Diagnosis of Carrion's disease: A systematic review in South American countries and meta-analysis

Abstract

Bartonella bacilliformis can cause a potentially fatal infection, Carrion's disease. This review synthesized data on the prevalence of this bacterial infection in South American countries. A comprehensive literature search relevant articles (published between 2010 and 2022) was conducted in four databases. Full texts were selected based on PECOTS eligibility and JBI methodological quality. The pooled bacterial infection rate was calculated using a random-effects meta-analysis model. Subgroup and meta-regression analyses were used to investigate statistical heterogeneity. Five studies (covering 717 individuals from Peru and Ecuador) were eligible for meta-analysis. The percentage of seropositive IgG antibodies against B. bacilliformis was 28.21% (95% CI: 6.29–33.39) among healthy Ecuadorian children. In Peru, the pooled bacterial detection rate in symptomatic individuals was 15.60% (95% CI: 4.24–31.98), using molecular tests. Carrion's disease is endemic in the Andean valleys, but a gradual reduction in infection rates among acute febrile patients in Peru has been observed in recent years. Laboratory diagnosis of this infection continues to be neglected in other South American countries. Public managers must plan effective arrangements in primary care services, integrating various technological levels to ensure comprehensive health care.