The data for 3 groups were analyzed for method. The lowest rate of CT samples was for serology 8.7% (95% CI: 8.08–9.4) and the highest prevalence rate of CT samples was for culture 65.6% (95% CI: 62.4–68.7). The heterogeneity, I2 = 99.9% (95% CI: 99.8–99.9), heterogeneity chi-squared test = 1334.51 with 2 degrees of freedom, and P value <.00, and moment-based estimate of between-study variance = 0.181.
The data for 4 area were analyzed (North, South, East, and West), the lowest rate of CT prevalence rate was in southern Iran 8.8% (95% CI: 7.6–10.07) and the highest CT prevalence rate was in eastern Iran 59.03% (95% CI: 56–62.01). Regarding heterogeneity, I2 = 99.7% (95% CI: 99.7–99.8), heterogeneity chi-squared test = 1198.73 with 3 degrees of freedom and P value <.0001, and moment-based estimate of between-study variance = 0.171, Kendall tau = 1, and P value = .08.
Begg funnel plot was used to evaluate publication bias the included studies. The appearance of the shape of funnel plot did not show any evidence of publication bias among included studies (Fig. 3).
The authors would like to thank Deputy of Research of Kurdistan University of Medical Sciences for financial support. The authors also appreciate of Social Determinants of Health Research Center and Cellular and Molecular Research Center, Department of Genecology of Kurdistan University of Medical Sciences in Iran.
. Cunningham F, Leveno K, Bloom S, et al. Williams Obstetrics. 2014;New York: McGraw-Hill, 24e.
. Nguyen TV, Van Khuu N, Le TTT, et al. Sexually transmitted infections and risk factors for Gonorrhea and Chlamydia in female sex workers in Soc Trang, Vietnam. Sex Transm Dis 2008;35:935–40.
. Stamm WE, Jones RB, Batteiger BE. Mandell GL, Bennett JE, Dolin R. Chlamydia trachomatis
(trachoma, perinatal infections, lymphogranuloma venereum, and other genital infections). Elsevier Churchill Livingstone, Principles and Practice of Infectious Diseases. Philadelphia, PA:2005.
. Hanski L, Vuorela P. Lead discovery strategies for identification of chlamydia pneumoniae inhibitors. Microorganisms 2016;4:43.
. Sciarra J. Sexually transmitted diseases: global importance. Int J Gynecol Obstet 1997;58:107–19.
. Duncan B, Hart G. Sexuality and health: the hidden costs of screening for Chlamydia trachomatis
. Br Med J 1999;318:931–3.
. Kataoka S, Yamada T, Chou K, et al. Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy. J Clin Microbiol 2006;44:51–5.
. Silveira M, Ghanem K, Erbelding E, et al. Chlamydia trachomatis infection
during pregnancy and the risk of preterm birth: a case-control study. Int J STD AIDS 2009;20:465–9.
. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.
. Jenab A, Golbang N, Golbang P, et al. Diagnostic value of PCR and ELISA for Chlamydia trachomatis
in a group of asymptomatic and symptomatic women in Isfahan, Iran. Int J Fertil Steril 2009;2:193–8.
. Jahromi AS, Farjam MR, Mogharrab F, et al. Chlamydia trachomatis
in women with full-term deliveries and women with abortion. Am J Infect Dis 2010;3:66–9.
. Moaiedmohseni S, Owje M. The value of Chlamydia trachomatis
antibody testing in prediction of tubal factor infertility. J Family Reprod Health 2008;2:29–32.
. Afrakhteh M, Beyhaghi H, Moradi A, et al. Sexually transmitted infections in Tehran. J Family Reprod Health 2008;2:123–8.
. Sattari M, Zeighami H, Peerayea SN. Detection of Chlamydia trachomatis
in endocervical smears of women with abortion. Res J Biol Sci 2008;3:214–6.
. Chamani Tabriz L, Jeddi-Tehrani M, Mosavi-Jarrahi A, et al. The prevalence of Chlamydia trachomatis infection
by molecular analysis of urine samples in women attending OB & GYN clinics in Tehran. J Reprod Infertil 2006;7:234–42.
