+ Models MYCMED-698; No. of Pages 22 Please cite this article in press as: Nasirian H. Contamination of cockroaches (Insecta: Blattaria) to medically fungi: A systematic review and meta-analysis. Journal De Mycologie Médicale (2017), http://dx.doi.org/10.1016/j.mycmed.2017.04.012 GENERAL REVIEW/REVUE GE ´ NE ´ RALE Contamination of cockroaches (Insecta: Blattaria) to medically fungi: A systematic review and meta-analysis H. Nasirian Department of medical entomology and vector control, school of public health, Tehran university of medical sciences, POB 6446-14155 Tehran, Iran Received 31 January 2017; received in revised form 8 April 2017; accepted 14 April 2017 KEYWORDS Blattella germanica; Cockroach fungal contamination; Fungal infection; Periplaneta americana; Supella longipalpa Summary Introduction. — Fungal infections have emerged worldwide. Cockroaches have been proved vectors of medically fungi. Methods. — A systematic meta-analysis review about cockroach fungal contamination was investigated. Relevant topics were collected between January 2016 and January 2017. After a preliminary review among 392 collected papers, 156 were selected to become part of the detailed systematic meta-analysis review. Results. — Cockroaches contaminated to 38 fungi species belonging to 19 families and 12 orders. About 38, 25 and 13 fungal species were recovered from the American, German and brown-banded cockroaches, respectively with a variety of medical importance. Except the fungi isolated from German and brown-banded cockroaches, 15 species have been isolated only from the American cockroaches. The global world mean and trend of cockroach fungal contamination were 84.1 and 50.6—100%, respectively in the human dwelling environments. There is a significant difference between cockroach fungal contamination in the urban and rural environments (P < 0.05) without a significant difference between hospital and house- hold environments (P > 0.05). The external and internal cockroach fungal contamination is more dangerous than entire surfaces, while the internal is more dangerous than the external surface. The German and brown-banded cockroach fungal contamination are more dangerous than the American cockroaches in the hospital environments. Conclusion. — The study indicates that globally cockroach fungal contamination has been increased recognizing as agents of human infections and associating with high morbidity and mortality in immune-compromised patients. These facts, along with insecticide resistance Journal de Mycologie Médicale (2017) xxx, xxx—xxx E-mail address: hanasirian@yahoo.com. Available online at ScienceDirect www.sciencedirect.com http://dx.doi.org/10.1016/j.mycmed.2017.04.012 1156-5233/# 2017 Elsevier Masson SAS. All rights reserved.