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The Pediatric Infectious Disease Journal Jul 2016Studies have explored the risk for and impact of respiratory syncytial virus (RSV) infection requiring hospitalization among healthy preterm infants born at 29-35 weeks... (Review)
Review
BACKGROUND
Studies have explored the risk for and impact of respiratory syncytial virus (RSV) infection requiring hospitalization among healthy preterm infants born at 29-35 weeks of gestational age not given RSV immunoprophylaxis. We performed a systematic review and qualitative synthesis of these studies.
METHODS
Two experienced reviewers used prespecified inclusion/exclusion criteria to screen titles/abstracts and full-text studies using MEDLINE, Embase, BIOSIS and Cochrane Library (January 1, 1985, to November 6, 2014). We abstracted data on risk factors for RSV hospitalization, incidence and short- and long-term outcomes of RSV hospitalization. Using standard procedures, we assessed study risk of bias and graded strength of evidence (SOE).
RESULTS
We identified 4754 records and reviewed 27. Important risk factors for RSV hospitalization included young age during the RSV season, having school-age siblings and day-care attendance, with odds ratios >2.5 in at least one study (high SOE). Incidence rates for RSV hospitalizations ranged from 2.3% to 10% (low SOE). Length of hospital stays ranged from 3.8 to 6.1 days (low SOE). Recurrent wheezing rates ranged from 20.7% to 42.8% 1 to 2 years after RSV hospitalization (low SOE).
CONCLUSIONS
Young chronological age and some environmental risk factors are important clinical indicators of an increased risk of RSV hospitalization in healthy preterm infants 32 to 35 weeks of gestational age. SOE was low for estimates of incidence of RSV hospitalizations, in-hospital resource use and recurrent wheezing in this population. Studies were inconsistent in study characteristics, including weeks of gestational age, age during RSV season and control for confounding factors.
Topics: Gestational Age; Hospitalization; Humans; Incidence; Infant, Premature; Infant, Premature, Diseases; Palivizumab; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus, Human; Risk Factors; Seasons; Treatment Outcome
PubMed: 27093166
DOI: 10.1097/INF.0000000000001163 -
Expert Review of Anti-infective Therapy Jun 2017Influenza-Like Illness is a leading cause of hospitalization in children. Disease burden due to influenza and other respiratory viral infections is reported on a... (Review)
Review
Influenza-Like Illness is a leading cause of hospitalization in children. Disease burden due to influenza and other respiratory viral infections is reported on a population level, but clinical scores measuring individual changes in disease severity are urgently needed. Areas covered: We present a composite clinical score allowing individual patient data analyses of disease severity based on systematic literature review and WHO-criteria for uncomplicated and complicated disease. The 22-item ViVI Disease Severity Score showed a normal distribution in a pediatric cohort of 6073 children aged 0-18 years (mean age 3.13; S.D. 3.89; range: 0 to 18.79). Expert commentary: The ViVI Score was correlated with risk of antibiotic use as well as need for hospitalization and intensive care. The ViVI Score was used to track children with influenza, respiratory syncytial virus, human metapneumovirus, human rhinovirus, and adenovirus infections and is fully compliant with regulatory data standards. The ViVI Disease Severity Score mobile application allows physicians to measure disease severity at the point-of care thereby taking clinical trials to the next level.
