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Journal of Infection and Public Health Dec 2022Occult hepatitis B (OBI) and C (OCI) infections lead to hepatic crises including cases of liver cirrhosis and even hepatocellular carcinoma (HCC). OBI and OCI also pose... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Occult hepatitis B (OBI) and C (OCI) infections lead to hepatic crises including cases of liver cirrhosis and even hepatocellular carcinoma (HCC). OBI and OCI also pose a significant problem of their transmissibility. This study aimed to assess the overall prevalence of OBI and OCI in the African continent, a region highly endemic for classical hepatitis B and C viruses.
METHODS
For this systematic review and meta-analysis, we searched: PubMed, Web of Science, African Journal Online and African Index Medicus for published studies on the prevalence of OBI and OCI in Africa. Study selection and data extraction were performed by at least two independent investigators. Heterogeneity (I²) was assessed using the χ² test on the Cochran Q statistic and H parameters. Sources of heterogeneity were explored by subgroup analyses. This study was registered in PROSPERO, with reference number CRD42021252772.
RESULTS
We obtained 157 prevalence data for this meta-analysis, from 134 studies for OBI prevalence; 23 studies on OCI prevalence, and a single study on the OBI case fatality rate. The overall estimate for the prevalence of OBI was 14.8% [95% CI = 12.2-17.7] among 18579 participants. The prevalence of seronegative OBI and seropositive OBI was 7.4% [95% CI = 3.8-11.8] and 20.0% [95% CI = 15.3-25.1] respectively. The overall estimate for the prevalence of OCI was 10.7% [95% CI = 6.6-15.4] among 2865 participants. The pooled prevalence of seronegative OCI was estimated at 10.7% [95%CI = 4.8-18.3] and that of seropositive OCI at 14.4% [95%CI = 5.2-22.1]. In Sub-group analysis, patients with malignancies, chronic hepatitis C, and hemodialysis had a higher OCI prevalence. While those with malignancies, liver disorders, and HIV positive registered highest OBI prevalence.
CONCLUSION
This review shows a high prevalence of OBI and OCI in Africa, with variable prevalence between countries and population groups.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Hepatitis B; Liver Cirrhosis; Africa
PubMed: 36395668
DOI: 10.1016/j.jiph.2022.11.008 -
Egg reappearance periods of anthelmintics against equine cyathostomins: The state of play revisited.International Journal For Parasitology.... Apr 2023Cyathostomins are the most common and highly prevalent parasites of horses worldwide. Historically, the control of cyathostomins has mainly relied on the routine use of... (Review)
Review
Cyathostomins are the most common and highly prevalent parasites of horses worldwide. Historically, the control of cyathostomins has mainly relied on the routine use of anthelmintic products. Increasing reports on anthelmintic resistance (AR) in cyathostomins are concerning. A potential method proposed for detecting emerging AR in cyathostomins has been estimating the egg reappearance period (ERP). This paper reviews the data available for the ERP of cyathostomins against the three major classes of anthelmintics, macrocyclic lactones, tetrahydropyrimidines, and benzimidazoles. Published peer-reviewed original research articles were obtained from three databases (PubMed, CAB Direct and Web of Science) and were evaluated for their inclusion in a systematic review. Subsets of articles were then subjected to a review of ERP data. A total of 54 (of 134) studies published between 1972 and 2022 met the criteria for inclusion in the systematic review. Until the beginning of 2022, there was no agreed definition of the ERP; eight definitions of ERP were identified in the literature, complicating the comparison between studies. Additionally, potential risk factors for the shortening of the ERP, including previous anthelmintic use and climate, were frequently not described. Reports of shortened ERP for moxidectin and ivermectin are frequent: 20 studies that used comparable ERP definitions reported shortened moxidectin and ivermectin ERPs of 35 and 28 days, respectively. It is unclear whether the ERPs of these anthelmintics reduced to such levels are due to the development of AR or some biological factors related to horses, cyathostomin species, and/or the environment. The ERPs for other anthelmintics, such as fenbendazole and pyrantel, were frequently not reported due to established resistance against these drugs. Future research in horses is required to understand the mechanism(s) behind the shortening of ERP for cyathostomins. Based on this systematic review, we propose recommendations for future ERP studies.
