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PLoS Neglected Tropical Diseases Nov 2023Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project,...
BACKGROUND
Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries.
METHODS
An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included.
RESULTS
Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure.
DISCUSSION
Despite the limitations of the included studies, this study is the first systematic review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.
Topics: Humans; Cost of Illness; Financial Stress; Chagas Disease; Chagas Cardiomyopathy; Heart Failure
PubMed: 37992061
DOI: 10.1371/journal.pntd.0011757 -
PLoS Neglected Tropical Diseases Jul 2023Strongyloides stercoralis is a neglected soil-transmitted helminth (STH) that leads to significant morbidity in endemic populations. Infection with this helminth has... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Strongyloides stercoralis is a neglected soil-transmitted helminth (STH) that leads to significant morbidity in endemic populations. Infection with this helminth has recently been recognised by the World Health Organization (WHO) as a major global health problem to be addressed with ivermectin preventive chemotherapy, and therefore, there is now, the need to develop guidelines for strongyloidiasis control that can be implemented by endemic countries. This study aimed to evaluate the impact of ivermectin preventive chemotherapy (PC) on S. stercoralis prevalence in endemic areas to generate evidence that can inform global health policy.
METHODOLOGY/PRINCIPAL FINDINGS
This study was a systematic review and meta-analysis. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and LILACS for literature published between 1990 and 2022 and reporting prevalence of S. stercoralis before and after PC with ivermectin, administered either at school or at community level. The search strategy identified 933 records, eight of which were included in the meta-analysis. Data extraction and quality assessment were carried out by two authors. Meta-analysis of studies based on fecal testing demonstrated a significant reduction of S. stercoralis prevalence after PC: prevalence Risk Ratio (RR) 0.18 (95% CI 0.14-0.23), I2 = 0. A similar trend was observed in studies that used serology for diagnosis: RR 0.35 (95% CI 0.26-0.48), I2 = 4.25%. A sensitivity analysis was carried out for fecal tests where low quality studies were removed, confirming a post-intervention reduction in prevalence. The impact of PC could not be evaluated at different time points or comparing annual vs biannual administration due to insufficient data.
CONCLUSIONS/SIGNIFICANCE
Our findings demonstrate a significant decrease of S. stercoralis prevalence in areas where ivermectin PC has taken place, supporting the use of ivermectin PC in endemic areas.
Topics: Animals; Humans; Strongyloides stercoralis; Ivermectin; Strongyloidiasis; Chemoprevention; Prevalence
PubMed: 37428815
DOI: 10.1371/journal.pntd.0011473 -
PLoS Neglected Tropical Diseases Mar 2024Cholangiohydatidosis (CH) is an evolutionary complication of hepatic cystic echinococcosis, associated with increased morbidity and mortality. The aim of this study was...
BACKGROUND
Cholangiohydatidosis (CH) is an evolutionary complication of hepatic cystic echinococcosis, associated with increased morbidity and mortality. The aim of this study was to describe the available evidence regarding clinical characteristics of CH, postoperative complications and hospital mortality.
METHODOLOGY/PRINCIPAL FINDINGS
Systematic review. Studies related to CH with no language or publication restriction were included. Sensitive searches were performed in Trip Database, SciELO, BIREME-BVS, WoS, PubMed, EMBASE and SCOPUS. MeSH and free terms were used, including articles up to April 2023. The main outcome variables were postoperative complications and hospital mortality; the secondary ones were publication year, origin and design of primary studies, main clinical manifestation, anatomical location and type of cysts, hospital stay, surgical procedure performed, reinterventions; and methodological quality of primary studies, which was assessed using MInCir-T and MInCir-P scales. Descriptive statistics, calculation of weighted averages and their comparison by least squares logistic regression were applied. 446 studies were retrieved from the searches performed, 102 of which met the inclusion and exclusion criteria. The studies analyzed represent 1241 patients. The highest proportion of articles was published in the last decade (39.2%). Reports are mainly from Turkey (28.4%), Greece (9.8%), Morocco and Spain (8.8% each). With a weighted mean of 14.3 days of hospital stance; it was verified that 26.2% of patients developed postoperative complications (74,3% Clavien y Dindo III y IV), 6.7% needed re-interventions, and 3.7% died. When comparing the variables age, postoperative complications, hospital mortality, and reinterventions in two periods of time (1982-2006 vs. 2007-2023), no statistically significant differences were found. When applying the MInCir-T and MInCir-P scales, the methodological quality of the primary studies was 9.6±1.1 and 14.5±4.3 points, respectively.
CONCLUSION/SIGNIFICANCE
CH is associated with severe postoperative complications and significant hospital mortality, independent of the development of therapeutic support associated with the passage of time.