Topics: Adenoviridae; Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Clinical Trials as Topic; Coinfection; Female; Humans; Infant; Influenza A virus; Influenza B virus; Male; Metapneumovirus; Mobile Applications; Respiratory Syncytial Virus, Human; Respiratory Tract Infections; Rhinovirus; Severity of Illness Index
PubMed: 28277820
DOI: 10.1080/14787210.2017.1295847 -
Tropical Animal Health and Production Jun 2022The present study intended to determine the prevalence of Newcastle disease in unvaccinated backyard poultry in Africa. Using the PRISMA approach, a systematic review... (Meta-Analysis)
Meta-Analysis Review
The present study intended to determine the prevalence of Newcastle disease in unvaccinated backyard poultry in Africa. Using the PRISMA approach, a systematic review and meta-analysis of 107 epidemiological studies was conducted. The meta-analysis identified significant variation of both seroprevalence (I = 99.38, P = 0.00) and Newcastle disease virus prevalence (I = 99.52, P = 0.00) reported in various studies included in this review. Publication bias was not detected in either case. Seroprevalence of Newcastle disease was 40.2 (95%CI 32.9-47.8). Seroprevalence was significantly influenced by sampling frame and the African region where the studies were conducted. The prevalence of Newcastle disease virus (NDV) was 12% (95%CI 7.3-17.8), and the variation was influenced by sampling frame, diagnostic test, and regions where the studies were conducted. Also, Newcastle disease (ND) accounted for 33.1% (95%CI 11.9-58.1) of sick chickens. Results also indicated that genotypes VI and VII are widely distributed in all countries included in the study. However, genotype V is restricted in East Africa, and genotypes XIV, XVII, and XVIII are restricted in West and Central Africa. On the other hand, genotype XI occurs in Madagascar only. In addition, virulent genotypes were isolated from apparently healthy and sick birds. It is concluded that several genotypes of NDV are circulating and maintained within the poultry population. African countries should therefore strengthen surveillance systems, be able to study the viruses circulating in their territories, and establish control programs.
Topics: Africa; Animals; Chickens; Genotype; Newcastle Disease; Newcastle disease virus; Phylogeny; Poultry; Poultry Diseases; Seroepidemiologic Studies
PubMed: 35705876
DOI: 10.1007/s11250-022-03198-4 -
Archives of Razi Institute Dec 2021Peste des petits ruminants (PPR) or goat plague is considered a leading, highly contagious, and most lethal infectious viral disease of small ruminants affecting the... (Meta-Analysis)
Meta-Analysis Review
Peste des petits ruminants (PPR) or goat plague is considered a leading, highly contagious, and most lethal infectious viral disease of small ruminants affecting the worldwide livestock economy and international animal trade. Although sheep and goats are the primarily affected, the PPR Virus (PPRV) host range has expanded to other livestock (large ruminants) and wildlife animals over the last few decades, resulting in serious concern to the ongoing PPR global eradication program, which is primarily optimized, designed, and targeted towards accessible sheep and goat population. A systematic review and meta-analysis study was conducted to estimate the prevalence and spill-over infection of PPRV in large ruminants (bovine and camel) and wildlife. Published articles from 2001 to October 2021 on the "PPR" were searched in four electronic databases of PubMed, Scopus, Science direct, and Google Scholars. The articles were then selected using inclusion criteria (detection/prevalence of PPRV in bovine, camel, and wildlife population), exclusion criteria (only sheep or goats, lack of prevalence data, experimental trial, test evaluation, and reviews written in other languages or published before 2001), and the prevalence was estimated by random effect meta-analysis model. In the current study, all published articles belonged to Africa and Asia. The overall pooled prevalence of PPR estimates was 24% (95% CI: 15-33), with 30% in Asia (95% CI: 14-49) and 20% in Africa (95% CI: 11-30). The overall estimated pooled prevalence at an Africa-Asia level in bovine and camel was 13% (95% CI: 8-19), and in wildlife, it was 52% (95% CI: 30-74) with significant heterogeneity (I = 97%) in most pooled estimates with a high prevalence in atypical hosts and wildlife across Asia and Africa. Over the last two decades, the host range has increased drastically in the wildlife population, even for prevalent PPR in the unnatural hosts only for a short time, contributing to virus persistence in multi-host systems with an impact on PPR control and eradication program. This observation on the epidemiology of the PPRV in unnatural hosts demands appropriate intervention strategies, particularly at the livestock-wildlife interface.
