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Parasites & Vectors Jan 2017Toxoplasmosis is caused by Toxoplasma gondii which can infect all warm-blooded animals. As the most common feline definitive host, cats play a vital role in the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxoplasmosis is caused by Toxoplasma gondii which can infect all warm-blooded animals. As the most common feline definitive host, cats play a vital role in the transmission of T. gondii. However, national estimates of the seroprevalence of T. gondii in cats in mainland China are lacking, and therefore a systematic review and meta-analysis were performed to provide insight into national environmental transmission levels and potential transmission to humans.
METHODS
Studies published up until July 1, 2016, on T. gondii seroprevalence in cats within mainland China were searched for in CNKI, WanFang, CBM, PubMed, Embase and through the reference lists of resulting articles. The seroprevalence with its 95% confidence interval (CI) for each individual study was presented, and then point estimates and their 95% confidence intervals (CIs) of pooled seroprevalence were calculated. Subgroup analyses were performed according to potential risk factors.
RESULTS
A total of 38 eligible studies, published between 1995 to 2016, covering fifteen provinces and municipalities, and involving 7,285 cats, were included. The seroprevalence in cats per study ranged from 3.9 to 79.4% with a median of 20.3%. As substantial heterogeneity existed among studies, a random-effects model was used to estimate the pooled seroprevalence. The value of the point estimate seroprevalence was 24.5% (95% CI: 20.1-29.0). Seroprevalence in stray cats was significantly higher than in pet cats (OR = 3.00, 95% CI: 1.60-5.64). The seroprevalence increased significantly with cat age (P = 0.018) with 17.4% (95% CI: 7.6-27.2) in the group of ≤ 1 year old, 19.5% (95% CI: 12.7-26.3) in the group of ≤ 3 year-old and 31.6% (95% CI: 22.9-40.3) in the group of > 3 year-old.
CONCLUSIONS
The seroprevalence of T. gondii in cats in mainland China was moderate and was associated with cat ownership and age. Due to the increasing prevalence of pet cats in China and the intimate relationship between these cats and humans, this might present a significant exposure risk, particularly for China's large susceptible population. Therefore, further research is needed into the links between cat ownership and human T. gondii infection and how to reduce T. gondii exposure in humans via cat contacts and the environmental contamination with T. gondii oocysts by cats.
Topics: Animals; Antibodies, Protozoan; Cat Diseases; Cats; China; Disease Transmission, Infectious; Humans; Risk Assessment; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis, Animal; Zoonoses
PubMed: 28086987
DOI: 10.1186/s13071-017-1970-6 -
PLoS Neglected Tropical Diseases Jan 2015Sub-microscopic (SM) Plasmodium infections represent transmission reservoirs that could jeopardise malaria elimination goals. A better understanding of the epidemiology... (Review)
Review
BACKGROUND
Sub-microscopic (SM) Plasmodium infections represent transmission reservoirs that could jeopardise malaria elimination goals. A better understanding of the epidemiology of these infections and factors contributing to their occurrence will inform effective elimination strategies. While the epidemiology of SM P. falciparum infections has been documented, that of SM P. vivax infections has not been summarised. The objective of this study is to address this deficiency.
METHODOLOGY/PRINCIPAL FINDINGS
A systematic search of PubMed was conducted, and results of both light microscopy (LM) and polymerase chain reaction (PCR)-based diagnostic tests for P. vivax from 44 cross-sectional surveys or screening studies of clinical malaria suspects were analysed. Analysis revealed that SM P. vivax is prevalent across different geographic areas with varying transmission intensities. On average, the prevalence of SM P. vivax in cross-sectional surveys was 10.9%, constituting 67.0% of all P. vivax infections detected by PCR. The relative proportion of SM P. vivax is significantly higher than that of the sympatric P. falciparum in these settings. A positive relationship exists between PCR and LM P. vivax prevalence, while there is a negative relationship between the proportion of SM P. vivax and the LM prevalence for P. vivax. Amongst clinical malaria suspects, however, SM P. vivax was not identified.
