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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 -
Journal of Global Health Dec 2020The World Health Organisation (WHO) estimates that hypertensive disorders of pregnancy (HDP) contribute 14% to global maternal mortality. HDP encompasses several... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The World Health Organisation (WHO) estimates that hypertensive disorders of pregnancy (HDP) contribute 14% to global maternal mortality. HDP encompasses several subcategories, including gestational hypertension (GH) and pre-eclampsia. These two conditions are both characterised by a rise in blood pressure, with an onset from 20 weeks of gestation. They also share some common risk factors. The current definition of pre-eclampsia includes raised blood pressure in the absence of proteinuria, thus presenting the two conditions as a spectrum. In this article, we refer to both conditions as gestational hypertension, which is our outcome of interest. The aetiology of GH is not yet clearly understood. Observational studies have suggested that malaria may be associated with GH. However, the evidence from these small studies has been inconclusive. Having a better understanding of the association between malaria and GH may help inform prevention strategies to reduce maternal and infant mortality and morbidity.
METHODS
In assessing the association between malaria infection and GH we explored open access articles published in the English language on Medline, Embase, WHO GIM and Google scholar. The subject related articles were retrieved and processed according to preferred reporting items in systematic reviews and meta-analyses (PRISMA) guidelines. Search date was 9th week of 2018. Inverse variance weighting method in Revman 5 software (Cochrane Collaboration, London, United Kingdom) was used to aggregate evidence by computing the pooled odds ratio to show the nature and strength of the relationship between malaria and GH.
RESULTS
Using critical appraisal skills program (CASP) checklist tool we identified four good quality case-control studies. The total sample size was 1281 women out of which 518 were cases. These studies together show malaria is associated with GH with an overall odds ratio of 2.67, 95% confidence interval (CI) = 1.58-4.53. Heterogeneity of the individual studies supported fixed effect modelling assumptions (I = 0%). Malaria infection may have a constant effect on GH across different African populations. The funnel plot did not suggest publication bias however, the four studies involved in the meta-analysis were insufficient to rule it out.
CONCLUSIONS
Our findings provide evidence of an association between malaria infection and gestational hypertension; this underscores the need to control malaria especially during pregnancy.
Topics: Africa; Female; Humans; Hypertension, Pregnancy-Induced; Malaria; Pregnancy
PubMed: 33110577
DOI: 10.7189/jogh.10.020417 -
BioMed Research International 2020is an intestinal parasitic infection mainly caused by . Although it is a predominant parasite in tropics and subtropics where sanitation and hygiene are poorly... (Meta-Analysis)
Meta-Analysis
BACKGROUND
is an intestinal parasitic infection mainly caused by . Although it is a predominant parasite in tropics and subtropics where sanitation and hygiene are poorly practiced, the true prevalence of s is not known due to low-sensitivity diagnostic methods.
OBJECTIVE
This systematic review and meta-analysis is aimed at determining the pooled prevalence of s in African countries, stratified by diagnostic methods, study settings, and patients.
METHODS
Cross-sectional studies on strongyloidiasis published in African countries from the year 2008 up to 2018 in PubMed and Google Scholar databases and which reported at least one spp. infection were included. Identification and screening of eligible articles were also done. Articles whose focus was on in animals, soil, and foreigners infected by spp. in Africa were excluded. The random effects model was used to calculate the pooled prevalence of s across African countries as well as by diagnostic methods and study settings. The heterogeneity between studies was also computed.
RESULT
A total of 82 studies were included. The overall pooled prevalence of s was 2.7%. By individual techniques, the pooled prevalence of strongyloidiasis was 0.4%, 1.0%, 3.4%, 9.3%, 9.6%, and 19.4% by the respective direct saline microscopy, Kato-Katz, formol ether concentration, polymerase chain reaction, Baermann concentration, and culture diagnostic techniques. The prevalence rates of strongyloidiasis among rural community, school, and health institution studies were 6.8%, 6.4%, and 0.9%, respectively. The variation on the effect size comparing African countries, diagnostic methods, study settings, and patients was significant ( ≤ 0.001).
CONCLUSIONS
This review shows that strongyloidiasis is overlooked and its prevalence is estimated to be low in Africa due to the use of diagnostic methods with low sensitivity. Therefore, there is a need for using a combination of appropriate diagnostic methods to approach the actual rates in Africa.