Topics: Animals; Animals, Wild; Camelus; Cattle; Cattle Diseases; Goat Diseases; Goats; Livestock; Peste-des-Petits-Ruminants; Peste-des-petits-ruminants virus; Prevalence; Sheep; Sheep Diseases
PubMed: 35546985
DOI: 10.22092/ari.2021.356900.1939 -
PLoS Neglected Tropical Diseases Feb 2016The 2013-15 Ebola outbreak was unprecedented due to sustained transmission within urban environments and thousands of survivors. In 2014 the World Health Organization... (Review)
Review
BACKGROUND
The 2013-15 Ebola outbreak was unprecedented due to sustained transmission within urban environments and thousands of survivors. In 2014 the World Health Organization stated that there was insufficient evidence to give definitive guidance about which body fluids are infectious and when they pose a risk to humans. We report a rapid systematic review of published evidence on the presence of filoviruses in body fluids of infected people and survivors.
METHODS
Scientific articles were screened for information about filovirus in human body fluids. The aim was to find primary data that suggested high likelihood of actively infectious filovirus in human body fluids (viral RNA). Eligible infections were from Marburg virus (MARV or RAVV) and Zaire, Sudan, Taï Forest and Bundibugyo species of Ebola. Cause of infection had to be laboratory confirmed (in practice either tissue culture or RT-PCR tests), or evidenced by compatible clinical history with subsequent positivity for filovirus antibodies or inflammatory factors. Data were extracted and summarized narratively.
RESULTS
6831 unique articles were found, and after screening, 33 studies were eligible. For most body fluid types there were insufficient patients to draw strong conclusions, and prevalence of positivity was highly variable. Body fluids taken >16 days after onset were usually negative. In the six studies that used both assay methods RT-PCR tests for filovirus RNA gave positive results about 4 times more often than tissue culture.
CONCLUSIONS
Filovirus was reported in most types of body fluid, but not in every sample from every otherwise confirmed patient. Apart from semen, most non-blood, RT-PCR positive samples are likely to be culture negative and so possibly of low infectious risk. Nevertheless, it is not apparent how relatively infectious many body fluids are during or after illness, even when culture-positive, not least because most test results come from more severe cases. Contact with blood and blood-stained body fluids remains the major risk for disease transmission because of the known high viral loads in blood.
Topics: Animals; Body Fluids; Ebolavirus; Hemorrhagic Fever, Ebola; Humans; Marburg Virus Disease; Marburgvirus; Survivors
PubMed: 26927697
DOI: 10.1371/journal.pntd.0004475 -
Jornal de Pediatria 2023To identify and assess the current evidence available about the costs of managing hospitalized pediatric patients diagnosed with Respiratory Syncytial Virus (RSV) and... (Review)
Review
OBJECTIVE
To identify and assess the current evidence available about the costs of managing hospitalized pediatric patients diagnosed with Respiratory Syncytial Virus (RSV) and Parainfluenza Virus Type 3 (PIV3) in upper-middle-income countries.
METHODS
The authors conducted a systematic review across seven key databases from database inception to July 2022. Costs extracted were converted into 2022 International Dollars using the Purchasing Power Parity-adjusted. PROSPERO identifier: CRD42020225757.
RESULTS
No eligible study for PIV3 was recovered. For RSV, cost analysis and COI studies were performed for populations in Colombia, China, Malaysia, and Mexico. Comparing the total economic impact, the lowest cost per patient at the pediatric ward was observed in Malaysia ($ 347.60), while the highest was in Colombia ($ 709.66). On the other hand, at pediatric ICU, the lowest cost was observed in China ($ 1068.26), while the highest was in Mexico ($ 3815.56). Although there is no consensus on the major cost driver, all included studies described that the medications (treatment) consumed over 30% of the total cost. A high rate of inappropriate prescription drugs was observed.
CONCLUSION
The present study highlighted how RSV infection represents a substantial economic burden to health care systems and to society. The findings of the included studies suggest a possible association between baseline risk status and expenditures. Moreover, it was observed that an important amount of the cost is destinated to treatments that have no evidence or support in most clinical practice guidelines.
