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The Lancet. Child & Adolescent Health Mar 2022Synthesised data on the prevalence of, and factors associated with, paediatric Helicobacter pylori infection at the global level remain scarce. We aimed to estimate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Synthesised data on the prevalence of, and factors associated with, paediatric Helicobacter pylori infection at the global level remain scarce. We aimed to estimate the global prevalence of H pylori infection and its associated factors in children and adolescents.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Embase, MEDLINE, and Scopus for observational population-based studies published between database inception and Oct 25, 2021, without language or geographical restrictions. We included studies that reported the prevalence of H pylori infection in children aged 18 years or younger. Records were screened and data were extracted using a standardised extraction form. We estimated the worldwide prevalence of H pylori infection in children (our main outcome) using multilevel mixed-effects meta-regression and then stratified prevalence by diagnostic method (serology vs urea breath tests or stool antigen tests). We analysed the significance of associated factors using a random-effects meta-analysis. This study is registered in PROSPERO, CRD42020209717.
FINDINGS
We identified 3181 records, of which 198 articles with 632 data points from 152 650 children were included. The overall global prevalence of H pylori infection in children was 32·3% (95% CI 27·3-37·8), which varied by diagnostic test (28·6% [23·0-35·0] for serology vs 35·9% [29·2-43·2] for urea breath tests or stool antigen tests). Regardless of diagnostic test, the prevalence of H pylori infection was significantly higher in low-income and middle-income countries than in high-income countries (43·2% [36·5-50·2] vs 21·7% [16·9-27·4]; p<0·0001) and in older children than in younger children (41·6% [35·6-47·8] in 13-18-year-olds vs 33·9% [28·6-39·7] in 7-12-year-olds vs 26·0% [21·4-31·0] in 0-6-year-olds; p<0·0001). Paediatric H pylori infection was significantly associated with lower economic status (odds ratio [OR] 1·63 [95% CI 1·46-1·82]), more siblings or children (1·84 [1·44-2·36]), room sharing (1·89 [1·49-2·40]), no access to a sewage system (1·60 [1·22-2·10]), having a mother infected with H pylori (3·31 [2·21-4·98]), having a sibling or siblings infected with H pylori (3·33 [1·53-7·26]), drinking unboiled or non-treated water (1·52 [1·32-1·76]), and older age (OR per year 1·27 [1·15-1·40]).
INTERPRETATION
H pylori infection is still highly prevalent in children and adolescents globally. Our findings can help to guide further research and the development and implementation of preventive and therapeutic measures to reduce H pylori infection in children.
FUNDING
None.
Topics: Adolescent; Child; Child, Preschool; Female; Global Burden of Disease; Helicobacter Infections; Humans; Infant; Male; Prevalence; Risk Factors
PubMed: 35085494
DOI: 10.1016/S2352-4642(21)00400-4 -
Chemosphere Jul 2024Estrogenic compounds are the endocrine disruptors that receive major attention because of their ability to imitate the natural female hormone, 17β-estradiol and cause...
Estrogenic compounds are the endocrine disruptors that receive major attention because of their ability to imitate the natural female hormone, 17β-estradiol and cause adverse effects on the reproductive system of animals. The presence of estrogenic compounds in drinking water is a warning to assess the risks to which human beings are exposed. The present work has the objectives of carrying out a systematic review of studies that investigated estrogenic compounds in drinking water around the world and estimate the human health and estrogenic activity risks, based on the concentrations of each compound reported. The systematic review returned 505 scientific papers from the Web of Science®, SCOPUS® and PubMED® databases and after careful analysis, 45 papers were accepted. Sixteen estrogenic compounds were identified in drinking water, from the classes of hormones, pharmaceutical drugs and personal care products, plasticizers, corrosion inhibitors, pesticides and surfactants. Di-(2-ethylhexyl) phthalate (DEHP) was the compound found at the highest concentration, reaching a value of 1.43 mg/L. Non-carcinogenic human health risk was classified as high for 17α-ethynilestradiol and DEHP, medium for dibutyl phthalate, and low for bisphenol A. The estrogenic activity risks were negligible for all the compounds, except DEHP, with a low risk. None of the estrogenic compounds presented an unacceptable carcinogenic risk, due to estrogenic activity. However, the risk assessment did not evaluate the interactions between compounds, that occurs in drinking water and can increase the risks and adverse effects to human health. Nonetheless, this study demonstrates the need for improvement of drinking water treatment plants, with more efficient technologies for micropollutant removal.
Topics: Drinking Water; Water Pollutants, Chemical; Estrogens; Endocrine Disruptors; Humans; Risk Assessment; Animals
PubMed: 38821126
DOI: 10.1016/j.chemosphere.2024.142463 -
International Journal of Sport... Sep 2021Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in...
Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in moderation, but its alcohol content may confer some negative effects. Despite beer's popularity, no review has explored its effects on exercise performance, recovery, and adaptation. Thus, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two reviewers. The search resulted in 16 studies that were appraised and reviewed. The mean PEDro score was 5.1. When individuals are looking to rehydrate postexercise, a low-alcohol beer (<4%) may be more effective. If choosing a beer higher in alcoholic content (>4%), it is advised to pair this with a nonalcoholic option to limit diuresis, particularly when relatively large volumes of fluid (>700 ml) are consumed. Adding Na+ to alcoholic beer may improve rehydration by decreasing fluid losses, but palatability may decrease. These conclusions are largely based on studies that standardized beverage volume, and the results may not apply equally to situations where people ingest fluids and food ad libitum. Ingesting nonalcoholic, polyphenol-rich beer could be an effective strategy for preventing respiratory infections during heavy training. If consumed in moderation, body composition and strength qualities seem largely unaffected by beer. Mixed results that limit sweeping conclusions are owed to variations in study design (i.e., hydration and exercise protocols). Future research should incorporate exercise protocols with higher ecological validity, recruit more women, prioritize chronic study designs, and use ad libitum fluid replacement protocols for more robust conclusions.
Topics: Alcohol Drinking; Beer; Dehydration; Exercise; Female; Fluid Therapy; Humans; Water-Electrolyte Balance
PubMed: 34284350
DOI: 10.1123/ijsnem.2021-0064 -
Biological Trace Element Research Apr 2019A systematic review, meta-analysis, and non-carcinogenic risk considering fluoride content of drinking water resources of 31 provinces of Iran among some international... (Meta-Analysis)
Meta-Analysis
A systematic review, meta-analysis, and non-carcinogenic risk considering fluoride content of drinking water resources of 31 provinces of Iran among some international databases such as Science Direct, Scopus, PubMed, and national databases including SID and Irandoc (2011 to July 2017) were conducted. In this context, 10 articles (40 studies) with 1706 samples were included in meta-analyses and risk assessment studies. The pooled concentration of fluoride in the cold, mild, and warm weather provinces were calculated as 0.39 mg/L (95% CI 0.32-0.48 mg/L), 0.52 (95% CI 0.43-0.61 mg/L), and 0.75 (95% CI 0.56-0.94 mg/L), respectively. The pooled concentration of fluoride in Iranian drinking water resources was 0.51 (95% CI 0.45-0.57 mg/L). The minimum and maximum concentrations of fluoride content were related to Kermanshah (0.19 mg/L) and Kerman (1.13 mg/L) provinces, respectively. The HQ of fluoride in the children and adults were 0.462 and 0.077, respectively as children are more vulnerable than adults. The HQ for children and adults was lower than 1 value. Therefore, there is no considerable non-carcinogenic risk for consumers due to drinking water in Iran. Although the non-carcinogenic of fluoride in drinking water was not significant, fluoride entry from other sources, such as food or inhalation, could endanger the health of the residents of Kerman and Bushehr provinces.
Topics: Adult; Drinking Water; Environmental Exposure; Fluorides; Humans; Iran; Risk Assessment; Water Pollutants, Chemical; Weather
PubMed: 29943372
DOI: 10.1007/s12011-018-1418-7 -
Presence of heavy metals in drinking water resources of Iran: a systematic review and meta-analysis.Environmental Science and Pollution... Jun 2021Water quality is one of the most important indices for public health especially for drinking water consumptions. This study was conducted to survey the presence of heavy... (Meta-Analysis)
Meta-Analysis Review
Water quality is one of the most important indices for public health especially for drinking water consumptions. This study was conducted to survey the presence of heavy metals in drinking water resources of Iran using a systematic review and meta-analysis. The literature search was conducted in data bases of PubMed, Web of Science, EMBASE, Scopus, Google Scholar, and some Persian databases up to 31 July 2018. Of all the articles reviewed (1151 articles), 61 papers were eligible for systematic review. Results indicated variable heterogeneity between studies for different pollutants (I between 0 and 100). A subgroup analysis was performed for three different types of water resources such as drinking water, groundwater, and surface water to find the possible source of the heterogeneity. The pooled mean concentration level of iron was the highest at 255.8 (95% CI = 79.48-432.13 μg/l) and vanadium the lowest at 3.21 (95% CI = 1.45-4.98 μg/l). The sequence of metal concentration (μg/l) in descending order is as follows: Fe (255.8) > B (159.81) > Al (158.5) > Zn (130.73) > As (85.85) > Mn (51.61) > Cu (47.98) > Se (42.68) > Pb (37.22) > Co (22.76) > Mo (18.92) > Ni (16.79) > Cr (13.47) > Hg (4.49) > Cd (4.19) > V (3.21). The mean pooled concentration level of Al, As, Se, Pb, and Cd was higher than the WHO guideline and Iran Standard, and the rest of the metals had lower mean pooled concentration level. Pb and Cd were the common heavy metals that existed in all subgroups. As a recommendation, the relationship assessment of water parameters and heavy metals could be addressed in future studies of Iran's water resources.
