Distribution Map of Echinococcus Granulosus Sensu Lato Genotypes in Human Cases in Turkey: A Systematic Meta-Analysis

Abstract

Objective: To date, many studies have been performed on genotyping of E. granulosus s.l. in Turkey. However, a systematically analysis of the data human E. granulosus s.l. genotypes in Turkey is lacking. In this context, the aim of this study is to provide summary information about the distribution of E.granulosus s.l. genotypes which have been detected with molecular methods in human isolates in Turkey. Materials and Methods: Both English and Turkish studies in four international and national databases up to September 2022 were searched with keywords related “Echinococcus” to access the eligible articles for our study. The selected articles were transferred StatsDirect software for performing meta-analysis. Results: Out of 3497 articles from literature search, 24 records were eligible for inclusion in this meta-analysis. All data were obtained from 34 cities in all regions of Turkey. Total of 815 human cases whose genotypes were sequenced and identified. With the present study, identified species of E. granulosus s.l in Turkey were determined as follows, from most common to the least: E.granulosus sensu stricto (G1-G3): 97.8%, E.equinus (G4): 0.12%, E.canadensis (G6-G10): 2.0%. In addition, according to proportion of the genotypes, while G1(48%; 95%CI: 40-49%) and G1-G3 complex genotype (47%; 95%CI:41-48%) were detected in all regions of the country, G3 (2.8%; 95%CI:1-3%) was detected in Southeast and Eastern Anatolia, G4 (0.12%; 95%CI:0.1-1%) only in Central Anatolia, G6 (0.25%; 95%CI:0.2-1%) only in Eastern Anatolia, G7 (0.25% ; 95%CI: 0.2-1%) in Aegean and Marmara regions, and G6/G7 ( 1.5% ; 95%CI: 0.7-2%) in Aegean, Central Anatolia and Eastern Anatolia. Conclusion: With this meta-analysis study, it has been revealed that the most predominant E.granulosus genotypes of humans cystic echinococcosis in Turkey were G1 and G1-G3 complex. The present study will be a guide for genotyping studies have not been performed in the other regions of the country. The more in-depth meta-analysis studies are needed to better understand the molecular characterization of E.granulosus s.l in other hosts such as dogs, sheep and cattle in Turkey.