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PloS One 2019Despite the adoption of campaigns to interrupt the main vector and to detect Trypanosoma cruzi in blood banks, millions of people are still chronically infected;... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Despite the adoption of campaigns to interrupt the main vector and to detect Trypanosoma cruzi in blood banks, millions of people are still chronically infected; however, the prevalence data are limited, and the epidemiology of Chagas disease has not been systematically evaluated. This study aimed to estimate the prevalence of Chagas disease in Colombia.
METHODS
A systematic literature review and meta-analysis was conducted to select all observational studies reporting the prevalence of Chagas disease in Colombia, based on serological diagnosis in participants of any age and published between January 2007 and November 2017. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random-effects models. In addition, the I2 statistic was calculated.
RESULTS
The literature search yielded a total of 1,510 studies; sixteen articles with relevant prevalence data were included in the systematic review. Of these, only 12 articles were included for entry in the meta-analysis. The pooled prevalence of Chagas disease across studies was 2.0% (95% CI: 1.0-4.0). A high degree of heterogeneity was found among studies (I2 > 75%; p < 0.001). The publication bias was not statistically significant (Egger's test, p = 0.078). The highest pooled prevalences were found in the adult population (3.0%, 95% CI: 1.0-4.0), pregnant women (3.0%, 95% CI: 3.0-4.0) and the Orinoco region (7.0%, 95% CI: 2.2-12.6).
CONCLUSIONS
The results indicate that the T. cruzi-infected population is aging, the adult population, pregnant women and that the Orinoco region (department of Casanare) have the highest prevalences. These results highlight the need to maintain screening and surveillance programs to identify people with chronic T. cruzi infections.
Topics: Animals; Chagas Disease; Chronic Disease; Colombia; Disease Vectors; Female; Health Services Needs and Demand; Humans; Mass Screening; Pregnancy; Pregnancy Complications, Parasitic; Prevalence; Trypanosoma cruzi
PubMed: 30615644
DOI: 10.1371/journal.pone.0210156 -
The Lancet. Global Health Apr 2023Humanitarian emergencies can lead to population displacement, food insecurity, severe health system disruptions, and malaria epidemics among individuals who are... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Humanitarian emergencies can lead to population displacement, food insecurity, severe health system disruptions, and malaria epidemics among individuals who are immunologically naive. We aimed to assess the impact of different vector control interventions on malaria disease burden during humanitarian emergencies.
METHODS
In this systematic review and meta-analysis, we searched ten electronic databases and two clinical trial registries from database inception to Oct 19, 2020, with no restrictions on language or study design. We also searched grey literature from 59 stakeholders. Studies were eligible if the population was affected by a humanitarian emergency in a malaria endemic region. We included studies assessing any vector control intervention and in which the primary outcome of interest was malaria infection risk. Reviewers (LAM, JF-A, KC, BP, and LP) independently extracted information from eligible studies, without masking of author or publication, into a database. We did random-effects meta-analyses to calculate pooled risk ratios (RRs) for randomised controlled trials, odds ratios (ORs) for dichotomous outcomes, and incidence rate ratios (IRR) for clinical malaria in non-randomised studies. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. This study is registered with PROSPERO, CRD42020214961.
FINDINGS
Of 12 475 studies screened, 22 studies were eligible for inclusion in our meta-analysis. All studies were conducted between Sept 1, 1989, and Dec 31, 2018, in chronic emergencies, with 616 611 participants from nine countries, evaluating seven different vector control interventions. Insecticide-treated nets significantly decreased Plasmodium falciparum incidence (RR 0·55 [95% CI 0·37-0·79]; high certainty) and Plasmodium vivax incidence (RR 0·69 [0·51-0·94]; high certainty). Evidence for an effect of indoor residual spraying on P falciparum (IRR 0·57 [95% CI 0·53-0·61]) and P vivax (IRR 0·51 [0·49-0·52]) incidence was of very low certainty. Topical repellents were associated with reductions in malaria infection (RR 0·58 [0·35-0·97]; moderate certainty). Moderate-to-high certainty evidence for an effect of insecticide-treated chaddars (equivalent to shawls or blankets) and insecticide-treated cattle on malaria outcomes was evident in some emergency settings. There was very low certainty evidence for the effect of insecticide-treated clothing.