Topics: Animals; Horses; Ivermectin; Horse Diseases; Drug Resistance; Anthelmintics; Parasite Egg Count; Feces
PubMed: 36543048
DOI: 10.1016/j.ijpddr.2022.12.002 -
Tropical Medicine & International... Sep 2022Malaria is one of the most important parasitic infectious diseases worldwide. Despite the scale-up of effective antimalarials, mortality rates from severe malaria (SM)... (Review)
Review
OBJECTIVES
Malaria is one of the most important parasitic infectious diseases worldwide. Despite the scale-up of effective antimalarials, mortality rates from severe malaria (SM) remain significantly high; thus, numerous trials are investigating both antimalarials and adjunctive therapy. This review aimed to summarise all the outcome measures used in trials in the last 10 years to see the need for a core outcome set.
METHODS
A systematic review was undertaken to summarise outcomes of individually randomised trials assessing treatments for SM in adults and children. We searched key databases and trial registries between 1 January 2010 and 30 July 2020. Non-randomised trials were excluded to allow comparison of similar trials. Trial characteristics including phase, region, population, interventions, were summarised. All primary and secondary outcomes were extracted and categorised using a taxonomy table.
RESULTS
Twenty-seven of 282 screened trials met our inclusion criteria, including 10,342 patients from 19 countries: 19 (70%) trials from Africa and 8 (30%) from Asia. A large amount of heterogeneity was observed in the selection of outcomes and instruments, with 101 different outcomes measures recorded, 78/101 reported only in a single trial. Parasitological outcomes (17 studies), neurological status (14 studies), death (14 studies) and temperature (10 studies), were the most reported outcomes. Where an outcome was reported in >1 study it was often measured differently: temperature (4 different measures), renal function (7 measures), nervous system (13 measures) and parasitology (10 measures).
CONCLUSION
Outcomes used in SM trials are inconsistent and heterogeneous. Absence of consensus for outcome measures used impedes research synthesis and comparability of different interventions. This systematic review demonstrates the need to develop a standardised collection of core outcomes for clinical trials of treatments for SM and next steps to include the development of a panel of experts in the field, a Delphi process, and a consensus meeting.
Topics: Adult; Africa; Antimalarials; Child; Consensus; Humans; Malaria; Outcome Assessment, Health Care
PubMed: 35916146
DOI: 10.1111/tmi.13803 -
Parasites & Vectors Jun 2022Blastocystis is a common intestinal protozoa found in animal and human fecal samples, with over 1 billion individuals infected worldwide. Since domestication, dogs and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Blastocystis is a common intestinal protozoa found in animal and human fecal samples, with over 1 billion individuals infected worldwide. Since domestication, dogs and cats have had a close bond with humans. However, their close proximity poses a potential health risk since they may harbor several zoonotic agents. A global estimate of Blastocystis infection and subtype (ST) distribution in dogs and cats would therefore be of great health importance to humans.
METHODS
We performed a comprehensive systematic search of four English-language databases (PubMed, Scopus, Google Scholar, Web of Science) for relevant articles up to 8 November 2021. The random-effects model was used to make pooled estimates with confidence intervals (CIs).
