Epidemiology of animal bite in Iran: A Systematic review and meta-analysis.

Abstract

Despite a lot of efforts made in the rabies health-care system, Iran is still in an endemic region and millions are spent annually to prevent rabies. Searching in national and international databases has been performed. The preferred reporting items for systematic reviews and meta-analyses protocol were followed. To assess heterogeneity, the I-index was calculated. In addition, sensitivity analysis was performed by the remove-one method. The publication bias was also investigated by Egger's regression test, and the trim and fill method. To perform a meta-analysis, CMA version 2 software was used. Totally, 33 studies with 250,980 animal-bite cases were meta-analyzed. A summary estimate of the incidence of 1200 per 100,000 population (95% CI 1000, 1500) with a mean age of 29.97±15.13years (95%CI: 29.33, 30.61) was estimated. The rate in men was higher 76.7% (95%CI 74.7%, 78.8%) than in women and in the rural 49.7% (95%CI: 42.8%, 58.6%) was equal in the urban. Most bites occurred in the spring and summer 20.5% (95%CI: 16.1%, 25.9%). The highest of job-related bites was in students 20.1% (95%CI: 19%, 23%). The highest rate of bite location and the animal type were estimated in the order of lower limbs and by dogs respectively. The rate of complete vaccination 61% (95%CI: 43%, 76%) and immunoglobulin injection 39% (95%CI: 22%, 59%), were estimated respectively. Estimates reveal that there has been little change in the animal bites over the years. It is necessary to take special actions to control the disease at the national and international levels.