A meta-analysis of Giardia lamblia in Iran

Giardia lamblia is the frequent cause of diarrhea in humans and other mammals across the world. The present systematic review and meta-analysis aimed to estimate the epidemiology of Giardia lamblia in the republic Islamic of Iran. The main international sources of ISI and Pubmed as well as the major national data banks in Iran including Magiran, IranMedex, SID  and IranDoc were systematically searched for the words"Giardia lamblia" since 1990 onward.  Overall, 43 reliable and similar studies in terms of methodology were selected for a systematic review. A meta-analysis was also conducted using the random-effects model. Heterogeneity was investigated by the Cochran's Q test. STATA was used for all analysis. Given the random- effects model, the prevalence ofGiardia lamblia in Iran was estimated to be 14.7% (95% reliability distance, 12.0%-16.6%). By age classification, the prevalence was 15.1% amongst fewer than 10 years children, 19.2% amongst adolescents and youngest of fewer than 20 years, and 6.7% amongst adults of between 20-30 years old (p<0.001). Annual classification showed that the maximum and minimum prevalence rates occurred in 1994 and 2005 (37.21 and 4.91% respectively). Geographical distribution of Giardia lamblia also showed that the eastern parts of the country nearby Pakistan and Afghanistan borders were extremely affected (35.5%). It was 16.9% in central provinces, 14.9% in the southern provinces, 13.2% in the north of country and 12.3% in the western provinces nearby Iraq and Turkey borders. Increased prevalence of Giardia lamblia in Iran, in spite of preventing strategies and valuable primary health care activities has been remained as a public health concern amongst children and in the eastern parts of the country nearby Pakistan and Afghanistan borders in particular.    Key words: Giardia lamblia, Iran, meta-analysis.