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BMC Pregnancy and Childbirth Jul 2021Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia.
METHODS
Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software.
RESULTS
Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia.
CONCLUSIONS
Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.
Topics: Ethiopia; Female; Humans; Intestinal Diseases, Parasitic; Pregnancy; Pregnant Women; Prevalence; Risk Factors
PubMed: 34210260
DOI: 10.1186/s12884-021-03908-0 -
PLoS Neglected Tropical Diseases Oct 2022Schistosomiasis is a parasitic disease that is endemic in 78 countries and affects almost 240 million people worldwide. It has been acknowledged that an integrated...
BACKGROUND
Schistosomiasis is a parasitic disease that is endemic in 78 countries and affects almost 240 million people worldwide. It has been acknowledged that an integrated approach that goes beyond drug treatment is needed to achieve control and eventual elimination of the disease. Improving hygiene has been encouraged by World Health Organisation, and one aspect of good hygiene is using soap during water-contact activities, such as bathing and doing laundry. This hygiene practice might directly reduce the skin exposure to cercariae at transmission sites. A systematic review was carried out to investigate the efficacy of soap against schistosome cercariae and to identify the knowledge gaps surrounding this topic.
METHODOLOGY
Six online databases were searched between 5th and 8th July of 2021. Records returned from these databases were screened to remove duplicates, and the remaining records were classified by reading titles, abstracts, and full texts to identify the included studies. The results were categorised into two groups based on two different protective mechanisms of soap (namely, damage to cercariae and protection of skin).
CONCLUSIONS
Limited research has been conducted on the efficacy of soap against schistosome cercariae and only 11 studies met the criteria to be included in this review. The review demonstrates that soap has the potential of protecting people against schistosome cercariae and there are two protective aspects: (1) soap affects cercariae adversely; (2) soap on the skin prevents cercariae from penetrating the skin, developing into adult worms and producing eggs. Both aspects of protection were influenced by many factors, but the differences in the reported experimental conditions, such as the cercarial endpoint measurement used and the cercaria numbers used per water sample, lead to low comparability between the previous studies. This review indicates that more evidence is needed to inform hygiene advice for people living in schistosomiasis endemic areas.
Topics: Animals; Cercaria; Schistosoma; Schistosomiasis; Soaps; Water
PubMed: 36191022
DOI: 10.1371/journal.pntd.0010820 -
PloS One 2021Cutaneous and mucocutaneous leishmaniasis affect a million people yearly, leading to skin lesions and potentially disfiguring mucosal disease. Current treatments can...
Cutaneous and mucocutaneous leishmaniasis affect a million people yearly, leading to skin lesions and potentially disfiguring mucosal disease. Current treatments can have severe side effects. Allylamine drugs, like terbinafine, are safe, including during pregnancy. This review assesses efficacy and safety of allylamines for the treatment of cutaneous and mucocutaneous leishmaniasis. It followed the PRISMA statement for reporting and was preregistered in PROSPERO(CRD4201809068). MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Global Health Library, Web of Science, Google Scholar, and clinical trial registers were searched from their creation to May 24th, 2020. All original human, animal, and in vitro studies concerning allylamines and cutaneous or mucocutaneous leishmaniasis were eligible for inclusion. Comparators-if any-included both placebo or alternative cutaneous or mucocutaneous leishmaniasis treatments. Complete cure, growth inhibition, or adverse events served as outcomes. The search identified 312 publications, of which 22 were included in this systematic review. There were one uncontrolled and two randomised controlled trials. The only well-designed randomised controlled trial that compared the treatment efficacy of oral terbinafine versus intramuscular meglumine antimoniate in 80 Leismania tropica infected patients showed a non-significant lower cure rate for terbinafine vs meglumine antimoniate (38% vs 53%). A meta-analysis could not be performed due to the small number of studies, their heterogeneity, and low quality. This systematic review shows that there is no evidence of efficacy of allylamine monotherapy against cutaneous and mucocutaneous leishmaniasis. Further trials of allylamines should be carefully considered as the outcomes of an adequately designed trial were disappointing and in vitro studies indicate minimal effective concentrations that are not achieved in the skin during standard doses. However, the in vitro synergistic effects of allylamines combined with triazole drugs warrant further exploration.
Topics: Allylamine; Animals; Humans; Leishmania; Leishmaniasis, Cutaneous; Leishmaniasis, Mucocutaneous; Prognosis
PubMed: 33826660
DOI: 10.1371/journal.pone.0249628 -
Parasites & Vectors Mar 2021Schistosomiasis is a highly prevalent parasitic disease that can lead to adverse maternal and perinatal outcomes. To our knowledge, there has been no systematic review... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Schistosomiasis is a highly prevalent parasitic disease that can lead to adverse maternal and perinatal outcomes. To our knowledge, there has been no systematic review and meta-analysis of schistosomiasis during pregnancy.
METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in international databases (PubMed, Science Direct, Scopus, Web of Science, and Google Scholar), from their inception until May 31, 2020. The retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale. OpenMeta Analyst software was used for the statistical analysis.
RESULTS
Thirty-two studies enrolling 21024 pregnant women were included in this meta-analysis. All 32 of these studies were conducted in Africa. Of these studies, 19, 11, and 2 investigated S. mansoni, S. haematobium, and combined S. mansoni and S. haematobium infections, respectively. The pooled prevalence estimate of schistosomiasis during pregnancy was 13.2% (95 CI 11.0-15.4). A random model was used because of high heterogeneity (Q = 99.14; P < 0.001). In subgroup analyses, the pooled prevalence estimate of S. haematobium was significantly higher than the pooled prevalence estimates of S. mansoni [22.5% (95% CI 1.6-43.5) vs 8.7% (95% CI 6.0-11.3, P = 0.016), respectively]. The results of meta-regression analyses showed a non-significant difference in the prevalence of schistosomiasis during pregnancy according to the study sample sizes and year of publication. Only six studies evaluated the association between schistosomiasis during pregnancy and anemia. Schistosomiasis was associated with anemia in these six studies (OR = 3.02, 95% = 1.25‒7.28, P = 0.014).
CONCLUSION
The present meta-analysis suggests that schistosomiasis during pregnancy is an existing health problem. This meta-analysis also highlights the lack of data on the determinants and outcomes of schistosomiasis during pregnancy. Preventive measures are needed and could be part of antenatal care in areas endemic with schistosomiasis.
Topics: Africa; Anemia; Female; Humans; Pregnancy; Prevalence; Schistosomiasis; Schistosomiasis haematobia
PubMed: 33653391
DOI: 10.1186/s13071-021-04642-4 -
Parasites & Vectors Mar 2017Taeniasis, cysticercosis and trichinellosis have been ranked as the most important food-borne parasites of humans in terms of public health, socioeconomic and trade... (Review)
Review
Taeniasis, cysticercosis and trichinellosis have been ranked as the most important food-borne parasites of humans in terms of public health, socioeconomic and trade impact. Despite this, information on these food-borne zoonoses in Vietnam is scarce and fragmented, and many local reports remain inaccessible to the international research community. This study aims to conduct comprehensive literature searches to report on the incidence and estimate the true prevalence of taeniasis in humans and T. solium cysticercosis in humans and pigs in Vietnam utilizing Bayesian models; in addition, to report the incidence and the distribution of trichinellosis. A Bayesian approach was used to estimate the true prevalence of taeniasis and cysticercosis based on published diagnostic test characteristics used in each published cross-sectional survey. The utilization of coproscopic-based examination of Taenia eggs in stool, although highly specific for genus-level detection, has poor sensitivity and led to an underestimation of the prevalence of human taeniasis. Similarly, post-mortem-based surveys of T. solium cysticercosis in pigs also led to the underestimation of prevalence of porcine cysticercosis. On the other hand, the low specificity of immunodiagnostic methods, in particular Ab-ELISA, led to a likely overestimation of T. solium cysticercosis in humans. Due to the use of imperfect diagnosis tests combined with poor descriptions of sampling methods, our ability to draw solid conclusions from these data is limited. We estimate that the true prevalence of taeniasis and T. solium cysticercosis in rural 'hotspots', is as high as 13% for each, in humans. Taeniasis and T. solium cysticercosis occurs in 60 of the 63 provinces of Vietnam. Most of the information relating to the distribution and prevalence of porcine cysticercosis is limited to commercial abattoir surveys. In Vietnam, Taenia asiatica appears to be confined to the north where it occurs sympatrically with T. solium and Taenia saginata. The status of T. asiatica in Central and South Vietnam remains unascertained. To date, five outbreaks of trichinellosis have been reported in the north and northwest of Vietnam, affecting a total of 114 people and responsible for eight fatalities. In the same region, studies of free-roaming pigs showed evidence of high levels of exposure to Trichinella and, in cases where larvae were recovered, the species present were identified as Trichinella spiralis. Based on five studies, the main risk factors for pork-borne zoonoses in Vietnam include the consumption of undercooked/raw meat and vegetables and the use of night-soil for fertilization of local produce. This systematic review draws attention to the importance of these pork-borne zoonoses.
Topics: Animals; Cysticercosis; Foodborne Diseases; Humans; Red Meat; Swine; Swine Diseases; Taeniasis; Vietnam
PubMed: 28320455
DOI: 10.1186/s13071-017-2085-9 -
Impact of parasitic infection on mental health and illness in humans in Africa: a systematic review.Parasitology Jul 2022A growing body of research implicates inflammation as a potential pathway in the aetiology and pathophysiology of some mental illnesses. A systematic review was...
