00 |
|
|
5 |
Sahargahi [24]
|
2014 |
458 |
44.4 |
55.6 |
0.80 |
10.0 |
90.0 |
33.10 |
|
39.40 |
|
|
|
|
|
34.70 |
|
|
6 |
Ghasemi [25]
|
2003 |
1,591 |
51.5 |
48.5 |
1.06 |
22.0 |
78.0 |
16.50 |
19.50 |
41.70 |
10.60 |
36.70 |
|
|
|
|
|
15–19 |
7 |
Ayazi [16]
|
2012 |
175 |
61.0 |
39.0 |
1.56 |
43.0 |
57.0 |
|
50.00 |
|
58.00 |
65.0 |
78.00 |
22.50 |
44.0 |
|
<1 |
7–12 |
8 |
Eini [15]
|
2012 |
230 |
56.5 |
43.5 |
1.30 |
23.8 |
72.6 |
|
|
|
39.70 |
60.30 |
77.40 |
70.00 |
46.90 |
40.84 |
>80 |
21–60 |
9 |
Kassiri [4]
|
2013 |
43 |
65.1 |
34.9 |
1.87 |
17.1 |
82.9 |
20.90 |
6.70 |
30.20 |
20.90 |
79.10 |
|
|
|
33.34 |
0–4 |
15–24 |
10 |
Shoraka [7]
|
2010 |
64 |
68.8 |
31.2 |
2.20 |
9.4 |
90.6 |
12.50 |
15.60 |
26.60 |
82.80 |
23.40 |
62.50 |
56.20 |
32.80 |
30.70 |
|
|
11 |
Karami [26]
|
2009 |
194 |
45.0 |
55.0 |
0.83 |
37.0 |
63.0 |
17.53 |
16.49 |
39.69 |
60.00 |
40.00 |
|
|
|
|
70–79 |
10–29 |
12 |
Rajabzadeh [27]
|
2013 |
1,310 |
55.3 |
44.7 |
1.24 |
28.5 |
71.5 |
19.80 |
13.10 |
36.30 |
77.80 |
60.89 |
|
|
|
|
|
|
13 |
Golsha [28]
|
2011 |
77 |
74.0 |
26.0 |
2.85 |
27.8 |
72.2 |
|
|
|
27.20 |
53.30 |
83.10 |
|
|
|
|
|
14 |
Fallah [29]
|
1998 |
1,148 |
54.0 |
46.0 |
1.20 |
|
|
|
|
|
|
|
|
|
|
|
>50 |
<25 |
15 |
Afsharpaiman [30]
|
2008 |
40 |
65.9 |
34.1 |
2.10 |
61.0 |
39.0 |
|
|
|
|
65.90 |
77.40 |
50.0 |
52.30 |
7.31 |
|
|
16 |
Beheshti [31]
|
2001 |
130 |
61.0 |
39.0 |
2.51 |
45.0 |
55.0 |
|
|
|
58.50 |
49.00 |
98.00 |
72.0 |
92.0 |
30.00 |
|
|
17 |
Bokaie [32]
|
2009 |
460 |
37.7 |
62.3 |
0.61 |
|
|
18.75 |
|
29.53 |
|
|
|
|
|
|
|
10–29 |
18 |
Mamishi [33]
|
2005 |
44 |
65.9 |
34.1 |
1.93 |
61.0 |
39.0 |
|
|
|
|
65.90 |
77.40 |
52.00 |
52.30 |
7.31 |
|
|
19 |
Bokaie [34]
|
2009 |
176 |
54.5 |
45.5 |
1.20 |
16.0 |
84.0 |
|
|
|
|
|
|
|
|
|
<19 |
20–40 |
20 |
Ebrahimpour [35]
|
2012 |
377 |
54.4 |
45.6 |
1.19 |
25.7 |
74.3 |
5.57 |
18.22 |
40.31 |
|
23.07 |
|
|
|
|
<10 |
>50 |
21 |
Hosseini [36]
|
2009 |
115 |
68.7 |
32.2 |
2.11 |
|
|
34.80 |
