Evidence map›Paper›PMID 41238952›Full record

SynthesisActa parasitologica2025

Prevalence of Free-Living Amoebae in Various Water Sources in Iran: A Systematic Review and Meta-Analysis.

Laya Shamsi, Mina Mamizadeh, Mohammad Reza Mohammadi, Ali Pouryousef, Maryam Kheiry, Milad Badri, Ali Asghari, Fariba Shadfar

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Acta parasitologica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Laya Shamsi *Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
Mina Mamizadeh *Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Mohammad Reza MohammadiDepartment of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Ali PouryousefLeishmaniasis Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Maryam KheiryNon-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Milad BadriMedical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Ali AsghariDepartment of Basic Medical Sciences, Khoy University of Medical Sciences, Khoy, Iran. asghari3@yahoo.com.ORCID https://orcid.org/0000-0002-4005-2687
Fariba ShadfarZoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran. faribashadfar03@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFree-living amoebae (FLA) are widespread protozoa found in various water sources and can cause serious human infections. Identifying their occurrence and diversity in environmental waters is crucial for public health risk assessment and prevention. This study aimed to systematically review the prevalence and species/genotype distribution of FLA in different Iranian water sources.

methodsA systematic search was conducted in major international (PubMed, Scopus, Web of Science, Google Scholar) and Persian (SID, MagIran) databases from inception up to June 6, 2025. Eligible studies reporting the detection of FLA from Iranian water sources were included. In total, 58 studies met the inclusion criteria, encompassing 4,387 water samples from 24 provinces. Water sources were categorized into five groups: drinking/domestic water (six studies, 454 samples), natural recreational water (14 studies, 606 samples), artificial recreational water (16 studies, 1,666 samples), surface/stagnant water (eight studies, 703 samples), and mixed water (14 studies, 958 samples). Statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software, applying a random-effects model with 95% confidence intervals (CIs). Heterogeneity was assessed using the I

resultsThe pooled prevalence of FLA in Iranian water sources was 40.2% (95% CI: 33.7-47.1%). Among water categories, the highest contamination was observed in surface/stagnant waters (59.9%), followed by mixed waters (42.5%), natural recreational waters (42.1%), drinking/domestic waters (38.0%), and artificial recreational waters (29.0%). By climate zone, water sources in warm/humid and temperate/humid areas showed the highest prevalence (49.2% and 44.7%, respectively). Provincially, the highest contamination rates were recorded in Sistan and Baluchestan (88.2%), Hamedan (87.5%), Kermanshah (76.7%), Khuzestan (71.7%), and North Khorasan (68.0%). Ten FLA genera were reported from Iranian water resources: Acanthamoeba, Naegleria, Vahlkampfia, Vermamoeba, Vannella, Platyamoeba, Saccamoeba, Balamuthia, Protacanthamoeba, and Stenamoeba. Reported species/genotypes included Acanthamoeba T2-T6, T11, T13, and T15; Naegleria fultoni, N. pagei, N. clarki, N. carteri, N. australiensis, N. gruberi, N. dobsoni, N. americana, N. polaris, N. lovaniensis, and N. philippinensis; Vahlkampfia avara; Vermamoeba vermiformis; Vannella persistens; Saccamoeba limax; Stenamoeba polymorpha; Balamuthia mandrillaris; and Protacanthamoeba bohemica. Sensitivity analysis confirmed the robustness of the pooled estimates, while meta-regression identified sample size as a significant contributor to result variability and a potential source of heterogeneity.

conclusionFLA are widely prevalent in various water sources of Iran, especially in surface waters and warm/humid climates. The presence of multiple pathogenic genera and genotypes highlights significant health risks. Continuous monitoring and targeted control strategies are essential to reduce exposure and guide future research on environmental and epidemiological factors influencing FLA distribution.

Indexed as

AmoebaDrinking WaterHumansIranPrevalenceDrinking WaterFree-living amoebae (FLA)Genotype distributionIranSpecies diversityWater contaminationWater sources

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.