Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1589 1599 Yalda MALEKZADEGAN Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mehrdad HALAJI Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran AND Poursina Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Meysam HASANNEJAD-BIBALAN Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Saba JALALIFAR Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Javad FATHI Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Hadi Sedigh EBRAHIM-SARAIE Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran 2019 09 03 Background: Clostridium difficile is the most common causes of hospital-acquired diarrhea affecting particularly hospitalized patients globally. This organism has re-emerged in recent years with significant morbidity and mortality. The present study aimed to estimate the burden of C. difficile infection (CDI) and to acquire information on the overall rates of community- and hospital-acquired CDI in western Asia. Methods: A systematic literature search was performed to identify articles published from the eight Persian Gulf countries in western Asia including Iran, Iraq, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates in the electronic databases within Jan of 2000 to Dec of 2017. Then, 20 publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. Results: Twenty studies reported the prevalence of toxigenic strains of C. difficile among patients from Persian Gulf countries, of these the pooled prevalence of CDI was 9% (95% CI: 6.5%-12.5%). Totally, 8 studies showed the prevalence of hospital-acquired CDI, from those studies the prevalence of CDI was estimated 8.4% (95% CI: 4.9%-14.1%). Moreover, 7 studies reported the prevalence of community-acquired CDI, from those studies the prevalence of CDI was estimated 1.8% (95% CI: 1.2%-2.9%). Conclusion: The prevalence of CDI in western Asia is lower than southern and eastern region. Moreover, the lower prevalence of community-acquired CDI compared to hospital-acquired CDI, indicate that the source of infection in western Asia is more likely in the hospitals.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18245 https://ijph.tums.ac.ir/index.php/ijph/article/download/18245/6497