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Infectious Diseases of Poverty Oct 2023The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently, serology is the reference standard technique; occasionally, results are inconclusive, and a different diagnostic technique is needed. Some guidelines recommend molecular testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples.
METHODS
A systematic review was conducted up to July 27, 2022, including studies published in international databases. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A random-effects model was used to calculate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed the outcomes. Heterogeneity was determined by I and Tau statistics and P values. Funnel plots and Deek's test were used to assess publication bias. A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed.
RESULTS
We identified 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns regarding the risk of bias and applicability of all included studies. A positive and nonsignificant correlation coefficient (S = 0.020; P = 0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population (ACD). A positive and significant correlation coefficient (S = 0.597; P < 0.000) was obtained in the case of studies performed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master mix origin and guanidine addition representing significant sources.
INTERPRETATION/CONCLUSIONS AND RELEVANCE
The results described in this meta-analysis (qualitative and quantitative analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis and optimization of the different molecular techniques is crucial to implement this efficient diagnosis in endemic areas.
Topics: Adult; Child; Humans; Sensitivity and Specificity; Chagas Disease
PubMed: 37845734
DOI: 10.1186/s40249-023-01143-7 -
Lupus Dec 2016The objective of this study was to conduct a systematic review of case reports documenting the development of antiphospholipid syndrome or antiphospholipid... (Review)
Review
OBJECTIVE
The objective of this study was to conduct a systematic review of case reports documenting the development of antiphospholipid syndrome or antiphospholipid syndrome-related features after an infection.
METHODS
We searched Medline, EMBASE, Web of Science, PubMed ePubs, and The Cochrane Library - CENTRAL through March 2015 without restrictions. Studies reporting cases of antiphospholipid syndrome or antiphospholipid syndrome-related features following an infection were included.
RESULTS
Two hundred and fifty-nine publications met inclusion criteria, reporting on 293 cases. Three different groups of patients were identified; group 1 included patients who fulfilled the criteria for definitive antiphospholipid syndrome (24.6%), group 2 included patients who developed transient antiphospholipid antibodies with thromboembolic phenomena (43.7%), and group 3 included patients who developed transient antiphospholipid antibodies without thromboembolic events (31.7%). The most common preceding infection was viral (55.6%). In cases that developed thromboembolic events Human immunodeficiency and Hepatitis C viruses were the most frequently reported. Parvovirus B19 was the most common in cases that developed antibodies without thromboembolic events. Hematological manifestations and peripheral thrombosis were the most common clinical manifestations. Positive anticardiolipin antibodies were the most frequent antibodies reported, primarily coexisting IgG and IgM isotypes. Few patients in groups 1 and 2 had persistent antiphospholipid antibodies for more than 6 months. Outcome was variable with some cases reporting persistent antiphospholipid syndrome features and others achieving complete resolution of clinical events.
CONCLUSIONS
Development of antiphospholipid antibodies with all traditional manifestations of antiphospholipid syndrome were observed after variety of infections, most frequently after chronic viral infections with Human immunodeficiency and Hepatitis C. The causal relationship between infection and antiphospholipid syndrome cannot be established, but the possible contribution of various infections in the pathogenesis of antiphospholipid syndrome need further longitudinal and controlled studies to establish the incidence, and better quantify the risk and the outcomes of antiphospholipid-related events after infection.
Topics: Antibodies, Anticardiolipin; Antiphospholipid Syndrome; Bacterial Infections; HIV Infections; Hepatitis C; Humans; Immunoglobulin Isotypes; Mycoses; Parasitic Diseases; Virus Diseases
PubMed: 27060064
DOI: 10.1177/0961203316640912 -
Parasite Epidemiology and Control May 2023Co-infection of COVID-19 with other diseases increases the challenges related to its treatment management. COVID-19 co-infection with parasites is studied with low... (Review)
Review
Co-infection of COVID-19 with other diseases increases the challenges related to its treatment management. COVID-19 co-infection with parasites is studied with low frequency. Here, we systematically reviewed the cases of parasitic disease co-infection with COVID-19. All articles on COVID-19 co-infected with parasites (protozoa, helminths, and ectoparasites), were screened through defined inclusion/exclusion criteria. Of 2190 records, 35 studies remained for data extraction. The majority of studies were about COVID-19 co-infected with malaria, followed by strongyloidiasis, amoebiasis, chagas, filariasis, giardiasis, leishmaniasis, lophomoniasis, myiasis, and toxoplasmosis. No or low manifestation differences were reported between the co-infected cases and naïve COVID-19 or naïve parasitic disease. Although there was a relatively low number of reports on parasitic diseases-COVID-19 co-infection, COVID-19 and some parasitic diseases have overlapping symptoms and also COVID-19 conditions and treatment regimens may cause some parasites re-emergence, relapse, or re-activation. Therefore, more attention should be paid to the on-time diagnosis of COVID-19 and the co-infected parasites.