Topics: Humans; Hospital Mortality; Postoperative Complications; Echinococcosis, Hepatic; Morbidity
PubMed: 38452054
DOI: 10.1371/journal.pntd.0011558 -
Heliyon Jun 2024Rodents are the largest group of mammals that adapt to different ecosystems and may act as the potential reservoirs of significant pathogens including gastrointestinal...
Rodents are the largest group of mammals that adapt to different ecosystems and may act as the potential reservoirs of significant pathogens including gastrointestinal (GI) helminths. Rodent-borne parasitic pathogens have been and remain a great concern for animal and human health. The aim of this systematic review and meta-analysis is thus to clarify and better understand the pooled prevalence of GI helminthic infections and the associated risk factors in rodents in Iran. Multiple databases (PubMed, Scopus, Web of Science, Google Scholar, SID, Magiran and Irandoc) were searched for relevant literature published up to March 2022. A random-effects meta-analysis model was applied to estimate the pooled prevalence with 95 % confidence interval. Moreover, heterogeneity among studies was evaluated using the Cochran's test and the -statistic. Out of the 5438 publications searched, 28 articles (30 datasets) were ultimately eligible for inclusion in the study. Thus, 3649 captured rodents belonging to 6 families, 20 genera, and 35 species were examined for GI helminths in Iran. Then, 54 helminth species were identified in the present research, including 33 nematodes, 16 cestodes, 4 trematods, and 1 acanthocephalan. The prevalence rate of GI parasitic infections was 56 % (95 % CI: 50-63 %). , and were the most common helminthic infections (13 %, 9 %, and 8 %, respectively). Moreover, 11 potential zoonotic helminths were found. There was no significant difference in pooled prevalence between male and female rodents (P = 0.40). Considering geographical areas, northern and eastern provinces had the highest prevalence of GI helminthic infections among rodents. The prevalence of GI worms in Iranian rodents was as high as 56 % with 11 zoonotic helminths. Therefore, it is suggested to observe the health of the environment, destroy the biological nests of rodents, avoid half-finished constructions, repair and improve streams and sidewalks, organize and collect garbage, and carry out biological and chemical control to handle the population of rodents. Increasing the awareness of local people about the harmful effects of rodents and the ways of transmission and prevention of rodent-borne intestinal worms transmitted to humans should be prioritized in health decisions.
PubMed: 38845951
DOI: 10.1016/j.heliyon.2024.e31955 -
Malaria Journal Oct 2023Imperfect adherence is a major barrier to effective primaquine radical cure of Plasmodium vivax. This study investigated the effect of reduced adherence on the risk of... (Meta-Analysis)
Meta-Analysis
Effect of adherence to primaquine on the risk of Plasmodium vivax recurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis.
BACKGROUND
Imperfect adherence is a major barrier to effective primaquine radical cure of Plasmodium vivax. This study investigated the effect of reduced adherence on the risk of P. vivax recurrence.
METHODS
Efficacy studies of patients with uncomplicated P. vivax malaria, including a treatment arm with daily primaquine, published between January 1999 and March 2020 were identified. Individual patient data from eligible studies were pooled using standardized methodology. Adherence to primaquine was inferred from i) the percentage of supervised doses and ii) the total mg/kg dose received compared to the target total mg/kg dose per protocol. The effect of adherence to primaquine on the incidence of P. vivax recurrence between days 7 and 90 was investigated by Cox regression analysis.
RESULTS
Of 82 eligible studies, 32 were available including 6917 patients from 18 countries. For adherence assessed by percentage of supervised primaquine, 2790 patients (40.3%) had poor adherence (≤ 50%) and 4127 (59.7%) had complete adherence. The risk of recurrence by day 90 was 14.0% [95% confidence interval: 12.1-16.1] in patients with poor adherence compared to 5.8% [5.0-6.7] following full adherence; p = 0.014. After controlling for age, sex, baseline parasitaemia, and total primaquine dose per protocol, the rate of the first recurrence was higher following poor adherence compared to patients with full adherence (adjusted hazard ratio (AHR) = 2.3 [1.8-2.9]). When adherence was quantified by total mg/kg dose received among 3706 patients, 347 (9.4%) had poor adherence, 88 (2.4%) had moderate adherence, and 3271 (88.2%) had complete adherence to treatment. The risks of recurrence by day 90 were 8.2% [4.3-15.2] in patients with poor adherence and 4.9% [4.1-5.8] in patients with full adherence; p < 0.001.
CONCLUSION
Reduced adherence, including less supervision, increases the risk of vivax recurrence.
