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Infectious Diseases of Poverty Feb 2018Plasmodium vivax is the most geographically widespread species among human malaria parasites. Immunopathological studies have shown that platelets are an important... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Plasmodium vivax is the most geographically widespread species among human malaria parasites. Immunopathological studies have shown that platelets are an important component of the host innate immune response against malaria infections. The objectives of this study were to quantify thrombocytopaenia in P. vivax malaria patients and to determine the associated risks of severe thrombocytopaenia in patients with vivax malaria compared to patients with P. falciparum malaria.
MAIN BODY
A systematic review and meta-analysis of the available literature on thrombocytopaenia in P. vivax malaria patients was undertaken. Relevant studies in health-related electronic databases were identified and reviewed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Fifty-eight observational studies (n = 29 664) were included in the current review. Severe thrombocytopaenia (< 50 000/mm) to very severe thrombocytopaenia (< 20 000/mm) was observed in 10.1% of patients with P. vivax infection. A meta-analysis of 11 observational studies showed an equal risk of developing severe/very severe thrombocytopaenia between the patients with P. vivax malaria and those with P. falciparum malaria (OR: 1.98, 95% CI: 0.92-4.25). This indicates that thrombocytopaenia is as equally a common manifestation in P. vivax and P. falciparum malaria patients. One study showed a higher risk of developing very severe thrombocytopaenia in children with severe P. vivax malaria than with severe P. falciparum malaria (OR: 2.80, 95% CI: 1.48-5.29). However, a pooled analysis of two studies showed an equal risk among adult severe cases (OR: 1.19, 95% CI: 0.51-2.77). This indicates that the risk of developing thrombocytopaenia in P. vivax malaria can vary with immune status in both children and adults. One study reported higher levels of urea and serum bilirubin in patients with P. vivax malaria and severe thrombocytopaenia compared with patients mild thrombocytopaenia or no thrombocytopaenia, (P < 0.001 in all comparisons). A pooled analysis of two other studies showed a similar proportion of bleeding episodes with thrombocytopaenia in severe P. vivax patients and severe P. falciparum patients (P = 0.09). This implied that both P. vivax and P. falciparum infections could present with bleeding episodes, if there had been a change in platelet counts in the infected patients. A pooled analysis of another two studies showed an equal risk of mortality with severe thrombocytopaenia in both P. vivax and P. falciparum malaria patients (OR: 1.16, 95% CI: 0.30-4.60). However, due to the low number of studies with small sample sizes within the subset of studies that provided clinically relevant information, our confidence in the estimates is limited.
CONCLUSION
The current review has provided some evidence of the clinical relevance of severe thrombocytopaenia in P. vivax malaria. To substantiate these findings, there is a need for well designed, large-scale, prospective studies among patients infected with P. vivax. These should include patients from different countries and epidemiological settings with various age and gender groups represented.
Topics: Adult; Child; Female; Humans; Malaria, Falciparum; Malaria, Vivax; Male; Observational Studies as Topic; Plasmodium falciparum; Plasmodium vivax; Severity of Illness Index; Thrombocytopenia
PubMed: 29427995
DOI: 10.1186/s40249-018-0392-9 -
Parasitology Sep 2016Parasitic infections are among the leading global public health problems with very high economic and mortality burdens. Unfortunately, the available treatment drugs are... (Review)
Review
Parasitic infections are among the leading global public health problems with very high economic and mortality burdens. Unfortunately, the available treatment drugs are beset with side effects and continuous parasite drug resistance is being reported. However, new findings reveal more promising compounds especially of plant origin. Among the promising leads are the pentacyclic triterpenes (PTs) made up of the oleanane, ursane, taraxastane, lupane and hopane types. This paper reviews the literature published from 1985 to date on the in vitro and in vivo anti-parasitic potency of this class of phytochemicals. Of the 191 natural and synthetic PT reported, 85 have shown high anti-parasitic activity against various species belonging to the genera of Plasmodium, Leishmania, Trypanosoma, as well as various genera of Nematoda. Moreover, structural modification especially at carbon 3 (C3) and C27 of the parent backbone of PT has led to improved anti-parasitic activity in some cases and loss of activity in others. The potential of this group of compounds as future alternatives in the treatment of parasitic diseases is discussed. It is hoped that the information presented herein will contribute to the full exploration of this promising group of compounds as possible drugs for parasitic diseases.