PubMed: 37091061
DOI: 10.1016/j.parepi.2023.e00299 -
The Lancet. Global Health Dec 2020The burden of malaria infection in sub-Saharan Africa among school-aged children aged 5-15 years is underappreciated and represents an important source of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The burden of malaria infection in sub-Saharan Africa among school-aged children aged 5-15 years is underappreciated and represents an important source of human-to-mosquito transmission of Plasmodium falciparum. Additional interventions are needed to control and eliminate malaria. We aimed to assess whether preventive treatment of malaria might be an effective means of reducing P falciparum infection and anaemia in school-aged children and lowering parasite transmission.
METHODS
In this systematic review and two meta-analyses, we searched the online databases PubMed, Embase, Cochrane CENTRAL, and Clinicaltrials.gov for intervention studies published between Jan 1, 1990, and Dec 14, 2018. We included randomised studies that assessed the effect of antimalarial treatment among asymptomatic school-aged children aged 5-15 years in sub-Saharan Africa on prevalence of P falciparum infection and anaemia, clinical malaria, and cognitive function. We first extracted data for a study-level meta-analysis, then contacted research groups to request data for an individual participant data meta-analysis. Outcomes of interest included prevalence of P falciparum infection detected by microscopy, anaemia (study defined values or haemoglobin less than age-adjusted and sex-adjusted values), clinical malaria (infection and symptoms on the basis of study-specific definitions) during follow-up, and code transmission test scores. We assessed effects by treatment type and duration of time protected, and explored effect modification by transmission setting. For study-level meta-analysis, we calculated risk ratios for binary outcomes and standardised mean differences for continuous outcomes and pooled outcomes using fixed-effect and random-effects models. We used a hierarchical generalised linear model for meta-analysis of individual participant data. This study is registered with PROSPERO, CRD42016030197.
FINDINGS
Of 628 studies identified, 13 were eligible for the study-level meta-analysis (n=16 309). Researchers from 11 studies contributed data on at least one outcome (n=15 658) for an individual participant data meta-analysis. Interventions and study designs were highly heterogeneous; overall risk of bias was low. In the study-level meta-analysis, treatment was associated with reductions in P falciparum prevalence (risk ratio [RR] 0·27, 95% CI 0·17-0·44), anaemia (0·77, 0·65-0·91), and clinical malaria (0·40, 0·28-0·56); results for cognitive outcomes are not presented because data were only available for three trials. In our individual participant data meta-analysis, we found treatment significantly decreased P falciparum prevalence (adjusted RR [ARR] 0·46, 95% CI 0·40-0·53; p<0·0001; 15 648 individuals; 11 studies), anaemia (ARR 0·85, 0·77-0·92; p<0·0001; 15 026 individuals; 11 studies), and subsequent clinical malaria (ARR 0·50, 0·39-0·60; p<0·0001; 1815 individuals; four studies) across transmission settings. We detected a marginal effect on cognitive function in children older than 10 years (adjusted mean difference in standardised test scores 0·36, 0·01-0·71; p=0·044; 3962 individuals; five studies) although we found no significant effect when combined across all ages.
INTERPRETATION
Preventive treatment of malaria among school-aged children significantly decreases P falciparum prevalence, anaemia, and risk of subsequent clinical malaria across transmission settings. Policy makers and programme managers should consider preventive treatment of malaria to protect this age group and advance the goal of malaria elimination, while weighing these benefits against potential risks of chemoprevention.
FUNDING
US National Institutes of Health and Burroughs Wellcome Fund/ASTMH Fellowship.