13.90 |
23.50 |
80.90 |
89.60 |
86.10 |
77.40 |
73.90 |
29.40 |
<2 |
17–35 |
22 |
Farahani [37]
|
2011 |
3,880 |
60.0 |
40.0 |
1.50 |
28.0 |
72.0 |
|
|
|
|
|
|
|
|
|
>70 |
10–19 |
23 |
Bahador [38]
|
2012 |
40 |
52.5 |
47.5 |
1.11 |
|
|
47.50 |
|
|
|
100.0 |
|
|
|
40.00 |
>64 |
8–16 |
24 |
Kamran [39]
|
2011 |
126 |
57.9 |
42.1 |
1.38 |
27.0 |
73.0 |
|
|
|
|
37.70 |
40.50 |
13.50 |
|
41.29 |
|
50–59 |
25 |
Almasi [40]
|
2012 |
210 |
69.9 |
30.1 |
2.32 |
|
|
|
|
|
46.20 |
52.90 |
|
61.40 |
|
34.30 |
>60 |
15–30 |
26 |
Soleimani [41]
|
2012 |
5,732 |
54.9 |
45.1 |
1.22 |
14.4 |
85.6 |
|
|
|
80.00 |
86.40 |
|
|
|
30.90 |
<5 |
15–25 |
27 |
Ettehad [42]
|
2007 |
51 |
76.5 |
23.5 |
3.25 |
34.0 |
66.0 |
|
|
|
|
62.00 |
84.20 |
44.00 |
60.20 |
6.25 |
|
|
28 |
Soleimani [43]
|
2010 |
42 |
68.8 |
24.4 |
2.82 |
33.0 |
67.0 |
|
|
|
33.30 |
|
|
83.0 |
76.40 |
|
<5 |
10–15 |
29 |
Maleki [44]
|
2015 |
492 |
52.3 |
47.7 |
1.10 |
19.0 |
81.0 |
8.30 |
15.00 |
39.40 |
|
|
|
|
|
|
>70 |
25–30 |
30 |
Moradi [18]
|
2006 |
3,880 |
52.1 |
47.9 |
1.09 |
18.2 |
81.8 |
20.80 |
20.60 |
39.40 |
62.10 |
|
|
|
|
30.03 |
45–54 |
16–44 |
31 |
Zeinalian Dastjerdi [45]
|
2012 |
1,996 |
32.8 |
67.2 |
0.49 |
32.0 |
68.0 |
18.10 |
15.20 |
25.70 |
|
|
|
|
|
|
|
15–20 |
32 |
Ghaffarpour [46]
|
2007 |
15 |
60.0 |
40.0 |
1.50 |
33.0 |
67.0 |
|
|
|
|
|
33.30 |
53.30 |
|
37.70 |
|
|
33 |
Haj Abdolbaghi [47]
|
2001 |
505 |
63.6 |
36.4 |
1.74 |
59.5 |
40.5 |
34.25 |
|
|
|
66.70 |
65.0 |
|
|
|
|
10–20 |
34 |
Sasan [48]
|
2012 |
82 |
60.0 |
40.0 |
1.21 |
29.8 |
70.2 |
|
|
|
76.0 |
91.60 |
5.0 |
79.70 |
|
8.02 |
|
|
35 |
Hasanjani Roushan [49]
|
2004 |
469 |
56.9 |
43.1 |
1.32 |
39.2 |
60.8 |
11.30 |
|
|
|
22.40 |
67.0 |
53.70 |
76.10 |
36.90 |
|
|
36 |
Pourahmad [50]
|
2012 |
168 |
68.5 |
31.5 |
2.17 |
|
|
4.80 |
|
7.70 |
|
|
|
|
|
28.51 |
≥60 |
10–29 |
37 |
Hajia [51]
|
2009 |
809 |
61.2 |
38.8 |
1.58 |
|
|
20.51 |
17.20 |
26.46 |
|
|
83.80 |
80.34 |
40.30 |
|
>80 |
11–20 |
38 |
Moumen Heravi [52]
|