Topics: Animals; Humans; Leishmania; Leishmaniasis; Malaria; Mice; Nematode Infections; Parasitic Diseases; Pentacyclic Triterpenes; Plasmodium; Tropical Climate; Trypanosoma; Trypanosomiasis
PubMed: 27240847
DOI: 10.1017/S0031182016000718 -
Biomedica : Revista Del Instituto... Jun 2022Introduction: Tafenoquine was approved in 2018 by the Food and Drug Administration in the United States and in 2019 by the Therapeutic Goods Administration in Australia.... (Meta-Analysis)
Meta-Analysis
Introduction: Tafenoquine was approved in 2018 by the Food and Drug Administration in the United States and in 2019 by the Therapeutic Goods Administration in Australia. Its administration in a single dose and its mechanism of action in the acute and latent phases of the disease have been studied to change the treatment regimen for Plasmodium vivax malaria. Objective: To evaluate the available scientific evidence of the efficacy of tafenoquine in prophylaxis and treatment between 2009 and 2019. Materials and methods: We established the MeSH and DeCS descriptors and we used the syntax ((Malaria Vivax) AND (tafenoquine) AND (prophylaxis)) OR [(Malaria Vivax) AND (tafenoquine) AND (relapse)] in the following databases: Pubmed, The Cochrane Central Register of Controlled Clinical Trials (CENTRAL), ISIS Web of Science, Lilacs, and Scopus. The results obtained were subjected to critical analysis (CASPE matrix). The quantitative analysis was performed with risk differences in survival analysis (Kaplan Meier) in the final three articles. Results: Three studies underwent meta-analysis (Llanos-Cuentas, 2014; Llanos-Cuentas, 2019, and Lacerda, 2019) to evaluate the efficacy of the treatment with tafenoquine compared to primaquine. A global risk difference of 0.04 was obtained (95% CI: 0.00-0.08; p=0.07). Tafenoquine did not show inferiority in the efficacy of treatment compared to the primaquine scheme. Conclusion: Tafenoquine is a therapeutic alternative to primaquine that improves adherence, which could bring Colombia closer to the goals of the World Technical Strategy against Malaria 2016-2030.
Topics: Colombia; Plasmodium vivax; Retrospective Studies
PubMed: 35867928
DOI: 10.7705/biomedica.5988 -
Acta Tropica Sep 2022Neosporosis is recognized as the main cause of abortions in cattle worldwide and there is an increasing concern about its role in ovine reproductive losses; however,... (Meta-Analysis)
Meta-Analysis
Neosporosis is recognized as the main cause of abortions in cattle worldwide and there is an increasing concern about its role in ovine reproductive losses; however, epidemiological studies regarding neosporosis in sheep are still limited. This meta-analysis aimed to estimate the global pooled seroprevalence and associated risk factors of ovine neosporosis. In the current report, a comprehensive strategy of search and data collection from 7 worldwide databases was performed. A final set of 73 studies (80 datasets) published from 2000 to 2021 were selected based on inclusion criteria, comprising data on 35,740 sheep (corresponding to 37,565 evaluated samples) from 30 countries worldwide. The global pooled seroprevalence of Neospora caninum infection in sheep estimated by the random-effects model was 13% (95% CI, 10-15) and showed high heterogeneity (Q = 5147.15, I = 98%, p< 0.001). Furthermore, by meta-analyses of subgroups it was demonstrated for the first time that seroprevalence significantly varied between continents (highest in Africa; 20%, 95% CI, 4-44), WHO regions (highest in African Region; 42%, 95% CI, 36-48), countries (highest in Colombia; 79%, 95% CI, 61-92%) and diagnostic methods (highest by IFAT; 17%, 95% CI, 12-23). Meta-regression indicated significant increasing trends in the prevalence of ovine neosporosis with decrease in geographical latitude (coefficient = -0.013; p<0.001), whereas longitude did not influence it (coefficient = -0.001; p=0.365). Regarding associated risk factors, older sheep were more likely to be infected with N. caninum than younger ones (OR 1.42; 95% CI 1.08-1.87), and sheep bred under intensive or semi-intensive systems resulted less susceptible to be seropositive than those bred under extensive