Topics: Adolescent; Africa South of the Sahara; Antimalarials; Child; Child, Preschool; Humans; Malaria
PubMed: 33222799
DOI: 10.1016/S2214-109X(20)30325-9 -
Acta Tropica May 2017Parasitic infections are a serious public health problem because they cause anemia, growth retardation, aggression, weight loss, and other physical and mental health... (Meta-Analysis)
Meta-Analysis Review
Parasitic infections are a serious public health problem because they cause anemia, growth retardation, aggression, weight loss, and other physical and mental health problems, especially in children. Numerous studies have been performed on intestinal parasitic infections in Iranian preschool and school children. However, no study has gathered and analyzed this information systematically. The aim of this study was to provide summary estimates for the available data on intestinal parasitic infections in Iranian children. We searched 9 English and Persian databases, unpublished data, abstracts of scientific congresses during 1996-2015 using the terms intestinal parasite, Giardia, Cryptosporidium, Enterobiusvermicularis, oxyure, school, children, preschool, and Iran. We conducted meta-analysis using STATA, and for all statistical tests, p-value less than 0.05was considered significant. Among the 68,532 publications searched as a result, 103 were eligible for inclusion in the study. The prevalence rate of intestinal parasitic infections was 38% (95% CI- 33%, 43%). Prevalence of protozoa, helminthic intestinal infections, and non-pathogenic parasites was 16.9%, 9.48%, and 18.5%, respectively, which affected 14.27% males and 15.3% females. The rate of infection in preschool and school children was 38.19% and 43.37% respectively. Giardia, Enterobiusvermicularis and Entamoeba coli were the most common among protozoa, helminthic, and non-pathogenic infections (15.1%, 16.5%, and 7.1%, respectively). The data analyses indicated that the prevalence of intestinal parasitic infection is decreasing in Iranian preschool and school children. Improvement of sanitation, personal hygiene, increased awareness of people, seasonal variations, and health education can be effective in reducing parasitic infections in different communities.
Topics: Animals; Child; Child, Preschool; Humans; Intestinal Diseases, Parasitic; Iran; Prevalence; Schools
PubMed: 28130101
DOI: 10.1016/j.actatropica.2017.01.019 -
Poultry Science Dec 2019In Ethiopia, poultry production is an important source of domestic food and nutrition security while providing income for nearly 80% of Ethiopians. However, several... (Meta-Analysis)
Meta-Analysis
In Ethiopia, poultry production is an important source of domestic food and nutrition security while providing income for nearly 80% of Ethiopians. However, several infectious and parasitic diseases hamper poultry production. To date, evidence on the nationwide burden of specific diseases has not been collated to inform targeting of poultry health interventions. The objective of this systematic review is to summarize and analyze the literature on poultry diseases since 2000. A detailed systematic review protocol was designed according to Cochrane collaboration, Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. The review revealed that 14 infectious and parasitic diseases of poultry were reported in 110 published studies from 2000 to 2017, and 81.82% (90/110) of the studies covered 6 diseases: Newcastle disease (ND), infectious bursal disease (IBD), avian coccidiosis, helminth infestation, ecto-parasite infestation, and Salmonella infection. The pooled prevalence estimates of ND and IBD were 44% (95% confidence interval [CI]: 27 to 63) and 41% (95% CI: 23 to 60), respectively. Among the parasitic diseases, avian coccidiosis, helminth infestation, and ecto-parasite infestation had estimated pooled prevalences of 37% (95% CI: 30 to 44), 62% (95% CI: 45 to 78), and 50% (95% CI: 33 to 68), respectively. The pooled prevalence estimate of Salmonella infection was found to be 51% (95% CI: 32 to 70). Most of the studies were conducted in central Ethiopia, in the State of Oromia, and focused on extensive farming systems. While the number of studies was low, the overall trend of disease reporting in the literature is increasing (Y = 0.99X-3.34). In conclusion, the high-pooled prevalence estimates of diseases and the scarcity of reported data for all of Ethiopia indicate an important data gap on infectious-disease distribution in the country. While the high-pooled prevalence points towards the need for intervention to control poultry diseases, there is also a need to ensure all diseases that result in production losses and public health risks are studied appropriately in all Ethiopian production systems.