Topics: Humans; Primaquine; Antimalarials; Plasmodium vivax; Recurrence; Malaria, Vivax; Folic Acid Antagonists
PubMed: 37817240
DOI: 10.1186/s12936-023-04725-w -
Scientific Reports Sep 2023Reduced glutathione (GSH) is a crucial antioxidant with recognized roles in malaria pathogenesis and host response. Despite its importance, reports on the association of... (Meta-Analysis)
Meta-Analysis
Reduced glutathione (GSH) is a crucial antioxidant with recognized roles in malaria pathogenesis and host response. Despite its importance, reports on the association of GSH with malaria are inconsistent. Therefore, this systematic review and meta-analysis investigated the differences in GSH levels in relation to Plasmodium infection. A comprehensive literature search of six electronic databases (Embase, MEDLINE, Ovid, PubMed, Scopus, and ProQuest) was conducted. Of the 2158 initially identified records, 18 met the eligibility criteria. The majority of studies reported a significant decrease in GSH levels in malaria patients compared with uninfected controls, and this was confirmed by meta-analysis (P < 0.01, Hedges g: - 1.47, 95% confidence interval [CI] - 2.48 to - 0.46, I: 99.12%, 17 studies). Additionally, there was no significant difference in GSH levels between Plasmodium falciparum malaria and P. vivax malaria (P = 0.80, Hedges g: 0.11, 95% CI - 0.76 to 0.98, I: 93.23%, three studies). Similarly, no significant variation was observed between symptomatic and asymptomatic malaria cases (P = 0.78, Hedges g: 0.06, 95% CI - 0.34 to 0.46, I: 48.07%, two studies). In conclusion, although GSH levels appear to be generally lower in malaria patients, further detailed studies are necessary to fully elucidate this complex relationship.
Topics: Humans; Malaria, Vivax; Plasmodium falciparum; Glutathione; Plasmodium vivax; Malaria, Falciparum; Malaria
PubMed: 37777547
DOI: 10.1038/s41598-023-43583-z -
International Journal of Infectious... Jun 2024Crusted scabies (CS, Norwegian scabies) is a severe form of scabies, characterized by hyper-infestation of Sarcoptes scabiei mites. CS is commonly associated with... (Review)
Review
OBJECTIVES
Crusted scabies (CS, Norwegian scabies) is a severe form of scabies, characterized by hyper-infestation of Sarcoptes scabiei mites. CS is commonly associated with immunosuppression but is also reported in overtly immunocompetent individuals. We reviewed immunosuppressive risk factors and comorbidities associated with CS.
METHODS
The National Library of Medicine (PubMed) database was reviewed for patient case reports of CS from January 1998 to July 2023. Two authors screened records for eligibility, extracted data, and one critically appraised the quality of the studies.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42023466126.
RESULTS
A total of 436 records were identified, of which 204 were included for systematic review. From these, 683 CS patients were included. CS impacted both genders equally. Adults (21-59 years) were more commonly affected (45.5%) compared to children (0-20 years, 21%). Corticosteroid use was the most prevalent immunosuppressive risk factor identified (27.7% of all cases). About 10.2% of reports were associated with HIV/AIDS, and 8.5% with HTLV-1 infection. 10.5% of patients were overtly immunocompetent with no known risk factors. Overall, 41 (6.0%) died, many subsequent to secondary bacteremia.
CONCLUSION
This study represents the first systematic review undertaken on immunosuppressive risk factors associated with CS. This provides insights into trends of immunosuppression and mechanisms of CS development.
Topics: Scabies; Humans; Risk Factors; Comorbidity; Female; Male; Adult; Immunocompromised Host; Middle Aged; Young Adult; Adolescent; Child; Animals; Infant; Sarcoptes scabiei; HIV Infections; Child, Preschool; HTLV-I Infections; Immunosuppression Therapy; Infant, Newborn
PubMed: 38570134
DOI: 10.1016/j.ijid.2024.107036 -
Seizure Aug 2023To document epilepsy-related mortality in sub-Saharan Africa (SSA) and investigate possible associations with onchocerciasis endemicity. (Meta-Analysis)
Meta-Analysis
PURPOSE
To document epilepsy-related mortality in sub-Saharan Africa (SSA) and investigate possible associations with onchocerciasis endemicity.
METHODS
Systematic review with meta-analysis. Searches were performed in PubMed and Google Scholar (search terms: 'epilepsy'; 'mortality/death'; 'sub-Saharan Africa'). Included studies were classified as high-risk or low-risk for onchocerciasis based on documented endemicity data. Pooled mortality rates and annual case fatality rates (CFR) were calculated, and risk factors for mortality among persons with epilepsy (PWE) were investigated using meta-regression analysis.