system (OR 0.65; 95% CI 0.42-0.99 and OR 0.74; 95% CI 0.62-0.89, respectively). Conversely, no apparent association was found between seroprevalence and other variables, such as sex (OR 1.06; 95% CI 0.9-1.24), the presence of dogs on the farm (OR 1.15; 95% CI 0.63-2.12) or the presence of abortion (OR 1.80; 95% CI 0.87-3.74). In conclusion, the seroprevalence of ovine neosporosis is widely and heterogeneously distributed throughout the world, and it is negatively associated with increasing geographical latitude. In addition, age and extensive production system represent risk factors, which suggest that the horizontal transmission route is relevant for this host species. It is recommended to pay more attention to this disease and emphasize the global need for more indexed studies concerning the seroprevalence and risk factors of ovine neosporosis to better understand the epidemiology of this coccidian infection.
Topics: Animals; Antibodies, Protozoan; Coccidiosis; Female; Neospora; Pregnancy; Risk Factors; Seroepidemiologic Studies; Sheep; Sheep Diseases
PubMed: 35752203
DOI: 10.1016/j.actatropica.2022.106569 -
BMJ Clinical Evidence Mar 2008Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy.... (Review)
Review
INTRODUCTION
Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy. About five per thousand non-immune pregnant women may acquire toxoplasma infection, with a 10-100% risk of transmission to the baby. Risks of transmission to the baby are higher later in pregnancy, but risks of infection causing harm to the baby are greater earlier in pregnancy.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects on mother and baby of treating toxoplasmosis during pregnancy? What are the effects of treating toxoplasmosis in neonates exposed to toxoplasmosis prenatally? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found four systematic reviews, RCTs or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiparasitic drugs in pregnancy, antiparasitic drugs in neonates.
Topics: Acute Disease; Antiparasitic Agents; Humans; Incidence; Pregnancy Complications, Parasitic; Toxoplasma; Toxoplasmosis; Toxoplasmosis, Congenital
PubMed: 19450322
DOI: No ID Found -
The Lancet. Infectious Diseases Jul 2011Despite recent changes in the epidemiology of HIV infection and malaria and major improvements in their control, these diseases remain two of the most important... (Review)
Review
Despite recent changes in the epidemiology of HIV infection and malaria and major improvements in their control, these diseases remain two of the most important infectious diseases and global health priorities. As they have overlapping distribution in tropical areas, particularly sub-Saharan Africa, any of their clinical, diagnostic, and therapeutic interactions might have important effects on patient care and public health policy. The biological basis of these interactions is well established. HIV infection induces cellular depletion and early abnormalities of CD4+ T cells, decreases CD8+ T-cell counts and function (cellular immunity), causes deterioration of specific antigen responses (humoral immunity), and leads to alteration of innate immunity through impairment of cytolytic activity and cytokine production by natural killer cells. Therefore, HIV infection affects the immune response to malaria, particularly premunition in adolescents and adults, and pregnancy-specific immunity, leading to different patterns of disease in HIV-infected patients compared with HIV-uninfected patients. In this systematic review, we collate data on the effects of HIV on malaria and discuss their therapeutic consequences. HIV infection is associated with increased prevalence and severity of clinical malaria and impaired response to antimalarial treatment, depending on age, immunodepression, and previous immunity to malaria. HIV also affects pregnancy-specific immunity to malaria and response to intermittent preventive treatment. Co-trimoxazole (trimethoprim-sulfamethoxazole) prophylaxis and antiretroviral treatment reduce occurrence of clinical malaria; however, these therapies interact with antimalarial drugs, and new therapeutic guidelines are needed for concomitant use.