INTERPRETATION
Study findings strengthen and support WHO policy recommendations to deploy insecticide-treated nets during chronic humanitarian emergencies. There is an urgent need to evaluate and adopt novel interventions for malaria control in the acute phase of humanitarian emergencies.
FUNDING
WHO Global Malaria Programme.
Topics: Humans; Animals; Cattle; Insecticides; Emergencies; Malaria; Malaria, Falciparum; Plasmodium falciparum
PubMed: 36925174
DOI: 10.1016/S2214-109X(23)00044-X -
PLoS Neglected Tropical Diseases Dec 2010Buruli ulcer is a neglected emerging disease that has recently been reported in some countries as the second most frequent mycobacterial disease in humans after... (Review)
Review
Buruli ulcer is a neglected emerging disease that has recently been reported in some countries as the second most frequent mycobacterial disease in humans after tuberculosis. Cases have been reported from at least 32 countries in Africa (mainly west), Australia, Southeast Asia, China, Central and South America, and the Western Pacific. Large lesions often result in scarring, contractual deformities, amputations, and disabilities, and in Africa, most cases of the disease occur in children between the ages of 4-15 years. This environmental mycobacterium, Mycobacterium ulcerans, is found in communities associated with rivers, swamps, wetlands, and human-linked changes in the aquatic environment, particularly those created as a result of environmental disturbance such as deforestation, dam construction, and agriculture. Buruli ulcer disease is often referred to as the "mysterious disease" because the mode of transmission remains unclear, although several hypotheses have been proposed. The above review reveals that various routes of transmission may occur, varying amongst epidemiological setting and geographic region, and that there may be some role for living agents as reservoirs and as vectors of M. ulcerans, in particular aquatic insects, adult mosquitoes or other biting arthropods. We discuss traditional and non-traditional methods for indicting the roles of living agents as biologically significant reservoirs and/or vectors of pathogens, and suggest an intellectual framework for establishing criteria for transmission. The application of these criteria to the transmission of M. ulcerans presents a significant challenge.
Topics: Age Factors; Animals; Buruli Ulcer; Communicable Diseases, Emerging; Disease Reservoirs; Disease Vectors; Ecosystem; Environmental Microbiology; Humans; Mycobacterium ulcerans
PubMed: 21179505
DOI: 10.1371/journal.pntd.0000911 -
Malaria Journal Nov 2018Meghalaya, one of eight states in the northeastern region of India, has been reported to carry a high malaria burden. However, malaria surveillance, epidemiology, and...
BACKGROUND
Meghalaya, one of eight states in the northeastern region of India, has been reported to carry a high malaria burden. However, malaria surveillance, epidemiology, and vector studies are sparse, and no reviews combining these topics with malaria prevention and control strategies have been published in recent years. Furthermore, no analysis of surveillance data has been published documenting the changes in epidemiology following the first distribution of long-lasting insecticidal nets (LLINs) statewide in 2016.
METHODS
A hybrid approach was used to describe the status of malaria in Meghalaya. First, a literature search was performed using the terms 'malaria' and 'Meghalaya'. Second, data were obtained from the Meghalaya State Malaria Control Programme for 2006-2017 for analysis of trends. Data from 3 years 2015-2017 were analysed further by district and year to assess changes in malaria incidence and distribution following the introduction of LLINs.