RESULTS
The 28 eligible studies reported 30 epilepsy surveys, of which 9 (30.0%) were conducted in onchocerciasis high-risk sites. The pooled epilepsy mortality rate was 20.9 (95% CI: 5.9-74.4) per 100,000 person-years, and the pooled CFR was 36.2 (95% CI: 23.9-54.4) per 1,000 PWE per year, albeit with substantial between-study heterogeneity. Compared to onchocerciasis low-risk sites, high-risk sites had higher pooled mortality (342.9 versus 10.0 per 100,000 PY; p<0.001) and CFR (57.0 versus 26.6 per 1,000 PWE per year; p = 0.001). Mortality of PWE was almost five-fold that of people without epilepsy (mortality risk ratio: 4.9; 95% CI: 3.5-6.8). Studies in onchocerciasis high-risk sites and the study which recruited only PWE with nodding syndrome were associated with higher CFR (p = 0.044 and p = 0.002, respectively). The leading causes of epilepsy-related death were status epilepticus (58.5%), drowning (15.7%), and sudden unexpected death in epilepsy (10.1%).
CONCLUSION
Epilepsy mortality remains high in SSA. Most reported causes of death among PWE might be averted by improving seizure control. Better epilepsy prevention and care are urgently needed, particularly in onchocerciasis-endemic settings.
Topics: Humans; Onchocerciasis; Epilepsy; Seizures; Status Epilepticus; Africa South of the Sahara; Prevalence
PubMed: 37451075
DOI: 10.1016/j.seizure.2023.07.006 -
PLoS Neglected Tropical Diseases May 2024Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital transmission and serious fetal and neonatal complications. This systematic review and meta-analysis aimed to assess the pooled seroprevalence of T. gondii infection and its determinants among pregnant women in African countries.
METHODS
All articles reporting the seroprevalence of toxoplasmosis among pregnant women in African countries and published from 2010 to 2023 were searched using various databases. The pooled prevalence of toxoplasmosis was calculated using a random-effect model. The variation between the included studies was assessed using a funnel plot and I2 heterogeneity statistics. To identify the sources of heterogeneity, sub-group analysis was further conducted by country, diagnostic method, and sub-African region. The association of prevalence rates with the socio-economic level and geoclimatic parameters was also explored.
RESULTS
In total, 29,383 pregnant women from 60 articles were included for analysis. The pooled T. gondii seroprevalence was 42.89% with high heterogeneity (I2 = 99.4%, P < 0.001). Sub-group analysis revealed variation by country (ranging from 2.62% in Namibia to 80.28% in Congo), diagnostic method used (from 8.66% in studies using a rapid diagnostic test to 55.69% in those using an agglutination test), and sub-African region (from 4.14% in regions of Southern Africa to 53.96 in Central Africa). Cat ownership (OR = 1.58) and the consumption of raw meat (OR = 1.50) and raw vegetables (OR = 1.48) had a statistically significant combined effect on T. gondii seroprevalence. No association was found between T. gondii prevalence and the level of income of the country or geoclimatic parameters.
CONCLUSION
The prevalence of toxoplasmosis infection among pregnant women in Africa is high, particularly in Central and Eastern Africa. The determinants of prevalence are multifactorial. Therefore, efforts should be made to increase the awareness of women concerning the risk factors for toxoplasmosis.
Topics: Humans; Female; Seroepidemiologic Studies; Pregnancy; Toxoplasmosis; Toxoplasma; Africa; Pregnancy Complications, Parasitic; Antibodies, Protozoan; Animals; Prevalence; Pregnant Women
PubMed: 38781272
DOI: 10.1371/journal.pntd.0012198 -
Veterinary Medicine and Science Jul 2024Eimeria is a protozoan parasite that affects poultry, particularly chickens, causing a disease known as coccidiosis. This disease imposes substantial significant... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Eimeria is a protozoan parasite that affects poultry, particularly chickens, causing a disease known as coccidiosis. This disease imposes substantial significant economic challenges to the poultry sector.
OBJECTIVES
The current study aimed to estimate the global prevalence and associated risk factors of Eimeria in domestic chickens.
METHODS
Multiple databases (Scopus, PubMed, ProQuest, Web of Science and Google Scholar) were searched for articles published until June 2023. The pooled prevalence was estimated using a random-effects model with a 95% confidence interval. The statistical analysis was conducted using meta packages in R version (3.6.1).
RESULTS
In total, 41 articles fulfilled the eligibility criteria. The global pooled prevalence was 44.3% (36.9%-51.8%) with Eimeria tenella (38.7%, 30.1%-47.7%) as the most prevalent species. The highest pooled prevalence was related to the Western Pacific Region (80.5%, 72.6%-87.3%) and urban areas (44.4%, 36.5%-52.6%). Moreover, areas with humid subtropical climates represent the highest overall prevalence (75.8%, 46.6%-95.9%).
CONCLUSION
The necessity for robust and innovative strategies for preventing and managing this disease cannot be overstated. Addressing Eimeria impact is crucial not only for safeguarding poultry health but also for sustaining the economic viability of the poultry industry.
Topics: Animals; Chickens; Coccidiosis; Eimeria; Poultry Diseases; Prevalence; Risk Factors
PubMed: 38814576
DOI: 10.1002/vms3.1469