title: Epidemiological and Clinical Features of People with Malta Fever in Iran: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  Numerous studies have reported the epidemiological and clinical features of Malta fever incidence in Iran. Review and synthesis of the related literature through meta-analysis can provide an appropriate measurement for aforementioned indices. Therefore, the present study aimed to determine the epidemiological and clinical features of people with Malta fever in Iran.
  
  
  METHODS
  The required documents were obtained through searching national and international databases. In each study, standard deviation of the indices was calculated using binomial distribution formulas. Finally, the heterogeneity index was determined between studies using Cochran (Q) and I (2) tests.
  
  
  RESULTS
  Combining the results of 47 articles in the meta-analysis indicated that 57.6% (55.02-60.1%) and 42.3% (49.8-44.9%) of the patients were male and female, respectively. Most of the patients lived in rural areas; 68.4% (63.6-73.2%) compared to 31.4% (26.7-36.3%). In addition, 20.8% (17.4-24.2%) of the patients were ranchers and farmers, 16.9% (14.5-19.4%) were students, and 31.6% (27-36.2%) were housewives. Of the patients studies, 50.5% (35.6-65.2%) experienced contact with animals and 57.1% (46.4-67.9%) used unpasteurized dairy products. Fever, joint pain, and sweating were detected among 65.7% (53.7-77.8%) and 55.3% (44.4-66.2%), respectively.
  
  
  CONCLUSIONS
  The present study revealed that the frequency of male patients with brucellosis was considerably more than that of female patients. The number of patients with Malta fever in rural areas was significantly more than in urban areas. High-risk behavior, unprotected contact with animals, and using unpasteurized dairy products were among the most significant factors affecting Malta fever incidence in Iran. Fever, joint pain, and sweating were detected among most of the patients with Malta fever.
authors.affiliation: Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Moosazadeh
authors.affiliation: Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Roja
authors.initials: R
authors.lastname: Nikaeen
authors.affiliation: Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Ghasem
authors.initials: G
authors.lastname: Abedi
authors.affiliation: Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Motahareh
authors.initials: M
authors.lastname: Kheradmand
authors.affiliation: Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Safiri
keywords: Iran; Malta fever; epidemiology; meta-analysis; systematic review