CONCLUSIONS/SIGNIFICANCE
SM P. vivax is prevalent across different geographic areas, particularly areas with relatively low transmission intensity. Diagnostic tools with sensitivity greater than that of LM are required for detecting these infection reservoirs. In contrast, SM P. vivax is not prevalent in clinical malaria suspects, supporting the recommended use of quality LM and rapid diagnostic tests in clinical case management. These findings enable malaria control and elimination programs to estimate the prevalence and proportion of SM P. vivax infections in their settings, and develop appropriate elimination strategies to tackle SM P. vivax to interrupt transmission.
Topics: Global Health; Humans; Malaria, Vivax; Plasmodium vivax; Polymerase Chain Reaction
PubMed: 25569135
DOI: 10.1371/journal.pntd.0003413 -
BMJ Global Health Dec 2023The optimal dosing of primaquine to prevent relapsing malaria in South Asia remains unclear. We investigated the efficacy and safety of different primaquine regimens to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The optimal dosing of primaquine to prevent relapsing malaria in South Asia remains unclear. We investigated the efficacy and safety of different primaquine regimens to prevent relapse.
METHODS
A systematic review identified efficacy studies from South Asia published between 1 January 2000 and 23 August 2021. In a one-stage meta-analysis of available individual patient data, the cumulative risks of recurrence at day 42 and 180 were assessed by primaquine total mg/kg dose and duration. The risk of recurrence by day 180 was also determined in a two-stage meta-analysis. Patients with a >25% drop in haemoglobin to <70 g/L, or an absolute drop of >50 g/L between days 1 and 14 were categorised by daily mg/kg primaquine dose.
RESULTS
In 791 patients from 7 studies in the one-stage meta-analysis, the day 180 cumulative risk of recurrence was 61.1% (95% CI 42.2% to 80.4%; 201 patients; 25 recurrences) after treatment without primaquine, 28.8% (95% CI 8.2% to 74.1%; 398 patients; 4 recurrences) following low total (2 to <5 mg/kg) and 0% (96 patients; 0 recurrences) following high total dose primaquine (≥5 mg/kg). In the subsequent two-stage meta-analysis of nine studies (3529 patients), the pooled proportions of recurrences by day 180 were 12.1% (95% CI 7.7% to 17.2%), 2.3% (95% CI 0.3% to 5.4%) and 0.7% (95% CI 0% to 6.1%), respectively. No patients had a >25% drop in haemoglobin to <70 g/L.
CONCLUSIONS
Primaquine treatment led to a marked decrease in recurrences following low (~3.5 mg/kg) and high (~7 mg/kg) total doses, with no reported severe haemolytic events.
PROSPERO REGISTRATION NUMBER
CRD42022313730.
Topics: Humans; Primaquine; Malaria, Vivax; Antimalarials; Plasmodium vivax; Recurrence; Asia, Southern; Hemoglobins
PubMed: 38123228
DOI: 10.1136/bmjgh-2023-012675 -
Parasitology Research Jan 2015Toxoplasmosis, a cosmopolitan parasitic infection caused by Toxoplasma gondii, is frequently found in meat-producing animals and human beings. This review and... (Meta-Analysis)
Meta-Analysis Review
Toxoplasmosis, a cosmopolitan parasitic infection caused by Toxoplasma gondii, is frequently found in meat-producing animals and human beings. This review and meta-analysis study was performed to evaluate the overall prevalence of T. gondii infection among sheep and goats in Iran. Data were systematically collected from 1977 to 2012 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, IranMedex, and Scientific Information Database (SID). Additionally, abstracts of national scientific congresses and dissertations were included. A total of 34 articles in field of sheep and 18 articles about goat toxoplasmosis, totalizing to the examination of 14,372 sheep and 3,120 goats, reporting prevalence of toxoplasmosis from different regions of Iran fulfilled our eligibility criteria. The overall prevalence rate of toxoplasmosis in Iran was estimated to be 31% (95% confidence interval (CI) = 0.259825 to 0.352382) in sheep and 27% (95% CI = 0.140097 to 0.424782) in goats, respectively. There was no significant difference in infection rate between males and females among sheep (odds ratio (OR) = 1.002, 95% CI = 0.59 to 1.696) and goats (OR = 1.027, 95% CI = 0.685 to 1.541). Analysis revealed that infection rate in sheep over than 1 year old was 2.4 times more than that in less than 1 year old (OR = 2.396, 95% CI = 1.050 to 5.467). This systematic review and meta-analysis study revealed that infection is widespread in Iran. Further studies are required to improve strategies for controlling infection among flocks and consequently in human population.