Topics: Adolescent; Adult; Africa South of the Sahara; Anti-HIV Agents; Antimalarials; Female; HIV; HIV Infections; Humans; Malaria; Male; Plasmodium; Pregnancy
PubMed: 21700241
DOI: 10.1016/S1473-3099(11)70031-7 -
Acta Parasitologica Sep 2021The present study aimed to analyze data available of the seroprevalence of Toxoplasma gondii (T. gondii) among camelids around the world. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The present study aimed to analyze data available of the seroprevalence of Toxoplasma gondii (T. gondii) among camelids around the world.
METHODS
The search was performed using seven international databases including Scopus, PubMed, Google Scholar, ProQuest, ScienceDirect, Web of Science, and EMBASE up to 11 October 2018. Random effects model was used to determine the pooled seroprevalence of T. gondii infection with 95% confidence intervals (CI) and analyzed data from four continents. Subgroup and meta-regression analyses were also performed according to continent and gender.
RESULTS
In total, 42 studies out of 3517 published articles involving 14,542 camels from 17 countries were included for the final analyses. The global pooled seroprevalence of T. gondii infection in the Camelidae family was 28.16% (95% CI 23.64-32.68%). Besides, the highest seroprevalence rate was in Europe (49.64%) followed by Africa (37.63%), America (21.76%), and Asia (17.58%). Moreover, the overall seroprevalence rates of T. gondii infection were 22% (95% CI 10-33%) and 15% (95% CI 9-22%) for the females and males, respectively.
CONCLUSION
This meta-analysis showed a high seroprevalence of T. gondii infection in camelids as these animals play an important role in the transmission cycle of this zoonotic disease.
Topics: Animals; Antibodies, Protozoan; Camelidae; Female; Male; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis; Zoonoses
PubMed: 33666861
DOI: 10.1007/s11686-020-00333-9 -
Acta Tropica Jun 2016Toxoplasmosis is a common and serious parasitic disease with high prevalence and global distribution in human and other warm-blooded vertebrates. Though the infection of... (Meta-Analysis)
Meta-Analysis Review
Toxoplasmosis is a common and serious parasitic disease with high prevalence and global distribution in human and other warm-blooded vertebrates. Though the infection of Toxoplasma gondii is usually asymptomatic in healthy people, it can lead to severe pathological effects to the fetus of infected women and immunocompromised patients. So pinpointing the risk factors and control procedures are of important works among these populations. In order to reach this goal, we conducted a systematic review and meta-analysis to identify the seroprevalence rate of T. gondii infection among Iranian pregnant women population to achieve a comprehensive explanation of the disease condition in Iran for future use. English electronic databases (PubMed, Science Direct, Scopus, Ovid and Cochrane) and Persian language databases (Scientific Information Database, Iran Medex, Magiran and Iran Doc) were searched. Furthermore, the proceedings of Iranian parasitology congresses were explored manually. Our review resulted in a total of 50 publications meeting the inclusion criteria during Jan 1990-June 2015. Totally, 20221 women had been tested during this period of which 7724 women had seropositivity for IgG. According to results of heterogeneity test, either Der Simonian and Laird's random-effects method or Mantel-Haenszel's fixed-effects method were used to pool the estimations. Weighted overall prevalence of toxoplasmosis in pregnant women were obtained using random-effects model, which was estimated 41% (95% CI=36-45%). Also IgG and IgM antibodies was obtained 38% (95% CI=34-42%) and 4% (95% CI=3-5%), respectively. The highest and the lowest seroprevalence of toxoplasmosis in five geographical zones of Iran were observed in South 53% (95% CI=30-77%) and East 33% (95% CI=23-42%), respectively. In order to detect publication bias, Egger's regression test was done which revealed that publication bias might not have a significant influence on overall prevalence estimate (P=0.89). Multivariate analysis showed that there's a statistically significant correlation between toxoplasmosis and two risk factors including "place of residence" (P=0.005) and "contact with cat" (P=0.002). There was no significant difference between toxoplasmosis and the other surveyed risk factors. It is highly recommended to further study for the aim of better disease management and developing more efficient diagnostic tests.