Topics: Humans; Child; Infant; Developing Countries; Financial Stress; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus, Human; Parainfluenza Virus 3, Human; Hospitalization
PubMed: 37247828
DOI: 10.1016/j.jped.2023.05.003 -
The Lancet. Infectious Diseases Nov 2020Ebola virus disease case definition is a crucial surveillance tool to detect suspected cases for referral and as a screening tool for clinicians to support admission and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ebola virus disease case definition is a crucial surveillance tool to detect suspected cases for referral and as a screening tool for clinicians to support admission and laboratory testing decisions at Ebola health facilities. We aimed to assess the performance of the WHO Ebola virus disease case definitions and other screening scores.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Scopus, Embase, and Web of Science for studies published in English between June 13, 1978, and Jan 14, 2020. We included studies that estimated the sensitivity and specificity of WHO Ebola virus disease case definitions, clinical and epidemiological characteristics (symptoms at admission and contact history), and predictive risk scores against the reference standard (laboratory-confirmed Ebola virus disease). Summary estimates of sensitivity and specificity were calculated using bivariate and hierarchical summary receiver operating characteristic (when four or more studies provided data) or random-effects meta-analysis (fewer than four studies provided data).
FINDINGS
We identified 2493 publications, of which 14 studies from four countries (Sierra Leone, Guinea, Liberia, and Angola) were included in the analysis. 12 021 people with suspected disease were included, of whom 4874 were confirmed as positive for Ebola virus infection. Six studies explored the performance of WHO case definitions in non-paediatric populations, and in all of these studies, suspected and probable cases were combined and could not be disaggregated for analysis. The pooled sensitivity of the WHO Ebola virus disease case definitions from these studies was 81·5% (95% CI 74·1-87·2) and pooled specificity was 35·7% (28·5-43·6). History of contact or epidemiological link was a key predictor for the WHO case definitions (seven studies) and for risk scores (six studies). The most sensitive symptom was intense fatigue (79·0% [95% CI 74·4-83·0]), assessed in seven studies, and the least sensitive symptom was pain behind the eyes (1·0% [0·0-7·0]), assessed in three studies. The performance of fever as a symptom varied depending on the cutoff used to define fever.
INTERPRETATION
WHO Ebola virus disease case definitions perform suboptimally to identify cases at both community level and during triage at Ebola health facilities. Inclusion of intense fatigue as a key symptom and contact history could improve the performance of case definitions, but implementation of these changes will require effective collaboration with, and trust of, affected communities.
FUNDING
Médecins sans Frontières.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Angola; Child; Child, Preschool; Diagnostic Techniques and Procedures; Diarrhea; Disease Outbreaks; Ebolavirus; Epidemiological Monitoring; Fatigue; Female; Fever; Guinea; Hemorrhagic Fever, Ebola; Humans; Infant; Infant, Newborn; Liberia; Male; Middle Aged; ROC Curve; Sensitivity and Specificity; Sierra Leone; Young Adult
PubMed: 32593318
DOI: 10.1016/S1473-3099(20)30193-6 -
Clinical Infectious Diseases : An... May 2016Factors affecting our ability to control an Ebola outbreak include transmissibility of the virus and the proportion of transmissions occurring asymptomatically. We... (Meta-Analysis)
Meta-Analysis Review
Factors affecting our ability to control an Ebola outbreak include transmissibility of the virus and the proportion of transmissions occurring asymptomatically. We performed a meta-analysis of Ebola household secondary attack rate (SAR), disaggregating by type of exposure (direct contact, no direct contact, nursing care, direct contact but no nursing care). The estimated overall household SAR is 12.5% (95% confidence interval [CI], 8.6%-16.3%). Transmission was driven by direct contact, with little transmission occurring in its absence (SAR, 0.8% [95% CI, 0%-2.3%]). The greatest risk factor was the provision of nursing care (SAR, 47.9% [95% CI, 23.3%-72.6%]). There was evidence of a decline in household SAR for direct contact between 1976 and 2014 (P = .018). We estimate that 27.1% (95% CI, 14.5%-39.6%) of Ebola infections are asymptomatic. Our findings suggest that surveillance and containment measures should be effective for controlling Ebola.