2007 |
590 |
59.0 |
41.0 |
0.61 |
68.4 |
31.6 |
|
|
|
|
|
19.20 |
70.0 |
59.70 |
|
≥60 |
20–39 |
39 |
Khalili [53]
|
2014 |
32 |
75.0 |
25.0 |
3.00 |
|
|
|
|
|
|
|
39.00 |
41.0 |
|
|
|
|
40 |
Mohammadian [54]
|
2014 |
554 |
64.4 |
35.6 |
1.81 |
9.7 |
90.3 |
|
|
|
|
|
|
|
|
34.30 |
<10 |
20–30 |
41 |
Noroozi [55]
|
2012 |
1,253 |
53.0 |
47.0 |
1.13 |
28.0 |
72.0 |
16.50 |
11.50 |
35.50 |
|
|
|
|
|
|
<10 |
20–29 |
42 |
Esmaeilnasab [56]
|
2007 |
1,059 |
50.8 |
49.2 |
1.03 |
10.0 |
90.0 |
27.10 |
12.70 |
44.20 |
|
|
|
|
|
34.05 |
>55 |
25–44 |
43 |
Hamzavi [57]
|
2014 |
777 |
52.6 |
47.4 |
1.11 |
12.4 |
87.6 |
32.30 |
|
37.80 |
|
|
|
|
|
|
≥70 |
20–29 |
44 |
Sawadkohi [58]
|
2002 |
116 |
|
|
1.60 |
|
|
|
|
|
|
|
97.0 |
|
44.0 |
|
6–24 |
60–144 |
45 |
Fanni [59]
|
2013 |
34 |
65.0 |
35.0 |
1.86 |
|
|
|
|
|
15.00 |
65.0 |
74.00 |
65.0 |
59.0 |
6.88 |
10–14 |
2–5 |
46 |
Mugahi [60]
|
2014 |
81 |
59.3 |
40.7 |
1.45 |
46.9 |
53.1 |
12.30 |
|
18.50 |
|
58.0 |
85.20 |
42.0 |
38.30 |
38.10 |
<20 |
>40 |
47 |
Dehnavi [61]
|
2015 |
305 |
53.4 |
46.6 |
1.15 |
|
|
8.20 |
20.70 |
37.00 |
|
|
56.10 |
81.0 |
18.40 |
36.66 |
>71 |
11–20 |
Table 2Estimation of frequency of brucellosis by epidemiological and clinical factors in Iran using meta-analysis.
Variables |
Frequency (95% CI) |
Heterogeneity
|
Q |
I2 (%) |
p
|
Male |
57.6 (55.02–60.1) |
790.02 |
94.3 |
<0.001 |
Female |
42.3 (39.8–44.9) |
795.8 |
94.3 |
<0.001 |
Urban |
31.4 (26.7–36.3) |
3,308.9 |
98.9 |
<0.001 |
Rural |
68.4 (63.6–73.2) |
3,311.8 |
98.9 |
<0.001 |
Ranchers & farmers |
20.8 (17.4–24.2) |
740.4 |
96.9 |
<0.001 |
Students |
16.9 (14.5–19.4) |
210.5 |
92.9 |
<0.001 |
Housewife |
31.6 (27–36.2) |
862.2 |
97.6 |
<0.001 |
Animal contact |
50.4 (35.6–65.2) |
6,575.3 |
99.7 |
<0.001 |
Unpasteurized dairy |
57.1 (46.4–67.9) |
3,684 |
99.3 |
<0.001 |
Fever |
65.7 (53.7–77.8) |
2,832.04 |
99.2 |
<0.001 |
Joint pain |
58.1 (49.5–66.6) |
788.5 |
97.3 |
<0.001 |
sweating |
55.3 (44.4–66.2) |
849.6 |
98.1 |
<0.001 |