Topics: Animals; Female; Goat Diseases; Goats; Iran; Male; Prevalence; Sheep; Sheep Diseases; Toxoplasma; Toxoplasmosis, Animal
PubMed: 25378258
DOI: 10.1007/s00436-014-4176-2 -
Preventive Veterinary Medicine Mar 2020Neospora caninum is an apicomplexan parasite with worldwide distribution, which primarily causes disease in dogs and cattle. It has been recognized as an important cause... (Meta-Analysis)
Meta-Analysis
Neospora caninum is an apicomplexan parasite with worldwide distribution, which primarily causes disease in dogs and cattle. It has been recognized as an important cause of epidemic and endemic abortion in cattle around the world. There is no study to demonstrate the country level picture of the disease in Iran and estimate the extent of the problem, quantitatively. Therefore, the aim of the present study was to systematically review the observational studies on bovine neosporosis in Iran and estimate an overall serologic prevalence of the infection in the cattle population. Search for all published reports on N. caninum in Iran was conducted from inception until September 2018. Major English (PubMed, Scopus and Science Direct) and Persian (IranDoc, SID, Iranmedex, and Magiran) electronic database sources were used for this study. After removing duplicated articles, 128 documents remained. Unrelated articles (89) were excluded after primary screening and 39 articles were evaluated for eligibility. Finally, 37 studies from 33 articles were recognized as eligible and were included in the present work. The author screened the studies and extracted the data twice, carefully. Based on the meta-analysis, the overall serologic prevalence of N. caninum in 10,967 cattle with 2619 positive ones was 23.6 % with 95 % CI: 19.8-27.9 %. The random effect model was used for meta-analysis because the Cochran Q value (795.10, df = 36, P < 0.001) and Higgins index (I = 95.47 %) showed statistically significant heterogeneity. In subgroup meta-analysis, abortion status of the animal and geographical location of the study showed significant association with serologic prevalence, while age and breed did not have significant associations. No publication bias was detected, and sensitivity analysis showed stability of the overall estimate after excluding any individual study. It could be concluded that N. caninum is widespread in cattle population in Iran and the time is right to implement national level educational and control programs for it.
Topics: Animals; Cattle; Cattle Diseases; Coccidiosis; Female; Iran; Neospora; Prevalence; Seroepidemiologic Studies
PubMed: 32066027
DOI: 10.1016/j.prevetmed.2020.104913 -
Parasites & Vectors Jun 2016The epidemiology of soil-transmitted helminth (STH) and Plasmodium co-infections need better understanding. The findings of the individual studies are inconclusive. A... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The epidemiology of soil-transmitted helminth (STH) and Plasmodium co-infections need better understanding. The findings of the individual studies are inconclusive. A systematic review was conducted to synthesize evidence on the association of STH infection with the prevalence and density of Plasmodium falciparum infection, and its effect on anaemia among children in sub-Saharan Africa (SSA).
METHODS
Relevant studies published before March 6, 2015 were identified by searching Medline (via Pubmed), Embase, Cochrane Library and CINAHL without any language restriction. Studies on P. falciparum and STH co-infection among children in SSA except for case studies were included in this study. Studies were screened for eligibility and data extracted independently by two authors. The primary outcome assessed was the prevalence of P. falciparum infection and the secondary outcomes included P. falciparum density and prevalence of anaemia. Heterogeneity was assessed using Cochrane Q and Moran's I (2) and publication bias was evaluated using Egger test. A random-effects model was used to estimate the summary odds ratio (OR) and the corresponding 95 % confidence intervals (CI).