RESULTS
In total, we identified 49 publications that met our inclusion criteria and subsequently analyzed the 65 datasets in these articles, of which 23 and 42 datasets were on cats and dogs, respectively. Among the 2934 cats included in the 23 datasets, which involved 16 countries, the prevalence rate of Blastocystis infection was 9.3% (95% CI 5.3-15.9%). The prevalence of Blastocystis infection was slightly lower [7%, 95% CI 4.7-10.4%) among the 7946 dogs included in the 42 datasets, involving 23 countries. The sensitivity analysis showed that no remarkable variation in the estimates upon the stepwise removal of each dataset. Higher ST diversity was found among the examined dogs (ST1-8, ST10, ST23, ST24) than among cats (ST1-4, ST10, ST14). Among dogs, ST3 was the most frequent ST (41.3%), followed by ST2 (39.3%), ST1 (30.9%), ST4 (13.4%), ST8 (12.7%), ST10 (11%) and ST5 (8.1%). Also among dogs, each of ST6, ST7, ST23 and ST24 was observed in only one study. Of the ST found in the cats examined, ST4 (29.5%), followed by ST10 (22.5%), ST1 (19.8%) and ST3 (17.6%) were the most common. A single study also reported the presence of both ST2 and ST14 in cats. With respect to zoonotic Blastocystis STs (ST1-ST9 and ST12), eight were reported from dogs (ST1-ST8) and four were isolated from cats (ST1-ST4), showing the implication of dog and cats in zoonotic transmission.
CONCLUSIONS
Taken together, our results show that elucidation of the true epidemiology and ST distribution of Blastocystis in dogs and cats demands more comprehensive studies, particularly in the negelected regions of the world.
Topics: Animals; Blastocystis; Blastocystis Infections; Cat Diseases; Cats; DNA, Protozoan; Dog Diseases; Dogs; Feces; Genetic Variation; Interleukin-1 Receptor-Like 1 Protein; Phylogeny; Prevalence
PubMed: 35733146
DOI: 10.1186/s13071-022-05351-2 -
Current Research in Parasitology &... 2022Ticks are significant ectoparasites of animals and humans. Published data indicate that most vectors that transmit livestock and human pathogens in sub-Saharan Africa,... (Review)
Review
Ticks are significant ectoparasites of animals and humans. Published data indicate that most vectors that transmit livestock and human pathogens in sub-Saharan Africa, are native to the region and originate from wild animals. Currently, there is a paucity of information on the role of wild animals on the epidemiology of zoonotic tick-borne pathogens in South Africa. This systematic review focuses on the distribution of ticks and prevalence of tick-borne pathogens in different wild animals in South Africa to identify potential reservoir hosts and possible hotspots for emergence of novel tick-borne pathogens. Following several screening processes, 38 peer-reviewed studies published from 1970 to 2021, were deemed eligible. The studies reported on ticks collected from 63 host species of 21 host families, mostly Canidae, Felidae, Bovidae and Muridae. A total of 49 tick species of nine genera, i.e. , , , , , , , and , were reported. Nine tick species, i.e. , , , , , , . () , and were the most commonly reported. Pathogens of the genera , , and were identified in the wild animals. This review provides more insight on the ecology of ticks and tick-borne pathogens of wild animals in South Africa and gives useful information for predicting their future spread. It also demonstrates that wild animals habour a diverse range of tick species. This level of diversity entails a similarly high potential for emergence of novel tick-borne pathogens. The review further indicates that wild animals in South Africa are sentinels of tick-borne protozoans of veterinary importance and some bacterial pathogens as most ticks they habour are known vectors of pathogens of domestic animals and humans. However, studies on potential tick-borne zoonoses are under-represented and should be included in future epidemiological surveys, especially in the light of climate change and other anthropogenic threats which might result in the emergence of novel tick-borne pathogens.
PubMed: 35601607
DOI: 10.1016/j.crpvbd.2022.100088 -
Frontiers in Cellular and Infection... 2021This study aims to provide an overview of the prevalence, distribution, and causative agents of fungal keratitis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This study aims to provide an overview of the prevalence, distribution, and causative agents of fungal keratitis.
METHODS
All the articles with data on the prevalence of fungal keratitis among various patient groups from January 1, 1990 to May 27, 2020 were retrieved through a systematic search in PubMed, Scopus, Web of Science, and Google Scholar. Data were extracted, and the pooled estimated prevalence of fungal keratitis, yeast/mold infection, the spectrum and frequency of various causative agents, and the pooled estimated prevalence of mixed infections were calculated in general and in various countries (wherever possible) using meta-analysis.
