Cryptococcus and cryptococcosis in Iran during 1969–2019: A systematic review and meta-analysis - 19/12/19

Doi : 10.1016/j.mycmed.2019.100917

Z. Bandalizadeh ^a, J. Javidnia ^a, S.A. Hosseini ^a,^b, M. Moosazadeh ^c, A. Amouei ^a,^b, F. Kermani ^a, S. Seyedmousavi ^d,^e,^f, T. Shokohi ^f,^g,⁎
^a Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
^b Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
^c Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
^d Molecular Microbiology Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, United States
^e Center of Expertise in Microbiology, Infection Biology, and Antimicrobial Pharmacology, Tehran, Iran
^f Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
^g Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

^⁎Corresponding author. Invasive Fungi Research Center, Department of Mycology, School of Medicine, Mazandaran University of Medical Sciences, 48471-91971 Sari, Iran.Invasive Fungi Research Center, Department of Mycology, School of Medicine, Mazandaran University of Medical SciencesSari48471-91971Iran

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 19 December 2019
This article has been published in an issue click here to access

Abstract

Objective

Limited data are available on the epidemiology and etiology of cryptococcal infections in the Middle East. We aimed to conduct the systematic review and meta-analysis to summarize the epidemiological data on prevalence of Cryptococcus species complexes in trees and their surroundings, bird guano and secretions, animals, and highlight the reported episodes of cryptococcosis in Iran.

Materials and methods

Twelve databases, including PubMed, Science Direct, Scopus, Proquest, Google Scholar, Embase, and the ISI Web of Science, as well as the national databases, from January 1969 to October 2019 were searched. Furthermore, gray literature (e.g., thesis, congress abstracts) was evaluated using Iran Doc and www.thesis.research.ac.ir/. Search process was accomplished on English or Persian language articles using the following keywords: “Cryptococcus”, “Cryptococcosis”, “invasive fungal infection”, “Humans”, “Birds”, “Pigeon”, “Animals”, “Tree”, “Eucalyptus”, and “Iran”, both alone and in combination.

Results

Overall 36 studies were eligible regarding Cryptococcus and cryptococcosis in Iran. The total prevalence rates of Cryptococcus species in the tree was 4.7% (95% CI: 2.3–7.8), and in bird guano was 20.4% (95% CI: 10.7–32.2). Cryptococcosis in animal, and human were 1.7% (95% CI: 0.01–5.1), and 2.8% (95% CI: 0.7v6.1), respectively. The highest prevalence of Cryptococcus in the trees (14.6%), and bird guano (89.4%) in Khorasan, animals (8.9%) in Chaharmahal and Bakhtiari, and human (4.4%) in Mazandaran provinces were reported.

Conclusions

Given the significant risk of Cryptococcus species for susceptible humans, mainly HIV-infected patients, it seems quite necessary to adopt concrete preventive strategies to pinpoint the environmental habitats of this yeast.

El texto completo de este artículo está disponible en PDF.

Keywords : Epidemiology, Cryptococcus neoformans, Cryptococcus gattii, Cryptococcosis, Tree, Bird guano, Animal, Human, AIDS, Iran