Topics: Africa; Diagnostic Techniques and Procedures; Humans; Prevalence; Publications; Strongyloidiasis
PubMed: 33274200
DOI: 10.1155/2020/2868564 -
Parasites & Vectors Sep 2021Little information is available about malaria and scrub typhus co-infection. This study aimed to investigate the pooled prevalence of malaria and scrub typhus... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Little information is available about malaria and scrub typhus co-infection. This study aimed to investigate the pooled prevalence of malaria and scrub typhus co-infection in febrile patients. Further, it aimed to estimate the prevalence of scrub typhus infection among patients with malaria and the odds of co-infection. This will aid the diagnosis and management of co-infected patients in endemic areas.
METHODS
We searched for relevant studies in three databases: PubMed, Scopus, and Web of Science. We assessed the quality of the included studies using the Joanna Briggs Institute checklist for analytical cross-sectional studies. We estimated (1) the pooled prevalence of malaria and scrub typhus co-infection, (2) the pooled prevalence of scrub typhus infection in malaria-positive patients, and (3) the pooled odds of co-infection using the DerSimonian-Laird method for random-effects models. The study results and summary estimates were visualized on a forest plot as point estimates (effect size, prevalence) and 95% confidence intervals (CI). We assessed the heterogeneity of the studies by Cochrane Q or I statistics. We performed subgroup analyses of countries and scrub typhus diagnostic tests to explore the sources of heterogeneity of the included studies. We assessed publication bias if more than 10 studies were used to estimate the outcome. All data analyses were conducted using Stata version 14 (StataCorp, College Station, TX, USA).
RESULTS
Of the 542 studies retrieved from three databases, we included 14 meeting the inclusion criteria in the systematic review and meta-analysis. The pooled prevalence of malaria and scrub typhus co-infection (56 cases) among febrile patients (7920 cases) was 1% (95% CI: 0-1%, I: 78.28%), while the pooled prevalence of scrub typhus infection (321 cases) in patients with malaria (1418 cases) was 21% (95% CI: 12-30%, I: 98.15%). Subgroup analysis showed that the pooled prevalence of scrub typhus infection among patients with malaria in India was 8% (95% CI: 4-13%, I: 85.87%, nine studies with 59/794 cases), while the pooled prevalence of scrub typhus infection among patients with malaria in Thailand was 35% (95% CI: 7-64%, I: 98.9%, four studies with 262/624 cases). The co-infections did not occur by chance (P = 0.013, odds: 0.43, 95% CI: 0.22-0.84%, I: 60.9%). In the sensitivity analysis, the pooled prevalence of malaria and scrub typhus co-infection among febrile patients was 0% (95% CI: 0-1%, I: 59.91%).
CONCLUSIONS
The present study showed the pooled prevalence and a significant association between malaria and scrub typhus. The results show the status of co-infection. Further research into co-infection in endemic areas is needed, in particular, to determine whether co-infection can accelerate disease progression or protect against severe disease.
Topics: Coinfection; Cross-Sectional Studies; Fever; Humans; India; Malaria; Prevalence; Scrub Typhus; Thailand
PubMed: 34521454
DOI: 10.1186/s13071-021-04969-y -
PLoS Neglected Tropical Diseases Oct 2022Zoonoses can cause a substantial burden on both human and animal health. Globally, estimates of the dual (human and animal) burden of zoonoses are scarce. Therefore,...
BACKGROUND
Zoonoses can cause a substantial burden on both human and animal health. Globally, estimates of the dual (human and animal) burden of zoonoses are scarce. Therefore, this study aims to quantify the dual burden of zoonoses using a comparable metric, "zoonosis Disability Adjusted Life Years" (zDALY).
METHODOLOGY
We systematically reviewed studies that quantify in the same article zoonoses in animals, through monetary losses, and in humans in terms of Disability Adjusted Life Years (DALYs). We searched EMBASE, Web of Science, Scopus, PubMed, and Google Scholar. We excluded articles that did not provide the data to estimate the zDALY or those for which full text was not available. This study was registered at PROSPERO, CRD42022313081.