RESULTS
From 11,235 articles retrieved in the primary search step, 169 met the inclusion criteria. The 169 eligible articles were divided into six groups and analyzed separately. The pooled prevalence of fungal keratitis was variable with values ranging from 0.05% among postkeratoplasty patients to 43.01% among patients with a clinical suspicion of fungal keratitis. There was also a country-dependent variation in the prevalence (Paraguay: 50.1% (95% CI, 35.11, 65.00); Ireland: 1.1% (95% CI, 0.03, 6.04)). Except for postkeratoplasty cases (yeast: 51.80%), in all patient groups, molds were more common than yeasts. Although more than 50 distinct species of fungi have been found to cause fungal keratitis, species followed by species were the most common causes of the disease. In general, 9.29% (95% CI, 6.52, 12.38) of fungal keratitis cases were mixed with bacterial agents.
CONCLUSION
The prevalence of fungal keratitis can vary dramatically depending on the patient groups and geographical origin; however, the dominant causative agents are generally similar.
Topics: Antifungal Agents; Corneal Ulcer; Eye Infections, Fungal; Fungi; Humans; Keratitis; Prevalence
PubMed: 34513726
DOI: 10.3389/fcimb.2021.698780 -
Vector Borne and Zoonotic Diseases... Jul 2020Worldwide, horses play critical roles in recreation, food production, transportation, and as working animals. Horses' roles differ by geographical region and the...
Worldwide, horses play critical roles in recreation, food production, transportation, and as working animals. Horses' roles differ by geographical region and the socioeconomic status of the people, but despite modern advances in transportation, which have in some ways altered humans contact with horses, potential risks for equine zoonotic pathogen transmission to humans occur globally. While previous reports have focused upon individual or groups of equine pathogens, to our knowledge, a systematic review of equine zoonoses has never been performed. Using PRISMA's systematic review guidelines, we searched the English literature and identified 233 previous reports of potential equine zoonoses found in horses. We studied and summarized their findings with a goal of identifying risk factors that favor disease transmission from horses to humans. These previous reports identified 56 zoonotic pathogens that have been found in horses. Of the 233 articles, 13 involved direct transmission to humans (5.6%).The main potential routes of transmission included oral, inhalation, and cutaneous exposures. Pathogens most often manifest in humans through systemic, gastrointestinal, and dermatological signs and symptoms. Furthermore, 16.1% were classified as emerging infectious diseases and thus may be less known to both the equine and human medical community. Sometimes, these infections were severe leading to human and equine death. While case reports of zoonotic infections directly from horses remain low, there is a high potential for underreporting due to lack of knowledge among health professionals. Awareness of these zoonotic pathogens, their disease presentation in horses and humans, and their associated risk factors for cross-species infection are important to public health officials, clinicians, and people with recreational or occupational equid exposure.
Topics: Animals; Bacterial Infections; Horse Diseases; Horses; Parasitic Diseases, Animal; Virus Diseases; Zoonoses
PubMed: 32077811
DOI: 10.1089/vbz.2019.2541 -
Clinical Microbiology and Infection :... Nov 2021The clinical and laboratory characterization of Strongyloides stercoralis infection at diagnosis and after treatment is still poorly defined. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The clinical and laboratory characterization of Strongyloides stercoralis infection at diagnosis and after treatment is still poorly defined.
OBJECTIVES
The primary objective was to describe the pattern and frequency of clinical and laboratory characteristics associated with S. stercoralis infection. The secondary objectives were (a) comparison of characteristics reported in endemic versus non-endemic areas; and (b) the evaluation of the resolution of identified characteristics after treatment.
METHODS
We searched PubMed, EMBASE, LILACS and CENTRAL up to May 2021. Eligible studies were randomized controlled trials (RCTs) for the treatment of S. stercoralis infection and prospective observational studies reporting data on symptoms caused by strongyloidiasis in individuals diagnosed with a highly specific test. Quality assessment was performed to assess the risk of bias. Demographic and clinical data were summarized using descriptive statistics. Meta-analysis was done by pooling the proportion of participants with symptoms with random effects model.
