Smolak A, et al. - Through a systematic review of Chlamydia trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence, researchers gave a comprehensive epidemiological evaluation of C trachomatis infection in the Middle East and North Africa. A total of 1,531 citations with 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries were recognized. No incidence measures were discovered. The pooled prevalence of current genital infection was 3·0%, 2·8%, 13·2%, 11·3%, 12·4%, 12·4%, and 17·4% in general populations, intermediate-risk populations, female sex workers, infertility clinic attendees, women with miscarriage, symptomatic women, and in symptomatic men, respectively. In men who had sex with men, the pooled prevalence of current rectal infection was 7·7%. Multivariable meta-regression demonstrated 29·0% of the variation. Population type was most powerfully correlated with prevalence. Further relationships were discovered with assay type, sample size, country, and sex, however, not with sampling methodology or response rate. No evidence for a temporal difference in prevalence between 1982 and 2018 was ascertained. Hence, C trachomatis prevalence in the Middle East and North Africa was comparable to other regions though greater than expected provided its sexually conservative norms. Great prevalence in infertility clinic attendees and in women with miscarriage hinted a possible role for C trachomatis in poor reproductive health outcomes in this region.