. Hashemi F, Pourakbari B, Mamishi S, et al. Detection of Chlamydia trachomatis
in endocervical specimens by an enzyme-linked polymerase chain reaction assay. DARU J Pharm Sci 2007;15:100–4.
. Akya A. The frequency of Chlamydia trachomatis
and Neisseria gonorrhoeae
infections among women in Kermanshah, Iran. Asian Biomed 2013;7:681–5.
. Taheri Beni B, Motamedi H, Roayaei Ardakani M. Genotyping of the prevalent Chlamydia trachomatis
strains involved in cervical infections in women in Ahvaz, Iran. J Med Microbiol 2010;59:1023–8.
. Badami N, Salari M. Rate of Chlamydia trachomatis
, Mycoplasma hominis
and Ureaplasma urealyticum
in infertile females and control group. Iran J Public Health 2001;30:57–60.
. Fallah F, Kazemi B, Goudarzi H, et al. Detection of Chlamydia trachomatis
from urine specimens by PCR in women with cervicitis. Iran J Public Health 2005;34:20–6.
. Yazdi JZ, Khorramizadeh M, Badami N, et al. Comparative assessment of Chlamydia trachomatis infection
in Iranian women
with cervicitis: a cross-sectional study. Iran J Public Health 2006;35:69–75.
. Salari M, Badami N. The rate of Chlamydia trachomatis
, Mycoplasma hominis
and Ureaplasma urealyticum
in females with habitual abortion and its comparison with control group. Acta Med Iran 2002;40:79–82.
. Farivar TN, Johari P. Lack of association between Chlamydia trachomatis infection
and cervical cancer—Taq Man realtime PCR assay findings. Asian Pac J Cancer Prev 2012;13:3701–4.
. Hassanzadeh P, Sharifi H, Bazargani A, et al. Non-detection of Chlamydia trachomatis infection
by polymerase chain reaction in pregnant Iranian women
. Microbiol Res 2012;3:e8.
. Dabbaghi Ghaleh T, Lalooha F, Amini F, et al. Assessment Chlamydia trachomatis
antibody intubal factor infertility. Novel Sci Int J Med Sci 2012;1:1.
. Behrouzi R, Moussavi Z. The prevalence of Chlamydia infection
among pregnant women in Iran: an immunofluorescence study. J Tissue Res 2004;4:249–52.
. Hajikhani B, Motallebi T, Norouzi J, et al. Classical and molecular methods for evaluation of Chlamydia trachomatis infection
in women with tubal factor infertility. J Reprod Infertil 2013;14:29–33.
. Hossein Rashidi B, Chamani-Tabriz L, Haghollahi F, et al. Effects of Chlamydia trachomatis infection
on fertility: a case-control study. J Reprod Infertil 2013;14:67–72.
. Nazer M, Nowroozi J, Mirsalehian A, et al. Determination of asymptomatic Chlamydia trachomatis
infections by Omp1 gene based-PCR. Yakhteh Med J 2008;1:41–6.
. Samarbaf-Zadeh A, Razi MT, Kelishadi M. Prevalence of C. trachomatis infection
among Ahvaz females with vaginal discharge. J Fertil Steril 2007;1:19–22.
. Kalantar SM, Kazemi MJ, Sheikhha MH, et al. Detection of Chlamydia trachomatis infection
in female partners of infertile couples. Iran J Fertil Steril 2007;1:79–84.
. Peivandi S, Moslemizadeh N, Gharajeh S, et al. The role of Chlamydia trachomatis
IgG antibody testing in predicting tubal factor infertility in Northern Iran. Int J Fertil Steril 2009;3:143–8.
. Hadi N, Barazandeh F, Azad F. The prevalence of Chlamydia trachomatis infection
in women attending health clinics in Shiraz, Islamic Republic of Iran. Int J Fertil Steril 2010;4:128–33.
. Hasanabad MH, Mohammadzadeh M, Bahador A, et al. Prevalence of Chlamydia trachomatis
and Mycoplasma genitalium
in pregnant women of Sabzevar-Iran. Iran J Microbiol 2011;3:123–8.
. Eslami G, Goudarzi H, Taheripanah R, et al. Chlamydia trachomatis
detection by nested-PCR method on females referred to medical centers of Tehran, Iran. Arch Clin Infect Dis 2012;7:124–7.