A growing body of research implicates inflammation as a potential pathway in the aetiology and pathophysiology of some mental illnesses. A systematic review was conducted to determine the association between parasitic infection and mental illnesses in humans in Africa and reviewed the state of the evidence available. The search focused on publications from Africa documenting the relationship between parasites from two parasite groups, helminths and protozoans, and four classifications of mental illness: mood affective disorders, neurotic and stress-related disorders, schizotypal disorders and unspecified mental illnesses. In the 26 reviewed papers, the prevalence of mental illness was significantly higher in people with parasitic infection compared to those without infection, i.e., 58.2% 41.8% ( < 0.001). An overall odds ratio found that the association of having a mental illness when testing positive for a parasitic infection was four times that of people without infection. Whilst the study showed significant associations between parasite infection and mental illness, it also highlights gaps in the present literature on the pathophysiology of mental illness in people exposed to parasite infection. This study highlighted the importance of an integrated intervention for parasitic infection and mental illness.
Topics: Africa; Animals; Helminthiasis; Humans; Inflammation; Mental Disorders; Mental Health; Parasitic Diseases; Prevalence; Protozoan Infections
PubMed: 35549773
DOI: 10.1017/S0031182022000166 -
PLoS Neglected Tropical Diseases Oct 2022Soil-transmitted helminths (STH) infect 1.5 billion people and countless animals worldwide. In Australian Indigenous communities, STH infections have largely remained... (Meta-Analysis)
Meta-Analysis
Soil-transmitted helminths (STH) infect 1.5 billion people and countless animals worldwide. In Australian Indigenous communities, STH infections have largely remained endemic despite control efforts, suggesting reservoirs of infection may exist. Dogs fulfil various important cultural, social and occupational roles in Australian Indigenous communities and are populous in these settings. Dogs may also harbour zoonotic STHs capable of producing morbidity and mortality in dogs and humans. This review provides an overview of human and zoonotic STH infections, identifies the Australian Indigenous locations affected and the parasite species and hosts involved. The meta-analysis provides estimates of individual study and pooled true prevalence of STH infections in Australian Indigenous communities and identifies knowledge gaps for further research on zoonotic or anthroponotic potential. A systematic literature search identified 45 eligible studies documenting the presence of Strongyloides stercoralis, Trichuris trichiura, Ancylostoma caninum, Ancylostoma duodenale, Ancylostoma ceylanicum, undifferentiated hookworm, and Ascaris lumbricoides. Of these studies, 26 were also eligible for inclusion in meta-analysis to establish true prevalence in the light of imperfect diagnostic test sensitivity and specificity by Rogan-Gladen and Bayesian methods. These studies revealed pooled true prevalence estimates of 18.9% (95% CI 15.8-22.1) for human and canine S. stercoralis infections and 77.3% (95% CI 63.7-91.0) for canine A. caninum infections indicating continued endemicity, but considerably more heterogenous pooled estimates for canine A. ceylanicum infections, and A. duodenale, undifferentiated hookworm and T. trichiura in humans. This review suggests that the prevalence of STHs in Australian Indigenous communities has likely been underestimated, principally based on imperfect diagnostic tests. Potential misclassification of hookworm species in humans and dogs due to outdated methodology, also obscures this picture. High-quality contemporary studies are required to establish current true prevalence of parasite species in all relevant hosts to guide future policy development and control decisions under a culturally sound One Health framework.
Topics: Humans; Dogs; Animals; Soil; Bayes Theorem; Australia; Helminths; Ascaris lumbricoides; Trichuris; Helminthiasis; Hookworm Infections; Ancylostomatoidea; Ancylostoma; Zoonoses; Prevalence; Feces
PubMed: 36279298
DOI: 10.1371/journal.pntd.0010895 -
Veterinary Parasitology Sep 2022To identify any universal impact of strongyle parasite burden on the growth rate of young cattle. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To identify any universal impact of strongyle parasite burden on the growth rate of young cattle.
METHODS
A meta-analysis and meta-regression of the relationship between differences in strongyle parasite burden between cohorts and average daily weight gain was conducted. Publications were identified from a search of databases applying PRISMA 2020 principles. Eligible studies had at least two groups of growing cattle on the same farm that were identical in composition, management and diet except for parasite exposure and were subject to body weight gain or average daily gain and faecal egg count measurements across the common growing period. The reference group had the lowest growth-period faecal egg count. A meta-regression estimated the impact of strongyle parasitism. The dependent variable was the log of the ratio of average daily gain between comparison groups and the reference group with the predictor variable as the common logarithm of the difference in average faecal egg count (plus 1) between the comparison and the reference groups.