RESULTS/CONCLUSIONS
Like malaria in mainland India, malaria in Meghalaya is complex, with both Plasmodium falciparum and Plasmodium vivax parasites in circulation, multiple Anopheles vector species, and reports of both unusual and severe malaria syndromes across all age groups. Integrated statewide malaria epidemiology, vector, and prevention and control data for Meghalaya are not readily available, and published studies are largely focused on a single topic or a single district or region of the state. Although malaria prevention and control approaches are available, (e.g. spraying, LLINs, personal repellents), their use and effectiveness is also not well characterized in the literature. Analysis of state malaria control programme data indicates that case incidence and related fatalities in Meghalaya have declined over the last decade. This could be attributed to changes in treatment guidelines and/or statewide distribution of effective prevention methods such as LLINs. Since the distribution of more than 900,000 LLINs in 2016, the malaria caseload has declined significantly in most Meghalaya districts, excluding the remote and geographically isolated South Garo Hills. Additionally, the proportion of adult malaria cases (15+ years of age versus children 0-14 years) in most districts was significantly greater following LLIN distribution, which likely reflects common lifestyle practices in these areas (e.g. adults working during night hours; small children in the households receiving priority for bed net protection). While reduction in malaria case incidence and related deaths is clear, the changes in malaria transmission and clinical manifestation have not been characterized. Routine epidemiology and vector surveillance combined with real-time data reporting are essential for the continued reduction and eventual elimination of malaria in Meghalaya.
Topics: Animals; Anopheles; Humans; Incidence; India; Malaria, Falciparum; Malaria, Vivax; Mosquito Vectors; Plasmodium falciparum; Plasmodium vivax; Prevalence
PubMed: 30400879
DOI: 10.1186/s12936-018-2563-3 -
Journal of the American Medical... Nov 2020In recent years numerous studies have achieved promising results in Alzheimer's Disease (AD) detection using automatic language processing. We systematically review...
OBJECTIVE
In recent years numerous studies have achieved promising results in Alzheimer's Disease (AD) detection using automatic language processing. We systematically review these articles to understand the effectiveness of this approach, identify any issues and report the main findings that can guide further research.
MATERIALS AND METHODS
We searched PubMed, Ovid, and Web of Science for articles published in English between 2013 and 2019. We performed a systematic literature review to answer 5 key questions: (1) What were the characteristics of participant groups? (2) What language data were collected? (3) What features of speech and language were the most informative? (4) What methods were used to classify between groups? (5) What classification performance was achieved?
RESULTS AND DISCUSSION
We identified 33 eligible studies and 5 main findings: participants' demographic variables (especially age ) were often unbalanced between AD and control group; spontaneous speech data were collected most often; informative language features were related to word retrieval and semantic, syntactic, and acoustic impairment; neural nets, support vector machines, and decision trees performed well in AD detection, and support vector machines and decision trees performed well in decline detection; and average classification accuracy was 89% in AD and 82% in mild cognitive impairment detection versus healthy control groups.
CONCLUSION
The systematic literature review supported the argument that language and speech could successfully be used to detect dementia automatically. Future studies should aim for larger and more balanced datasets, combine data collection methods and the type of information analyzed, focus on the early stages of the disease, and report performance using standardized metrics.
Topics: Alzheimer Disease; Artificial Intelligence; Decision Trees; Humans; Language Disorders; Language Tests; Machine Learning; Natural Language Processing; Speech
PubMed: 32929494
DOI: 10.1093/jamia/ocaa174 -
PLoS Neglected Tropical Diseases Jul 2019Vector control remains the primary method to prevent dengue infections. Environmental interventions represent sustainable and safe methods as there are limited risks of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vector control remains the primary method to prevent dengue infections. Environmental interventions represent sustainable and safe methods as there are limited risks of environmental contamination and toxicity. The objective of this study is to perform a systematic review and meta-analysis of the effectiveness of the following environmental methods for dengue vector control.