. Jenab A, Roghanian R, Golbang N, et al. Comparison of three methods of DNA extraction in endocervical specimens for Chlamydia trachomatis infection
by spectrophotometry, agarose gel, and PCR. Arch Immunol Ther Exp 2010;58:227–34.
. Hamid B, Braham A, Mohtaram H. Prevalence of infection
with Nisseria gonorrhoeae
and Chlamydia trachomatis
in women visitors of gynecology and obstetrics clinics in Zanjan Province of Iran. Afr J Microbiol Res 2011;5:2447–50.
. Tabasi Z, Badami N, Atabakhshi M, et al. Evaluation of the prevalence of Chlamydia trachomatis
and its associated factors in patients with pelvic inflammatory disorders in Shabihkhani Hospital in Kashan in 2000. KAUMS J (FEYZ) 2001;5:43–9.
. Tayebeh N, Fatemeh K, Abbas B. Comparison of Chlamydia infection
prevalence between patients with and without ectopic pregnancy using the PCR method. Ginekol Polska 2012;83:819–21.
. Afrakhteh M, Mahdavi A, Beyhaghi H, et al. The prevalence of Chlamydia trachomatis
in patients who remained symptomatic after completion of sexually transmitted infection
treatment. Iran J Reprod Med 2013;11:285.
. Kajbaf MJ, Gholamnezhad A. Prevalence of Chlamydia trachomatis
antigen and antibody in infertile women in Ahwaz. Iran Biomed J 1998;2:45–8.
. Fatholahzadeh B, Bahador A, Hasanabad MH, et al. Comparative screening of Chlamydia trachomatis infection
in women population in Tehran, Iran. Iran Red Crescent Med J 2012;14:289–93.
. Marashi SMA, Moulana Z, Imani Fooladi AA, et al. Comparison of genital Chlamydia trachomatis infection
incidence between women with infertility and healthy women in Iran using PCR and immunofluorescence methods. Jundishapur J Microbiol 2014;7:e9450.
. Khalili M, Atapour M, Aali S, et al. Frequency of Chlamydia trachomatis
in genital specimens: Kerman city, PCR method. Tehran Univ Med J 2008;66:127–30.
. Bakhtiari A, Firoozjahi A. Chlamydia trachomatis infection
in women attending health centres in Babol: prevalence and risk factors. East Mediterr Health J 2007;13:1124–31.
. Khazardoost S, Haghollahi F, Roostaie S, et al. Chlamydia trachomatis infection
in pregnant women. J Reprod Infertil 2009;10:121–8.
. Sohrabi A, Samarbaf ZA, Mak VM, et al. A seroepidemiological study of parvovirus B19, Toxoplasma gondii
and Chlamydia trachomatis
in pregnant women referring to Obs & Gyn ward of Ahwaz Imam Khomeini Hospital. Reprod Infertil 2007;8:171–5.
. Mohammadzadeh M, Amirmozafari N, Shayanfar N, et al. Prevalence of Chlamydia trachomatis
infections in symptomatic women by polymerase chain reaction (PCR) immunofluorescence and Giemsa stain. Afr J Biotechnol 2013;10:6601–5.
. Khajehkarramedini M, Hashemi S, Naderinasab M, et al. Frequency of Chlamydia trachomatis infection
in cervical and urethral samples referred to Ghaem Hospital of Mashhad. Iran J Obstet Gyneocol Infertil 2011;22:474–7.
. Lewis D, Newton DC, Guy RJ, et al. The prevalence of Chlamydia trachomatis infection
in Australia: a systematic review and meta-analysis
. BMC Infect Dis 2012;12:113.
. Adams E, Charlett A, Edmunds W, et al. Chlamydia trachomatis
in the United Kingdom: a systematic review and analysis of prevalence studies. Sex Transm Infect 2004;80:354–62.
. Watson EJ, Templeton A, Russell I, et al. The accuracy and efficacy of screening tests for Chlamydia trachomatis
: a systematic review. J Med Microbiol 2002;51:1021–31.
. Cook RL, Hutchison SL, Østergaard L, et al. Systematic review: noninvasive testing for Chlamydia trachomatis
and Neisseria gonorrhoeae
. Ann Intern Med 2005;142:914–25.