# Coxiella burnetii in Pakistan: a meta-analysis

## TL;DR

This study summarizes research on Coxiella burnetii in Pakistan, highlighting gaps in understanding its prevalence and impact on animals and humans.

## Contribution

The paper provides the first meta-analysis of C. burnetii studies in Pakistan, identifying key knowledge gaps and regional disparities.

## Key findings

- Infection rates were highest in camels (31.3%) but based on a single study, and lower in goats and sheep.
- Most studies were conducted in Punjab, with limited data on human and environmental prevalence.
- High heterogeneity in pooled prevalence estimates suggests inconsistent reporting and diagnostic methods.

## Abstract

Coxiella (C.) burnetii is a zoonotic pathogen that can infect humans, domestic and wildlife animals, and non-mammalian species. The pathogen is prevalent worldwide and exhibits high environmental stability; therefore, it has “One Health” significance. The objective of this meta-analysis was to summarize findings from studies about C. burnetii in Pakistan and included 19 published articles from 2015 to 2023. The collection and evaluation of scientific literature published on C. burnetii in Pakistan were done in accordance with PRISMA criteria. Three internet databases—Google Scholar, PubMed, and Science Direct—were used to find published research articles. The results showed 19 eligible studies involving small ruminants, large ruminants, camels, soil, ticks, and women from three provinces of Pakistan. The occurrence of infection was high in camels (31.3%) based on one study only, which limits its reliability, medium in goats and sheep (20.39% and 20.01% respectively), and low in women (8.41%). The maximum number of studies was conducted in Punjab (89.47%). The current study found that published information was scarce on the prevalence and distribution of C. burnetii in animals, humans (including men, women, and children), and the environment. The high heterogeneity was also observed in the estimated pooled prevalence. Future research might be focused on addressing these limitations and filling the gaps between the veterinary and human health systems. Improving diagnostics, standardizing reporting, and conducting large-scale studies are essential for estimating the real impact of Q fever and coxiellosis on public health and animals in Pakistan.

The online version contains supplementary material available at 10.1186/s12917-025-05215-8.