METHODOLOGY/PRINCIPAL FINDINGS
Following the PRISMA guidelines, a systematic literature search was conducted using the databases PubMed, EMBASE, LILACS, the Cochrane Library and Google Scholar. Quality assessment was done using the CONSORT 2010 checklist. For the meta-analysis the difference-in-differences (DID) and the difference-of-endlines (DOE) were calculated according to the Schmidt-Hunter method for the Breteau index (BI) and the pupae per person index (PPI). Nineteen studies were eligible for the systematic review, sixteen contributed data to the meta-analysis. The following methods were evaluated: (a) container covers with and without insecticides, (b) waste management and clean-up campaigns, and (c) elimination of breeding sites by rendering potential mosquito breeding sites unusable or by eliminating them. Study quality was highest for container covers with insecticides, followed by waste management without direct garbage collection and elimination of breeding places. Both, systematic review and meta-analysis, showed a weak effect of the interventions on larval populations, with no obvious differences between the results of each individual method. For the meta-analysis, both, container covers without insecticides (BI: DID -7.9, DOE -5) and waste management with direct garbage collection (BI: DID -8.83, DOE -6.2) achieved the strongest reductions for the BI, whereas for the PPI results were almost opposite, with container covers with insecticides (PPI: DID -0.83, DOE 0.09) and elimination of breeding places (PPI: DID -0.95, DOE -0.83) showing the strongest effects.
CONCLUSIONS
Each of the investigated environmental methods showed some effectiveness in reducing larval and pupal densities of Aedes sp. mosquitoes. However, there is a need for more comparable high-quality studies at an adequate standard to strengthen this evidence.
Topics: Aedes; Animals; Dengue; Environmental Microbiology; Insecticides; Larva; Mosquito Control; Mosquito Vectors; Pupa; Urban Health; Water Supply
PubMed: 31295250
DOI: 10.1371/journal.pntd.0007420 -
Artificial Intelligence in Medicine May 2023Indigenous peoples often have higher rates of morbidity and mortality associated with cardiometabolic disease (CMD) than non-Indigenous people and this may be even more... (Review)
Review
BACKGROUND
Indigenous peoples often have higher rates of morbidity and mortality associated with cardiometabolic disease (CMD) than non-Indigenous people and this may be even more so in urban areas. The use of electronic health records and expansion of computing power has led to mainstream use of artificial intelligence (AI) to predict the onset of disease in primary health care (PHC) settings. However, it is unknown if AI and in particular machine learning is used for risk prediction of CMD in Indigenous peoples.
METHODS
We searched peer-reviewed literature using terms associated with AI machine learning, PHC, CMD, and Indigenous peoples.
RESULTS
We identified 13 suitable studies for inclusion in this review. Median total number of participants was 19,270 (range 911-2,994,837). The most common algorithms used in machine learning in this setting were support vector machine, random forest, and decision tree learning. Twelve studies used the area under the receiver operating characteristic curve (AUC) to measure performance. Two studies reported an AUC of >0.9. Six studies had an AUC score between 0.9 and 0.8, 4 studies had an AUC score between 0.8 and 0.7. 1 study reported an AUC score between 0.7 and 0.6. Risk of bias was observed in 10 (77 %) studies.
CONCLUSION
AI machine learning and risk prediction models show moderate to excellent discriminatory ability over traditional statistical models in predicting CMD. This technology could help address the needs of urban Indigenous peoples by predicting CMD early and more rapidly than conventional methods.
