Prevalence and Clinical Investigation of the Behcet's Disease in Middle East and North Africa: A Systematic Review and Meta-Analysis

Context: This systematic review and meta-analysis was performed to determine the prevalence (by overall relative frequency) and clinical information of the Behcet’s disease in Middle East and north Africa (MENA) and it has an important effect on the health policy and performing complementary studies in future.
Evidence Acquisition: We performed this systematic literature review from several databases including PubMed, Scopus and ISI Web of Science according to search strategy with two filters, place (MENA countries) and time (all articles published from Jan 1980 to Jan 2016 were considered). The keywords such as “Behcet’s syndrome”, “Behcet’s disease”, “triple symptom complex”, “Middle East” were searched. Out of 4013 relevant articles and according to inclusion and exclusion criteria, 28 papers were selected to study. To examine the quality of the studies, all papers were evaluated independently by two authors and the Kappa coefficient was 95%. Afterwards, the critical appraisal was performed by strengthening the reporting of observational studies in epidemiology (STROBE) form. Due to sever heterogeneity, the pooled prevalence (per 100,000 people) was derived by the random effect model that takes between-study variation into account.
According to the results of the present study, the prevalence rate of BD in Iran was 68; it was after Turkey among MENA. The pooled prevalence (per 100,000 people) of BD in MENA was 120 (95% CI: 86.8, 166.8) according to the random effect model. The oral aphthosis was the most frequent symptom among other symptoms and HLA-51 association was its poor prognosis. Turkey had the highest prevalence (per 100,000 people) of 420 (95%CI: 340, 510) and the lowest prevalence 2.1 related to Kuwait in MENA countries.
There are different statistics about the prevalence rates of the disease that have been published; these different prevalence statistics can be explained by racial and geographical divergence, patient selection and BD diagnosis criteria. The results of this study can be useful for health policy and other studies which are needed to find the reasons of this prevalence difference.