Topics: Asymptomatic Infections; Disease Outbreaks; Ebolavirus; Family Characteristics; Hemorrhagic Fever, Ebola; Humans
PubMed: 26932131
DOI: 10.1093/cid/ciw114 -
Tropical Animal Health and Production Oct 2021Abortive infections are a major health challenge affecting productive and reproductive performance of sheep and goats. However, there is no comprehensive summary on the... (Review)
Review
Abortive infections are a major health challenge affecting productive and reproductive performance of sheep and goats. However, there is no comprehensive summary on the occurrence and distribution of these infections in Algeria. This systematic review provides a comprehensive summary on the prevalence of different abortive diseases and assesses potential risk factors in small ruminants in Algeria. Five databases were used to search epidemiological data on the prevalence of different abortive diseases (bacterial, parasitic, and viral). Data were collected from 25 papers published between 2003 and 2020. The total mean sample size was 53,080 small ruminants. The majority of the diseases/infections were diagnosed by serological and molecular tests. The overall prevalence of brucellosis was 0.39% in sheep and 5.31% in goats. Chlamydia and Q fever were observed in 32.72% and 20.62% of small ruminants, respectively. The prevalence of peste des petits ruminants was 15.76% and the overall prevalence of bluetongue in sheep and goats was, respectively, 13.41% and 44.50%. Border disease and bovine viral diarrhea were detected in 22.68% and 1.01% of sheep examined, respectively. Toxoplasma gondii infection prevalence among sheep and goats was 21.43% and 32.31% respectively. This study is a comprehensive epidemiological analysis of abortion diseases in small ruminants in Algeria and will therefore be a useful tool for researchers. Larger and more robust prevalence studies are needed to adequately support risk assessment and management of animal and public health threats.
Topics: Algeria; Animals; Goat Diseases; Goats; Peste-des-petits-ruminants virus; Risk Factors; Sheep; Sheep Diseases
PubMed: 34669051
DOI: 10.1007/s11250-021-02926-6 -
Expert Review of Vaccines 2024This review aimed to systematically evaluate the immunogenicity and safety of the candidate Ebola virus vaccine (EVV). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This review aimed to systematically evaluate the immunogenicity and safety of the candidate Ebola virus vaccine (EVV).
METHODS
We searched five databases for randomized controlled trials (RCTs) evaluating the effects of EVV on healthy adults. The primary outcomes were relative risk (RR) of sero-conversion or sero-response of EVV in healthy adults between the groups that received EVV and the controls.
RESULTS
Twenty-nine RCTs ( = 23573) were included. There was a significant difference in RR of sero-conversion of EVV (RR 13.18; 95% CI 11.28-15.41; I = 33%; < 0.01) between the two groups. There was a significant difference in RR of adverse events (AEs) of EVV (RR 1.49; 95% CI 1.27-1.74; I = 88%; < 0.01), although no difference in RR of serious AE (SAE) between the two groups. Subgroup analysis showed that there was no significant difference in RR of AEs for DNAEBO, EBOV-GP, MVA, and rVSVN4CT1 vaccines, compared with controls.
CONCLUSIONS
The DNAEBO, EBOV-GP, MVA, and rVSVN4CT1 vaccines are likely to be safe and immunogenic, tending to support the vaccination against Ebola disease. These findings should provide much-needed evidence for public health policy makers to develop preventive measures based on disease prevalence features and socio-economic conditions.
Topics: Adult; Humans; Ebola Vaccines; Randomized Controlled Trials as Topic; Hemorrhagic Fever, Ebola; Vaccination; Antibody Formation; Ebolavirus
PubMed: 38112249
DOI: 10.1080/14760584.2023.2296937