Topics: Humans; Artificial Intelligence; Machine Learning; Algorithms; Indigenous Peoples; Cardiovascular Diseases
PubMed: 37100506
DOI: 10.1016/j.artmed.2023.102534 -
Preventive Veterinary Medicine Jun 2018Japanese encephalitis virus (JEV) is a virus of the Flavivirus genus that may result in encephalitis in human hosts. This vector-borne zoonosis occurs in Eastern and... (Review)
Review
Japanese encephalitis virus (JEV) is a virus of the Flavivirus genus that may result in encephalitis in human hosts. This vector-borne zoonosis occurs in Eastern and Southeastern Asia and an intentional or inadvertent introduction into the United States (US) would have major public health and economic consequences. The objective of this study was to gather, appraise, and synthesize primary research literature to identify and quantify vector and host competence for JEV, using a systematic review (SR) of the literature. After defining the research question, we performed a search in selected electronic databases and journals. The title and abstract of the identified articles were screened for relevance using a set of exclusion and inclusion criteria, and relevant articles were subjected to a risk of bias assessment, followed by data extraction. Data were extracted from 171 peer-reviewed articles. Most studies were observational studies (59.1%) and reported vector competence (60.2%). The outcome measures reported pertained to transmission efficiency, host preference, and vector susceptibility to infection within vector competence; and susceptibility to infection within host competence. Regarding vector competence, the proportion of JEV infection reported across all 149 mosquito species in all observational studies ranged from 0 to 100%. In experimental studies, infection, dissemination, and transmission rates varied between 0 and 100%. Minimum infection rates (MIR) varied between 0 and 333.3 per 1000 mosquitoes. Maximum likelihood estimation (MLE) values ranged from 0 to 53.8 per 1000 mosquitoes. The host species in which mosquitoes mostly fed consisted of pigs and cattle (total of 84 blood meals taken by mosquitoes from each of these host species). As for host competence, the proportion of JEV infection varied between 0 (in rabbits, reptiles, and amphibians) and 88.9% (cattle). This SR presents comprehensive data on JEV vector and host competence, which can be used to quantify risks associated with the introduction of JEV into the US.
Topics: Animals; Cattle; Culex; Disease Vectors; Encephalitis Virus, Japanese; Encephalitis, Japanese; Humans; Mosquito Vectors; Rabbits; Zoonoses
PubMed: 29685447
DOI: 10.1016/j.prevetmed.2018.03.018 -
Viruses Jan 2023Vector control methods are considered effective in averting dengue transmission. However, several factors may modify their impact. Of these controls, chemical methods,... (Review)
Review
Vector control methods are considered effective in averting dengue transmission. However, several factors may modify their impact. Of these controls, chemical methods, in the long run, may increase mosquitoes' resistance to chemicides, thereby decreasing control efficacy. The biological methods, which may be self-sustaining and very effective, could be hampered by seasonality or heatwaves (resulting in, e.g., loss of infection). The environmental methods that could be more effective than the chemical methods are under-investigated. In this study, a systematic review is conducted to explore the present understanding of the effectiveness of vector control approaches via dengue transmission models.
Topics: Animals; Humans; Dengue; Aedes; Mosquito Vectors; Models, Theoretical; Wolbachia
PubMed: 36680294
DOI: 10.3390/v15010254 -
Viruses Jul 2023The spread of lumpy skin disease (LSD) to free countries over the last 10 years, particularly countries in Europe, Central and South East Asia, has highlighted the... (Review)
Review
The spread of lumpy skin disease (LSD) to free countries over the last 10 years, particularly countries in Europe, Central and South East Asia, has highlighted the threat of emergence in new areas or re-emergence in countries that achieved eradication. This review aimed to identify studies on LSD epidemiology. A focus was made on hosts, modes of transmission and spread, risks of outbreaks and emergence in new areas. In order to summarize the research progress regarding the epidemiological characteristics of LSD virus over the last 40 years, the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement guidelines were followed, via two databases, i.e., PubMed (biomedical literature) and Scopus (peer-reviewed literature including scientific journals, books, and conference proceedings). A total of 86 scientific articles were considered and classified according to the type of epidemiological study, i.e., experimental versus observational. The main findings and limitations of the retrieved articles were summarized: buffaloes are the main non-cattle hosts, the main transmission mode is mechanical, i.e., via blood-sucking vectors, and stable flies are the most competent vectors. Vectors are mainly responsible for a short-distance spread, while cattle trade spread the virus over long distances. Furthermore, vaccine-recombinant strains have emerged. In conclusion, controlling animal trade and insects in animal transport trucks are the most appropriate measures to limit or prevent LSD (re)emergence.
Topics: Animals; Cattle; Lumpy Skin Disease; Disease Outbreaks; Bison; Books; Buffaloes
PubMed: 37631965
DOI: 10.3390/v15081622