Topics: Animals; Chickens; Ethiopia; Poultry Diseases; Prevalence
PubMed: 31801311
DOI: 10.3382/ps/pez521 -
PLoS Neglected Tropical Diseases Feb 2015Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis.
METHODS
A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%.
PRINCIPAL FINDINGS
Six studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27-3.9), p = 0.005.
CONCLUSIONS
Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy.
Topics: Chronic Disease; Epilepsy; Humans; Middle Aged; Odds Ratio; Risk Factors; Toxoplasma; Toxoplasmosis
PubMed: 25695802
DOI: 10.1371/journal.pntd.0003525 -
Current Drug Targets 2023Diseases caused by protozoa are one of the leading causes of death worldwide, especially in tropical regions such as Brazil. Chagas disease, leishmaniasis, and malaria...
INTRODUCTION
Diseases caused by protozoa are one of the leading causes of death worldwide, especially in tropical regions such as Brazil. Chagas disease, leishmaniasis, and malaria are responsible for around 234 million cases and more than 400,000 deaths worldwide. Despite this scenario, drugs for these diseases have several limitations, which justifies the search for new treatments. Iron superoxide dismutase is a promising target for the drug design to treat patients with these diseases. It is a validated target and protects against oxidative stress.
AIM
Thus, this systematic review aimed to synthesize evidence on the importance of superoxide dismutase in the drug design to treat patients with this protozoosis.
METHODS
A search was performed for in vitro and in vivo studies, without publication and language restrictions, in MEDLINE (PubMed), LILACS (BVS), Science Direct, and EMBASE (Elsevier). Studies that pointed to the relationship between the reduction or increase in superoxide dismutase activity and the diseases were included. 23 studies were selected for the qualitative synthesis.
RESULTS
The results showed that the inhibition or reduction of the enzyme activity decreases the degree of infection and reinfection and improves the results in treating these diseases. In contrast, the increase in activity caused a high degree of survival and resistance of the parasites.
CONCLUSION
However, the overall quality of evidence is low and more studies with methodological rigor are provided.
Topics: Humans; Chagas Disease; Leishmaniasis; Malaria; Drug Design; Superoxide Dismutase
PubMed: 36503390
DOI: 10.2174/1389450124666221209105822 -
BMJ Clinical Evidence Jun 2010Infection 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 1000 non-immune pregnant women may acquire toxoplasma infection, with a 10% to 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 May 2010 (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 seven 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, and antiparasitic drugs in neonates.
Topics: Acute Disease; Antiparasitic Agents; Humans; Incidence; Pregnancy Complications, Parasitic; Toxoplasma; Toxoplasmosis; Toxoplasmosis, Congenital
PubMed: 21418689
DOI: No ID Found -
Child's Nervous System : ChNS :... Mar 2023Neurocysticercosis (NCC) is considered a neglected infectious disease, but the most common parasitic disease of the central nervous system (CNS). Due to oral tendencies... (Review)
Review
PURPOSE
Neurocysticercosis (NCC) is considered a neglected infectious disease, but the most common parasitic disease of the central nervous system (CNS). Due to oral tendencies in childhood, it is hypothesized that individuals are infected around this age and develop symptoms as lately as during young adulthood. Although it is considered a benign disease, it may cause great impact in the patient's quality of life due to epilepsy, visual symptoms, and hydrocephalus, which eventually requires frequent hospitalizations. The treatment of hydrocephalus is the main challenge for neurosurgeons.
METHODS
We performed a concise review on neurocysticercosis in children and the main presentations of NCC in the neurosurgery practice and a systematic review on hydrocephalus secondary to extraparenchymal NCC.
RESULTS
Our review showed a rate of complete resolution of hydrocephalus secondary to NCC of around 80% with the first attempt of surgical treatment combined with medication therapy. Endoscopic removal of the intraventricular cysts with third ventriculostomy was the most common treatment modality. Patients previously managed with ventricular shunts are likely to have worse outcomes and complications.
CONCLUSION
Endoscopic approach is the gold standard surgical treatment for hydrocephalus secondary to neurocysticercosis.
Topics: Humans; Child; Young Adult; Adult; Neurocysticercosis; Neurosurgery; Quality of Life; Ventriculostomy; Hydrocephalus
PubMed: 36689000
DOI: 10.1007/s00381-022-05784-1