RESULTS
26 publications containing 85 groups and 59 comparison ratios were analysed. Papers included representatives from dairy and beef industries and from pasture and feedlot production systems and from all cattle-producing continents. The comparison group average daily growth rate was 0.89 (95%CI 0.81-0.97) that of the reference group. Meta-regression identified a 0.131 linear reduction in average daily weight gain ratio for every log increase in the difference between comparison and reference group faecal egg count. Direction of effect was consistent across all subset analyses (continent, class of stock and production system). Whilst small faecal egg count differences between the comparison and reference groups often provided similar rates of daily weight gain, the trend was negative with most comparison groups having lower daily weight gains than their reference group.
CONCLUSIONS
Strongyle parasitism of growing cattle as measured by faecal egg count is associated with reduced growth across all production systems, geographies and classes of cattle.
Topics: Animals; Cattle; Cattle Diseases; Farms; Feces; Parasite Egg Count; Strongylida Infections; Weight Gain
PubMed: 35841691
DOI: 10.1016/j.vetpar.2022.109760 -
Travel Medicine and Infectious Disease 2021In 2018, tafenoquine was approved for malaria chemoprophylaxis. We evaluated all available data on the safety and efficacy of tafenoquine chemoprophylaxis. (Meta-Analysis)
Meta-Analysis
BACKGROUND
In 2018, tafenoquine was approved for malaria chemoprophylaxis. We evaluated all available data on the safety and efficacy of tafenoquine chemoprophylaxis.
METHODS
This systematic review followed the PRISMA guidelines and was registered on PROSPERO (CRD42019123839). We searched PubMed, Embase, Scopus, CINAHL and Cochrane databases. Two authors (JDM, PS) screened all papers.
RESULTS
We included 44 papers in the qualitative and 9 in the quantitative analyses. These 9 randomized, controlled trials included 2495 participants, aged 12-60 years with 27.3% women. Six studies were conducted in Plasmodium spp.-endemic regions; two were human infection studies. 200 mg weekly tafenoquine and higher dosages lead to a significant reduction of Plasmodium spp. infection compared to placebo and were comparable to 250 mg mefloquine weekly with a protective efficacy between 77.9 and 100% or a total risk ratio of 0.22 (95%-CI: 0.07-0.73; p = 0.013) in favour of tafenoquine. Adverse events (AE) were comparable in frequency and severity between tafenoquine and comparator arms. One study reported significantly more gastrointestinal events in tafenoquine users (p ≤ 0.001). Evidence of increased, reversible, asymptomatic vortex keratopathy in subjects with prolonged tafenoquine exposures was found. A single, serious event of decreased macular sensitivity occurred.
CONCLUSION
This systematic review and meta-analysis of trials of G6PD-normal adults show that weekly tafenoquine 200 mg is well tolerated and effective as malaria chemoprophylaxis focusing primarily on Plasmodium falciparum but also on Plasmodium vivax. Our safety analysis is limited by heterogenous methods of adverse events reporting. Further research is indicated on the use of tafenoquine in diverse traveller populations.
Topics: Adult; Aminoquinolines; Antimalarials; Chemoprevention; Female; Humans; Malaria; Male
PubMed: 33227500
DOI: 10.1016/j.tmaid.2020.101908 -
Tropical Medicine & International... Aug 2014To estimate the prevalence of Chagas disease in pregnant women and the risk of congenital transmission of Trypanosoma cruzi infection in Brazil, through a systematic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the prevalence of Chagas disease in pregnant women and the risk of congenital transmission of Trypanosoma cruzi infection in Brazil, through a systematic review and meta-analysis.
METHODS
We searched electronic databases, grey literature and reference lists of included publications to identify epidemiological studies on the prevalence of Chagas disease in pregnant women and on the congenital transmission rate of T. cruzi infection in Brazil published between January 1980 and June 2013. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using fixed- and random-effects models.
RESULTS
Sixteen articles were included - 12 studies on the prevalence of Chagas disease in pregnant women (549,359 pregnant women) and nine on congenital transmission rates (1687 children born to infected mothers). Prevalence of Chagas disease in pregnant women ranged from 0.1% to 8.5%, and congenital transmission rates from 0% to 5.2%. The pooled prevalence of Chagas disease among pregnant women across studies was 1.1% (95% CI: 0.6-2.0); the pooled congenital transmission rate was 1.7% (95% CI: 0.9-3.1). In 2010, 34,629 pregnant women were estimated to be infected with T. cruzi, and 312-1073 children born (mean: 589 cases) with congenital infection.
CONCLUSION
Congenital Chagas disease is a neglected public health problem in Brazil. Systematic congenital Chagas disease control programs through routine prenatal screening for T. cruzi should be widely implemented in Brazil's endemic areas, to identify infected pregnant women and newborns at risk of congenital infection.
Topics: Brazil; Chagas Disease; Female; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Pregnancy; Pregnancy Complications, Parasitic; Trypanosoma cruzi
PubMed: 24815954
DOI: 10.1111/tmi.12328