Topics: Aged; Animals; Antibodies, Protozoan; Cats; Female; Humans; Iran; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis
PubMed: 26952970
DOI: 10.1016/j.actatropica.2016.03.003 -
Pathogens and Global Health May 2020, as an opportunistic neurotropic parasite of the Apicomplexa family, was firstly described in 1908. As attention-deficit hyperactivity disorder (ADHD) is one of the... (Meta-Analysis)
Meta-Analysis
, as an opportunistic neurotropic parasite of the Apicomplexa family, was firstly described in 1908. As attention-deficit hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders in children and adolescents and often persists into adulthood, the purpose of this systematic review and meta-analysis was to investigate the relationship between infection and ADHD.The data were systematically collected from seven electronic databases up to May 1 2019 with no language restriction. This study was registered at the International Prospective Register of Systematic Reviews (PROSPERO; code: CRD42020149353). Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using a random effects model. Seven studies involving five cross-sectional and two case-control studies were included in this meta-analysis.Results indicated that there was a statistically non-significant association between exposure to infection and increased risk of ADHD based on the detection of immunoglobulin G (IgG) antibody (2.02 [95% CI: 0.97-4.20]; I=58.7%). However, obtained results of Egger's tests for anti- IgG antibody showed publication bias (P=0.014).Sensitivity analysis revealed stable results for the association between anti- IgG antibody with ADHD.Given the small number of studies in this field and the obtained results, it cannot be conclusively stated that is a risk factor for ADHD.It is important to have reliable information about the relationship between and ADHD around the world; as it may lead to better insight to elucidate the possible association of toxoplasmosis and the pathogenesis of ADHD.
Topics: Antibodies, Protozoan; Attention Deficit Disorder with Hyperactivity; Cross-Sectional Studies; Humans; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis
PubMed: 32186992
DOI: 10.1080/20477724.2020.1738153 -
BMC Infectious Diseases Jun 2020Cerebral malaria is the most severe form of infection with Plasmodium falciparum characterized by a highly inflammatory response. This systematic review aimed to...
BACKGROUND
Cerebral malaria is the most severe form of infection with Plasmodium falciparum characterized by a highly inflammatory response. This systematic review aimed to investigate the association between TNF-α levels and cerebral malaria.
METHODS
This review followed the Preferred Reporting of Systematic Review and Meta-analyses (PRISMA) guidelines. The search was performed at PubMed, LILACS, Scopus, Web of Science, The Cochrane Library, OpenGrey and Google Scholar. We have included studies of P. falciparum-infected humans with or without cerebral malaria and TNF-α dosage level. All studies were evaluated using a risk of bias tool and the GRADE approach.
RESULTS
Our results have identified 2338 studies, and 8 articles were eligible according to this systematic review inclusion criteria. Among the eight articles, five have evaluated TNF- α plasma dosage, while two have evaluated at the blood and one at the brain (post-Morten). Among them, only five studies showed higher TNF-α levels in the cerebral malaria group compared to the severe malaria group. Methodological problems were identified regarding sample size, randomization and blindness, but no risk of bias was detected.
CONCLUSION
Although the results suggested that that TNF-α level is associated with cerebral malaria, the evidence is inconsistent and imprecise. More observational studies evaluating the average TNF-alpha are needed.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Malaria, Cerebral; Malaria, Falciparum; Male; Middle Aged; Plasmodium falciparum; Tumor Necrosis Factor-alpha; Young Adult
PubMed: 32576141
DOI: 10.1186/s12879-020-05107-2