RESULTS
Out of 2985 articles screened, 11 articles were included in the systematic review; of these seven were considered in the meta-analysis. Of the 11 studies with 7458 study participants, seven were cross-sectional, one prospective cohort and three were randomized controlled trials. Four studies examined the outcome for hookworms, one for Ascaris lumbricoides and six for pooled (at least one) STH species. Eight studies measured prevalence/incidence of uncomplicated P. falciparum infection, two calculated prevalence of asymptomatic P. falciparum infection, three evaluated P. falciparum density and four considered prevalence of P. falciparum infection related anaemia/mean haemoglobin reduction. The odds of asymptomatic/uncomplicated P. falciparum infection were higher among children infected with STH than those uninfected with intestinal helminths (summary Odds Ratio [OR]: 1.4; 95 % Confidence Interval [CI]: 1.05-1.87; I (2) = 36.8 %). Plasmodium falciparum density tended to be higher among children infected with STH than those uninfected with intestinal helminths. However, STH infection was associated with lower odds of P. falciparum infection related anaemia (summary OR: 0.5; 95 % CI: 0.21-0.78; I (2) = 43.3 %).
CONCLUSIONS
The findings suggest that STH infection may increase susceptibility to asymptomatic/uncomplicated P. falciparum infection but may protect malaria-related anaemia in children. Future studies should investigate the effect of STH infection upon the incidence of severe P. falciparum infection among children in SSA.
Topics: Africa South of the Sahara; Child; Coinfection; Helminthiasis; Humans; Malaria, Falciparum; Plasmodium falciparum; Soil
PubMed: 27306987
DOI: 10.1186/s13071-016-1594-2 -
PLoS Neglected Tropical Diseases Sep 2021Ethiopia is one of the scarce African countries where Plasmodium vivax and P. falciparum co-exist. There has been no attempt to derive a robust prevalence estimate of P.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ethiopia is one of the scarce African countries where Plasmodium vivax and P. falciparum co-exist. There has been no attempt to derive a robust prevalence estimate of P. vivax in the country although a clear understanding of the epidemiology of this parasite is essential for informed decisions. This systematic review and meta-analysis, therefore, is aimed to synthesize the available evidences on the distribution of P. vivax infection by different locations/regions, study years, eco-epidemiological zones, and study settings in Ethiopia.
METHODS
This study was conducted in accordance with Preferred Reposting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Studies conducted and published over the last two decades (2000 to 2020) that reported an estimate of P. vivax prevalence in Ethiopia were included. The Cochrane Q (χ2) and the I2 tests were used to assess heterogeneity, and the funnel plot and Egger's test were used to examine publication bias. A p-value of the χ2 test <0.05 and an I2 value >75% were considered presence of considerable heterogeneity. Random effect models were used to obtain pooled estimate of P. vivax infection prevalence. This study is registered with PROSPERO (International Prospective Register of Systematic Reviews): ID CRD42020201761.
RESULTS
We screened 4,932 records and included 79 studies that enrolled 1,676,659 confirmed malaria cases, from which 548,214 (32.69%) were P. vivax infections and 1,116,581 (66.59%) were due to P. falciparum. The rest were due to mixed infections. The pooled estimate of P. vivax prevalence rate was 8.93% (95% CI: 7.98-9.88%) with significant heterogeneity (I2 = 100%, p<0.0001). Regional differences showed significant effects (p<0.0001, and I2 = 99.4%) on the pooled prevalence of P. vivax, while study years (before and after the scaling up of interventional activities) did not show significant differences (p = 0.9, I2 = 0%). Eco-epidemiological zones considered in the analysis did show a significant statistical effect (p<0.001, I2 = 78.5%) on the overall pooled estimate prevalence. Also, the study setting showed significant differences (p = 0.001, and I2 = 90.3%) on the overall prevalence, where significant reduction of P. vivax prevalence (4.67%, 95%CI: 1.41-7.93%, p<0.0001) was observed in studies conducted at the community level. The studies included in the review demonstrated lack of publication bias qualitatively (symmetrical funnel plot) and quantitatively [Egger's test (coefficient) = -2.97, 95% CI: -15.06-9.13, p = 0.62].
CONCLUSION
The estimated prevalence of P. vivax malaria in Ethiopia was 8.93% with P. vivax prevailing in the central west region of Ethiopia, but steadily extending to the western part of the country. Its distribution across the nation varies according to geographical location, study setting and study years.
Topics: Ethiopia; Humans; Malaria, Vivax; Plasmodium vivax
PubMed: 34525091
DOI: 10.1371/journal.pntd.0009781 -
Malaria Journal Jan 2021Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available...
BACKGROUND
Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included.
METHODS
Medical records from a tertiary care centre in the Western Brazilian Amazon (2009-2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted.
