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Variation in Mycobacterium Tuberculosis Population Structure in Iran: A Systemic Review and Meta-Analysis Publisher Pubmed



Hadifar S1, 2 ; Fateh A1, 2 ; Pourbarkhordar V3 ; Siadat SD1, 2 ; Mostafaei S4, 5 ; Vaziri F1, 2
Authors
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Authors Affiliations
  1. 1. Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
  2. 2. Microbiology Research Centre (MRC), Pasteur Institute of Iran, Tehran, Iran
  3. 3. Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Science, Isfahan University of Medical Science, Isfahan, Iran
  4. 4. Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  5. 5. Epidemiology and Biostatistics Unit, Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Infectious Diseases Published:2021


Abstract

Background: Acquiring comprehensive insight into the dynamics of Mycobacterium tuberculosis (Mtb) population structure is an essential step to adopt effective tuberculosis (TB) control strategies and improve therapeutic methods and vaccines. Accordingly, we performed this systematic review and meta-analysis to determine the overall prevalence of Mtb genotypes/ sublineages in Iran. Methods: We carried out a comprehensive literature search using the international databases of MEDLINE and Scopus as well as Iranian databases. Articles published until April 2020 were selected based on the PRISMA flow diagram. The overall prevalence of the Mtb genotypes/sublineage in Iran was determined using the random effects or fixed effect model. The metafor R package and MedCalc software were employed for performing this meta-analysis. Results: We identified 34 studies for inclusion in this study, containing 8329 clinical samples. Based on the pooled prevalence of the Mtb genotypes, NEW1 (21.94, 95% CI: 16.41–28.05%), CAS (19.21, 95% CI: 14.95–23.86%), EAI (12.95, 95% CI: 7.58–19.47%), and T (12.16, 95% CI: 9.18–15.50%) were characterized as the dominant circulating genotypes in Iran. West African (L 5/6), Cameroon, TUR and H37Rv were identified as genotypes with the lowest prevalence in Iran (< 2%). The highest pooled prevalence rates of multidrug-resistant strains were related to Beijing (2.52, 95% CI) and CAS (1.21, 95% CI). Conclusions: This systematic review showed that Mtb populations are genetically diverse in Iran, and further studies are needed to gain a better insight into the national diversity of Mtb populations and their drug resistance pattern. © 2021, The Author(s).
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