PRINCIPAL FINDINGS/SIGNIFICANCE
We identified 512 potentially eligible records. After deduplication and screening of the title and abstract, 23 records were assessed for full-text review. Fourteen studies were included in this systematic review. The data contains estimates from 10 countries, a study at continental level (Asia and Africa), and 2 studies on a global scale. Rabies was the most frequently reported zoonosis where zDALYs were calculated, based on the following included studies: for Kazakhstan 457 (95% CI 342-597), Viet Nam 5316 (95% CI 4382-6244), Asia 1,145,287 (90% CI 388,592-1,902,310), Africa 837,158 (90% CI 283,087-1,388,963), and worldwide rabies 5,920,014 (95% CI 1,547,860-10,290,815). This was followed by echinococcosis, the zDALYs in Peru were 2238 (95% CI 1931-2546), in China 1490 (95% CI 1442-1537), and worldwide cystic echinococcosis 5,935,463 (95% CI 4,497,316-7,377,636). Then, the zDALYs on cysticercosis for Mozambique were 2075 (95% CI 1476-2809), Cameroon 59,540 (95% CR 16,896-101,803), and Tanzania 34,455 (95% CI 12,993-76,193). Brucellosis in Kazakhstan were 2443 zDALYs (95% CI 2391-2496), and brucellosis and anthrax in Turkey 3538 zDALYs (95% CI 2567-6706). Finally, zDALYs on leptospirosis in New Zealand were 196, and Q fever in Netherlands 2843 (95% CI 1071-4603). The animal burden was superior to the human burden in the following studies: worldwide cystic echinococcosis (83%), brucellosis in Kazakhstan (71%), leptospirosis in New Zealand (91%), and brucellosis, and anthrax in Turkey (52%). Countries priorities on zoonoses can change if animal populations are taken into consideration.
Topics: Animals; Humans; Rabies; Anthrax; Zoonoses; Brucellosis; Echinococcosis; Leptospirosis; Tanzania
PubMed: 36240240
DOI: 10.1371/journal.pntd.0010540 -
PloS One 2021Fascioliasis is a globally distributed, parasitic zoonosis, caused by Fasciola hepatica and F. gigantica. A comprehensive overview of the epidemiology of human...
Fascioliasis is a globally distributed, parasitic zoonosis, caused by Fasciola hepatica and F. gigantica. A comprehensive overview of the epidemiology of human fascioliasis in Africa is missing up to now. Therefore, our objective was to conduct a systematic review aiming to summarize recent knowledge on the distribution, prevalence, and risk factors of human fascioliasis in Africa. A key word search was performed in PubMed, Web of Science and Africa Wide, to gather relevant literature, published between the 1st of January 2000 and 31st of December 2020. A total of 472 records were initially retrieved, with 40 full text articles retained for the qualitative synthesis. Human fascioliasis was reported in 12 African countries, namely Algeria, Angola, Cape Verde, Egypt, Ethiopia, Ghana, Morocco, Nigeria, Senegal, South-Africa, Tanzania and Tunisia. The majority of the studies was conducted in Egypt. A total of 28 records were population surveys. Coproscopy was the most commonly used tool for fascioliasis diagnosis in these surveys. Gender (being female), consumption of raw vegetables/seeds, age, owning livestock, and use of unsafe drinking water sources, were identified as risk factors in 7 studies. Furthermore, 43 case reports were retrieved, described in 12 studies. Eosinophilia was present in 39 of these cases, while 11 had positive coproscopy results. Eight cases described having eaten raw wild vegetables. Overall, the low number and quality of records retrieved indicates that human fascioliasis remains a truly neglected disease in Africa, and more epidemiological studies are urgently needed to both establish the actual distribution as well as risk factors on the continent.
Topics: Africa; Animals; Fasciola; Fascioliasis; Humans
PubMed: 34882738
DOI: 10.1371/journal.pone.0261166 -
Parasitology Oct 2021Bovines, especially cattle, are considered as one of the main sources of Toxoplasma gondii infection for humans. A more comprehensive understanding of the occurrence of... (Meta-Analysis)
Meta-Analysis Review
Bovines, especially cattle, are considered as one of the main sources of Toxoplasma gondii infection for humans. A more comprehensive understanding of the occurrence of T. gondii is needed to provide a global perspective on the prevalence of T. gondii in bovines. Here, we present the results of the first systematic review and meta-analysis on the global T. gondii seroprevalence in bovines. Six databases (PubMed, ScienceDirect, Web of Science, Scopus, ProQuest and Google Scholar) were comprehensively searched for relevant studies published between 1 January 1967 and 30 May 2019. Among 7691 publications searched, 178 studies (from 50 countries) with 193 datasets were included in the meta-analysis. The global pooled and weighted seroprevalence of T. gondii among bovines was 17.91% [95% confidence interval (CI): 15.32–20.6]. Weighted prevalence based on the host was as follows: cattle 16.94% (95% CI: 14.25–19.81), buffalo 22.26% (95% CI: 16.8–29), yak 23% (95% CI: 14–33) and bison 8.1% (95% CI: 3.9–13.7). Continued monitoring on the status of T. gondii seroprevalence in bovines is essential. Study on the prevalence of T. gondii in the products of bovines such as milk, meat, etc., which are considered as the source of transmission of infection to humans, is recommended.