Topics: Drinking Water; Environmental Monitoring; Iran; Metals, Heavy; Risk Assessment; Water Pollutants, Chemical; Water Resources
PubMed: 33791963
DOI: 10.1007/s11356-021-13293-y -
Risk factors associated with childhood stunting in Indonesia: A systematic review and meta-analysis.Asia Pacific Journal of Clinical... 2023In Indonesia, stunting is one of the most public health concerns. This study aims to systematically review and meta-analyze childhood stunting risk factors in the... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
In Indonesia, stunting is one of the most public health concerns. This study aims to systematically review and meta-analyze childhood stunting risk factors in the country.
METHODS AND STUDY DESIGN
We did a systematic review and meta-analysis of observational (cross-sectional and longitudi-nal) studies on stunting risk factors published between 2010 and 2021 based on available publications in online databases of PubMed, ProQuest, EBSCO, and google scholar. The quality of the publications was evaluated using the Newcastle-Ottawa Quality Assessment Scale and organized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Publication bias was examined using Egger's and Begg's tests.
RESULTS
A total of 17 studies from the literature search satisfied the inclusion criteria, with 642,596 subjects. The pooled stunting prevalence was 30.9% (95% CI 25.0%-36.8%). Children born with low birth weight (POR 2.39, 2.07-2.76), female (POR 1.05, 1.03-1.08), and did not get the deworming program (1.10, 1.07-1.12) are the primary child characteristics that contributed to stunting. Meanwhile, maternal age ≥ 30 years (POR 2.33, 2.23-2.44), preterm birth (POR 2.12, 2.15-2.19), and antenatal care <4 times (POR 1.25, 1.11-1.41) were among mother characteristics consistently associated with stunting. The primary household and community risk factors for stunting were food insecurity (POR 2.00, 1.37-2.92), unimproved drinking water (POR 1.42, 1.26-1.60), rural residence (POR 1.31, 1.20-1.42), and unimproved sanitation (POR 1.27, 1.12-1.44).
CONCLUSIONS
A diverse range of risk factors associated with childhood stunting in In-donesia demonstrates the need to emphasize nutrition programs by scaling up to more on these determinants.
Topics: Child; Infant, Newborn; Pregnancy; Humans; Female; Adult; Indonesia; Cross-Sectional Studies; Premature Birth; Growth Disorders; Mothers
PubMed: 37382316
DOI: 10.6133/apjcn.202306_32(2).0001 -
Current Environmental Health Reports Mar 2015Skin lesions and cancer are known manifestations of chronic exposure to arsenic contaminated drinking water. Epidemiologic data primarily comes from regions with... (Review)
Review
Skin lesions and cancer are known manifestations of chronic exposure to arsenic contaminated drinking water. Epidemiologic data primarily comes from regions with exposures 1-2 orders of magnitude above the current World Health Organization (WHO) guidelines of 10 μg/L. Emerging evidence indicates that more common exposures may also be related to both noncancerous and cancerous changes to the skin. In this review, we focus on the body of epidemiologic literature that encompasses exposures within the WHO guidelines, excluding studies that lacked individual exposure estimates and case reports. For skin lesions and skin cancers, 15 and 10 studies were identified that met our criteria, respectively. For skin lesions, a consistent dose-response relationship with water arsenic has been observed, with increased risk evident at low- to moderate-dose exposure. Of the larger studies of specific histologic types of skin cancers, although with differing exposure definitions, there was evidence of dose-related relationships with both basal cell carcinomas and squamous cell carcinomas. The effect of arsenic exposure on skin lesion risk is likely modified by genetic variants that influence arsenic metabolism. Accumulating evidence suggests that arsenic may increase risk of skin lesions and skin cancers at levels not previously considered harmful, and that genetic factors may influence risk.
Topics: Arsenic; Arsenic Poisoning; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Dose-Response Relationship, Drug; Drinking Water; Environmental Exposure; Global Health; Humans; Male; Skin Diseases; Water Pollution, Chemical
PubMed: 26231242
DOI: 10.1007/s40572-014-0040-x -
Foods (Basel, Switzerland) Aug 2023Interest in water chemical activity, its content, and its impact on human health has greatly increased throughout the last decade. Some studies suggest that drinking... (Review)
Review
BACKGROUND
Interest in water chemical activity, its content, and its impact on human health has greatly increased throughout the last decade. Some studies suggest that drinking water with high hardness may have preventative effects on cardiovascular diseases. This study aims to investigate the association between drinking water hardness and cardiovascular disease (CVD) mortality.