RESULTS
Twenty studies were included: nine RCTs and 13 observational studies. Overall, symptoms were reported in 50.4% cases (95% CI 47.6-53.1), and were more often reported in non-endemic (58.6%, 95% CI 55.0-62.2) than in endemic (35.7%, 95% CI 31.4-39.9) areas. The removal of an article of lower quality did not impact on figures. Frequency of symptoms tended to reduce after treatment. Three studies reported the proportion of participants with eosinophilia before and after treatment: 76.9% of participants (95% CI 73.4-80.4) had eosinophilia at diagnosis, reducing to 27.4% (95% CI 24.0-30.7) after treatment.
CONCLUSIONS
About half of infected people complain at least of one symptom and almost 70% have eosinophilia. The frequency of symptoms and eosinophilia decreased after treatment, though the association with cure is not clearly defined. Providing relief from symptoms and eosinophilia is another reason, in addition to prevention of disseminated disease, for promoting screening and treatment of individuals with strongyloidiasis.
Topics: Animals; Eosinophilia; Humans; Observational Studies as Topic; Randomized Controlled Trials as Topic; Strongyloides stercoralis; Strongyloidiasis
PubMed: 34325063
DOI: 10.1016/j.cmi.2021.07.016 -
Pathogens (Basel, Switzerland) Apr 2023In equine stables and their surroundings, a large number of insects are present that can be a nuisance to their equine hosts. Previous studies about dipterans... (Review)
Review
In equine stables and their surroundings, a large number of insects are present that can be a nuisance to their equine hosts. Previous studies about dipterans transmitting infectious agents to Equidae have largely focused on Nematocera. For the preparation of this systematic review, the existing literature (until February 2022) was systematically screened for various infectious agents transmitted to Equidae via insects of the suborder Brachycera, including Tabanidae, Muscidae, Glossinidae and Hippoboscidae, acting as pests or potential vectors. The PRISMA statement 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews were followed. The two concepts, Brachycera and Equidae, were combined for the search that was carried out in three languages (English, German and French) using four different search engines. In total, 38 articles investigating Brachycera as vectors for viral, bacterial and parasitic infections or as pests of equids were identified. Only 7 of the 14 investigated pathogens in the 38 reports extracted from the literature were shown to be transmitted by Brachycera. This review clearly shows that further studies are needed to investigate the role of Brachycera as vectors for pathogens relevant to equine health.
PubMed: 37111454
DOI: 10.3390/pathogens12040568 -
International Journal For Parasitology.... Apr 2021In Vietnam, fisheries play a key role in the national economy. Helminth infections in fish have a major impact on public health and sustainable fish production. A... (Review)
Review
In Vietnam, fisheries play a key role in the national economy. Helminth infections in fish have a major impact on public health and sustainable fish production. A comprehensive summary of the recent knowledge on fish helminths is important to understand the distribution of parasites in the country, and to design effective control measures. Therefore, a systematic review was conducted, collecting available literature published between January 2004 and October 2020. A total of 108 eligible records were retrieved reporting 268 helminth species, among which are digeneans, monogeneans, cestodes, nematodes and acanthocephalans. Some helminths were identified with zoonotic potential, such as, the heterophyids, opisthorchiids, the nematodes , sp. and spp. and the cestode ; and with highly pathogenic potential, such as, the monogeneans of Capsalidae, Diplectanidae and Gyrodactylidae, the nematodes and Camallanidae, the tapeworm the acanthocephalans and Overall, these studies only covered about nine percent of the more than 2400 fish species occurring in the waters of Vietnam. Considering the expansion of the aquaculture sector as a part of the national economic development strategy, it is important to expand the research to cover the helminth fauna of all fish species, to assess their potential zoonotic and fish health impacts.
PubMed: 33384920
DOI: 10.1016/j.ijppaw.2020.12.001