RESULTS
A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%.
CONCLUSION
Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.
Topics: Adolescent; Adult; Aged; Brazil; Child; Coinfection; Female; HIV Infections; HIV-1; Humans; Incidence; Malaria, Vivax; Male; Middle Aged; Plasmodium vivax; Prevalence; Young Adult
PubMed: 33407474
DOI: 10.1186/s12936-020-03518-9 -
Zoonoses and Public Health May 2021The objective of this systematic review and meta-analysis was to summarize the available knowledge on the seroprevalence of T. gondii in roe deer (Capreolus capreolus)... (Meta-Analysis)
Meta-Analysis
The objective of this systematic review and meta-analysis was to summarize the available knowledge on the seroprevalence of T. gondii in roe deer (Capreolus capreolus) and red deer (Cervus elaphus) in Europe. A computerized literature search of electronic databases (PubMed and CAB abstracts) was performed along with hand searches of library resources for relevant papers, books, abstracts and conference proceedings. A random-effect model was employed to calculate pooled seroprevalence estimates with 95% confidence intervals, and I statistic was used to assess heterogeneity. Further, moderator analysis was performed to evaluate the effect of geographical area on the seroprevalence in roe deer. From a total of 190 studies initially identified, 16 and 8 articles were included for roe deer and red deer, respectively. These comprise 3,913 roe deer and 2,913 red deer from different European countries. The pooled seroprevalence was estimated to be 29% (95% CI: 23%-35%) in roe deer and 15% (95% CI: 10%-20%) in red deer. High heterogeneity was detected in the seroprevalence data within each species. In roe deer, the pooled seroprevalence estimate was significantly different according to geographical area with 40% (95% CI: 31%-49%) in Western Europe, 31% (95% CI: 21%-43%) in Northern Europe, 27% (95% CI: 15%-41%) in Eastern Europe and 21% (95% CI: 14%-28%) in Southern Europe. The present study indicates a moderate exposure to T. gondii in roe deer and red deer in Europe, with very high prevalence in Western Europe. Our results highlight the significant risk associated to the consumption of venison, encouraging proper handling and cooking of game meat to prevent toxoplasmosis in humans.
Topics: Animals; Deer; Europe; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis, Animal
PubMed: 33164352
DOI: 10.1111/zph.12780 -
Parasitology Research Apr 2017Babesiosis is a protozoal disease caused by Babesia spp. in mammals and humans worldwide. It is one of the most important tick-borne diseases, which affects livestock... (Meta-Analysis)
Meta-Analysis Review
Babesiosis is a protozoal disease caused by Babesia spp. in mammals and humans worldwide. It is one of the most important tick-borne diseases, which affects livestock productions, reproductions, and accordingly failing economy. In this, systematic review and meta-analysis, study, the prevalence of babesiosis among domestic herbivores in Iran, between 1998 and 2015, was methodically reviewed. Nine databases including five English and four Persian databases were explored. A total of 49 articles, as regards the examination of 13,547 sheep, 1920 goats, 7167 cattle, and 940 horses, corresponding to prevalence of babesiosis from different regions of Iran were gathered for our qualifying criteria. The overall prevalence of babesiosis was expected to be 14% (95% CI 12%, 16%) in domestic herbivores. Our results showed the highest prevalence in Khorasan Razavi (18.6%) and West Azarbaijan (15.2%) and the lowest in Mazandaran (8.8%) and Isfahan provinces (9.6%), respectively. The high prevalence of Babesia infection in herbivores (mostly sheep and goats) confirms the established enzootic situation of babesiosis in Iran, particularly in western and northeastern regions of the country. Our data offered important and updated information on the epidemiology of babesiosis, for the first time, in domestic herbivores in Iran, and will likely be contributing to the expansion of the screening and control strategies to reduce health and economic impacts among farm animals.
Topics: Animals; Animals, Domestic; Babesia; Babesiosis; Cattle; Cattle Diseases; Goat Diseases; Goats; Herbivory; Horse Diseases; Horses; Humans; Iran; Livestock; Sheep; Sheep Diseases; Sheep, Domestic; Tick-Borne Diseases
PubMed: 28054180
DOI: 10.1007/s00436-016-5368-8