METHODS
The study selection process was designed to find the association between drinking water hardness and CVDs mortality. The search included both qualitative and quantitative research and was performed in three databases: Web of Science (Clarivate Analytics, Ann Arbor, MI, USA), PubMed (National Institute of Health, Bethesda, MA, USA), and Scopus (Elsevier, RELX Group plc, London, UK). The project was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42020213102.
RESULTS
Seventeen studies out of a total of twenty-five studies qualitatively analyzed indicated a significant relation between total water hardness and protection from CVD mortality. The quantitative analysis concluded that high drinking water hardness has a significantly lowering effect on mortality from CVDs, however, the heterogeneity was high.
CONCLUSIONS
This systematic literature review shows that total water hardness could affect CVD prevention and mortality. Due to the many confounding factors in the studies, more research is needed.
PubMed: 37685186
DOI: 10.3390/foods12173255 -
Scientific Reports Jan 2023Exposure to low levels of nitrate in drinking water may have adverse reproductive effects. We reviewed evidence about the association between nitrate in drinking water... (Meta-Analysis)
Meta-Analysis
Exposure to low levels of nitrate in drinking water may have adverse reproductive effects. We reviewed evidence about the association between nitrate in drinking water and adverse reproductive outcomes published to November 2022. Randomized trials, cohort or case-control studies published in English that reported the relationship between nitrate intake from drinking water and the risk of perinatal outcomes were included. Random-effect models were used to pool data. Three cohort studies showed nitrate in drinking water is associated with an increased risk of preterm birth (odds ratio for 1 mg/L NO-N increased (OR) = 1.01, 95% CI 1.00, 1.01, I = 23.9%, 5,014,487 participants; comparing the highest versus the lowest nitrate exposure groups pooled OR (OR) = 1.05, 95% CI 1.01, 1.10, I = 0%, 4,152,348 participants). Case-control studies showed nitrate in drinking water may be associated with the increased risk of neural tube defects OR = 1.06, 95% CI 1.02, 1.10; 2 studies, 2196 participants; I = 0%; and OR = 1.51, 95% CI 1.12, 2.05; 3 studies, 1501 participants; I = 0%). The evidence for an association between nitrate in drinking water and risk of small for gestational age infants, any birth defects, or any congenital heart defects was inconsistent. Increased nitrate in drinking water may be associated with an increased risk of preterm birth and some specific congenital anomalies. These findings warrant regular review as new evidence becomes available.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Nitrates; Drinking Water; Premature Birth; Reproduction; Parturition
PubMed: 36631499
DOI: 10.1038/s41598-022-27345-x -
PLoS Medicine May 2014Access to safe drinking-water is a fundamental requirement for good health and is also a human right. Global access to safe drinking-water is monitored by WHO and UNICEF... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Access to safe drinking-water is a fundamental requirement for good health and is also a human right. Global access to safe drinking-water is monitored by WHO and UNICEF using as an indicator "use of an improved source," which does not account for water quality measurements. Our objectives were to determine whether water from "improved" sources is less likely to contain fecal contamination than "unimproved" sources and to assess the extent to which contamination varies by source type and setting.
METHODS AND FINDINGS
Studies in Chinese, English, French, Portuguese, and Spanish were identified from online databases, including PubMed and Web of Science, and grey literature. Studies in low- and middle-income countries published between 1990 and August 2013 that assessed drinking-water for the presence of Escherichia coli or thermotolerant coliforms (TTC) were included provided they associated results with a particular source type. In total 319 studies were included, reporting on 96,737 water samples. The odds of contamination within a given study were considerably lower for "improved" sources than "unimproved" sources (odds ratio [OR] = 0.15 [0.10-0.21], I2 = 80.3% [72.9-85.6]). However over a quarter of samples from improved sources contained fecal contamination in 38% of 191 studies. Water sources in low-income countries (OR = 2.37 [1.52-3.71]; p<0.001) and rural areas (OR = 2.37 [1.47-3.81] p<0.001) were more likely to be contaminated. Studies rarely reported stored water quality or sanitary risks and few achieved robust random selection. Safety may be overestimated due to infrequent water sampling and deterioration in quality prior to consumption.
CONCLUSION
Access to an "improved source" provides a measure of sanitary protection but does not ensure water is free of fecal contamination nor is it consistent between source types or settings. International estimates therefore greatly overstate use of safe drinking-water and do not fully reflect disparities in access. An enhanced monitoring strategy would combine indicators of sanitary protection with measures of water quality.
Topics: Developing Countries; Drinking Water; Environmental Monitoring; Feces; Geography; Humans; Income; Publication Bias; Regression Analysis; Water Microbiology
PubMed: 24800926
DOI: 10.1371/journal.pmed.1001644