Abstract
BackgroundAcquiring 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.MethodsWe 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.ResultsWe 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).ConclusionsThis 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.
Highlights
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
Quality assessment Based on the scores of the STROBE checklist, the highest and lowest scores were related to the studies of Velayati et al (2014) and Feyisa et al (2016), respectively
Based on the pooled prevalence of the Mtb genotypes in the Pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) samples, 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
Summary
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. Human-adapted Mycobacterium tuberculosis complex (MTBC), as a causative agent of TB infection, belong to eight phylogenetic branches with a phylogeographical population structure [2, 3]. In West and South Asia, a sharp increase has been documented in the circulation of certain sublinages such as NEW-1 (Lineage 4) and CAS (Lineage 3) strains that are prone to emerging as resistant clones [13,14,15] This growing increase seems be more important in Iran with the national average TB rate of 14 cases per 100,000 population, due to the influx of Afghan refugees and population growth [1]. Acquiring comprehensive insight into the dynamics of Mtb population structure is an essential step to adopt effective TB control strategies and improve therapeutic methods and vaccines
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