Topics: Animals; Bison; Cattle; Meat; Prevalence; Seroepidemiologic Studies; Toxoplasmosis
PubMed: 34187606
DOI: 10.1017/S0031182021001116 -
Veterinary Medicine and Science Jan 2023Toxoplasma gondii (T. gondii) is a zoonotic parasite that can be transmitted from animals to humans, with felids acting as its definitive host. Thus, understanding the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxoplasma gondii (T. gondii) is a zoonotic parasite that can be transmitted from animals to humans, with felids acting as its definitive host. Thus, understanding the epidemiology of this parasite in animal populations is vital to controlling its transmission to humans as well as to other animal groups.
OBJECTIVES
This systematic review and meta-analysis aims to summarise and analyse reports of T. gondii infection in animal species residing in the Arabian Peninsula.
METHODS
It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with relevant studies being retrieved from MEDLINE/PubMed, Scopus, Cochrane Library, Google Scholar and ScienceDirect. All articles published in Arabic or English languages between January 2000 and December 2020 were screened for eligibility. Random effects model was used to calculate the pooled prevalence of T. gondii infection in different animal populations which were found to harbour this infection. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies.
RESULTS
A total of 15 studies were retrieved, reporting prevalence estimates from 4 countries in this region and in 13 animal species. Quantitative meta-analysis estimated a pooled prevalence of 43% in felids [95% confidence interval (CI) = 23-64%, I index = 100%], 48% in sheep (95% CI = 27-70%, I = 99%) and 21% in camels (95% CI = 7-35%, I = 99%). Evidence of possible publication bias was found in both felids and sheep.
CONCLUSIONS
This meta-analysis estimates a high prevalence of T. gondii infection in animal species which are of high economic and cultural importance to countries of this region. Hence, these findings provide valuable insight to public health authorities as well as economic and animal resources advisors in countries of the Arabian Peninsula.
Topics: Humans; Animals; Sheep; Prevalence; Toxoplasma; Camelus; Toxoplasmosis; Sheep Diseases
PubMed: 36408778
DOI: 10.1002/vms3.1004 -
PLoS Neglected Tropical Diseases Feb 2021Schistosomiasis is a parasitic disease caused by trematode worms of the genus Schistosoma and belongs to the neglected tropical diseases. The disease has been reported...
BACKGROUND
Schistosomiasis is a parasitic disease caused by trematode worms of the genus Schistosoma and belongs to the neglected tropical diseases. The disease has been reported in 78 countries, with around 290.8 million people in need of treatment in 2018. Schistosomiasis is predominantly considered a rural disease with a subsequent focus of research and control activities in rural settings. Over the past decades, occurrence and even expansion of schistosomiasis foci in peri-urban and urban settings have increasingly been observed. Rural-urban migration in low- and middle-income countries and subsequent rapid and unplanned urbanization are thought to explain these observations. Fifty-five percent (55%) of the world population is already estimated to live in urban areas, with a projected increase to 68% by 2050. In light of rapid urbanization and the efforts to control morbidity and ultimately achieve elimination of schistosomiasis, it is important to deepen our understanding of the occurrence, prevalence, and transmission of schistosomiasis in urban and peri-urban settings. A systematic literature review looking at urban and peri-urban schistosomiasis was therefore carried out as a first step to address the research and mapping gap.
METHODOLOGY
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic computer-aided literature review was carried out using PubMed, ScienceDirect, and the World Health Organization Database in November 2019, which was updated in March 2020. Only papers for which at least the abstract was available in English were used. Relevant publications were screened, duplicates were removed, guidelines for eligibility were applied, and eligible studies were reviewed. Studies looking at human Schistosoma infections, prevalence, and intensity of infection in urban and peri-urban settings were included as well as those focusing on the intermediate host snails.
PRINCIPAL FINDINGS
A total of 248 publications met the inclusion criteria. The selected studies confirm that schistosomiasis is prevalent in peri-urban and urban areas in the countries assessed. Earlier studies report higher prevalence levels in urban settings compared to data extracted from more recent publications, yet the challenge of migration, rapid uncontrolled urbanization, and resulting poor living conditions highlight the potential for continuous or even newly established transmission to take place.
CONCLUSIONS
The review indicates that schistosomiasis has long existed in urban and peri-urban areas and remains a public health problem. There is, however, a challenge of comparability of settings due to the lack of a clear definition of what constitutes urban and peri-urban. There is a pressing need for improved monitoring of schistosomiasis in urban communities and consideration of treatment strategies.
Topics: Animals; Humans; Schistosoma; Schistosomiasis; Snails; Suburban Population; Urban Population
PubMed: 33630833
DOI: 10.1371/journal.pntd.0008995 -
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