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Diagnostics (Basel, Switzerland) Jun 2021Mobile health devices are emerging applications that could help deliver point-of-care (POC) diagnosis, particularly in settings with limited laboratory infrastructure,... (Review)
Review
Mobile health devices are emerging applications that could help deliver point-of-care (POC) diagnosis, particularly in settings with limited laboratory infrastructure, such as Sub-Saharan Africa (SSA). The advent of Severe acute respiratory syndrome coronavirus 2 has resulted in an increased deployment and use of mHealth-linked POC diagnostics in SSA. We performed a systematic review and meta-analysis to evaluate the accuracy of mobile-linked point-of-care diagnostics in SSA. Our systematic review and meta-analysis were guided by the Preferred Reporting Items requirements for Systematic Reviews and Meta-Analysis. We exhaustively searched PubMed, Science Direct, Google Scholar, MEDLINE, and CINAHL with full text via EBSCOhost databases, from mHealth inception to March 2021. The statistical analyses were conducted using OpenMeta-Analyst software. All 11 included studies were considered for the meta-analysis. The included studies focused on malaria infections, , , soil-transmitted helminths, and . The pooled summary of sensitivity and specificity estimates were moderate compared to those of the reference representing the gold standard. The overall pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of mobile-linked POC diagnostic devices were as follows: 0.499 (95% CI: 0.458-0.541), 0.535 (95% CI: 0.401-0.663), 0.952 (95% CI: 0.60-1.324), 1.381 (95% CI: 0.391-4.879), and 0.944 (95% CI: 0.579-1.538), respectively. Evidence shows that the diagnostic accuracy of mobile-linked POC diagnostics in detecting infections in SSA is presently moderate. Future research is recommended to evaluate mHealth devices' diagnostic potential using devices with excellent sensitivities and specificities for diagnosing diseases in this setting.
PubMed: 34204848
DOI: 10.3390/diagnostics11061081 -
The Lancet. Microbe Apr 2024Accurate diagnosis is pivotal for implementing strategies for surveillance, control, and elimination of schistosomiasis. Despite their low sensitivity in low-endemicity... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Accurate diagnosis is pivotal for implementing strategies for surveillance, control, and elimination of schistosomiasis. Despite their low sensitivity in low-endemicity areas, microscopy-based urine filtration and the Kato-Katz technique are considered as reference diagnostic tests for Schistosoma haematobium and Schistosoma mansoni infections, respectively. We aimed to collate all available evidence on the accuracy of other proposed diagnostic techniques.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Embase, the Cochrane Library, and LILACS for studies published from database inception to Dec 31, 2022, investigating the sensitivity and specificity of diagnostic tests for S haematobium and S mansoni infections against Kato-Katz thick smears or urine microscopy (reference tests) involving adults (aged ≥18 years), school-aged children (aged 7 to 18 years), or preschool-aged children (aged 1 month to 7 years). We extracted raw data on true positives, true negatives, false positives, and false negatives for the diagnostic tests and data on the number of participants, study authors, publication year, journal, study design, participants' age and sex, prevalence of Schistosoma infection, and treatment status. To account for imperfect reference tests, we used a hierarchical Bayesian latent class meta-analysis to model test accuracy.
FINDINGS
Overall, we included 121 studies, assessing 28 different diagnostic techniques. Most studies (103 [85%] of 121) were done in Africa, 14 (12%) in South America, one (1%) in Asia, and one (1%) in an unknown country. Compared with the reference test, Kato-Katz thick smears, circulating cathodic antigen urine cassette assay version 1 (CCA1, 36 test comparisons) had excellent sensitivity (95% [95% credible interval 88-99]) and reasonable specificity (74% [63-83]) for S mansoni. ELISA-based tests had a performance comparable to circulating cathodic antigen, but there were few available test comparisons. For S haematobium, proteinuria (42 test comparisons, sensitivity 73% [62-82]; specificity 94% [89-98]) and haematuria (75 test comparisons, sensitivity 85% [80-90]; specificity 96% [92-99]) reagent strips showed high specificity, with haematuria reagent strips having better sensitivity. Despite limited data, nucleic acid amplification tests (NAATs; eg, PCR or loop-mediated isothermal amplification [LAMP]) showed promising results with sensitivity estimates above 90%. We found an unclear risk of bias of about 70% in the use of the reference or index tests and of 50% in patient selection. All analyses showed substantial heterogeneity (I>80%).
INTERPRETATION
Although NAATs and immunological diagnostics show promise, the limited information available precludes drawing definitive conclusions. Additional research on diagnostic accuracy and cost-effectiveness is needed before the replacement of conventional tests can be considered.
FUNDING
WHO and Luxembourg Institute of Health.
Topics: Child; Child, Preschool; Adult; Animals; Humans; Adolescent; Schistosoma mansoni; Schistosoma haematobium; Hematuria; Reagent Strips; Microscopy; Bayes Theorem; Feces; Antigens, Helminth; Urinalysis; Schistosomiasis haematobia; Diagnostic Tests, Routine
PubMed: 38467130
DOI: 10.1016/S2666-5247(23)00377-4 -
Tropical Diseases, Travel Medicine and... Dec 2021Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia....
BACKGROUND
Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels.
METHODS AND MATERIAL
The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model.
RESULT
Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02-44.24). High heterogeneity was observed with I of 99.4%, P < 0.000. According to subgroup analysis, the pooled prevalence was high in the SNNPR (41.49%: 95%CI: 19.52-63.46) followed by the Amhara region (41.11%: 95%CI: 30.41-51.8), the Tigray region (31.40%: 95%CI:11.72-51.09), and the Oromia region (28.98%: 95%CI: 18.85-39.1). Year from 2011 to 2015 contributed to the highest prevalence of Schistosoma mansoni infection among children (46.31%: 95%:34.21-59.05).
CONCLUSION
This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.
PubMed: 34847958
DOI: 10.1186/s40794-021-00156-0 -
Infectious Diseases of Poverty Apr 2018The speedy rate of change in the environmental and socio-economics factors may increase the incidence, prevalence and risk of schistosomiasis infections in Zambia.... (Review)
Review
BACKGROUND
The speedy rate of change in the environmental and socio-economics factors may increase the incidence, prevalence and risk of schistosomiasis infections in Zambia. However, available information does not provide a comprehensive understanding of the biogeography and distribution of the disease, ecology and population dynamics of intermediate host snails. The current study used an information-theoretical approach to understand the biogeography and prevalence schistosomiasis and identified knowledge gaps that would be useful to improve policy towards surveillance and eradication of intermediate hosts snails in Zambia.
METHODS
To summarise the existing knowledge and build on past and present experiences of schistosomiasis epidemiology for effective disease control in Zambia, a systematic search of literature for the period 2000-2017 was done on PubMed, Google Scholar and EBSCOhost. Using the key words: 'Schistosomiasis', 'Biomphalaria', 'Bulinus', 'Schistosoma mansoni', 'Schistosoma haematobium', and 'Zambia', in combination with Booleans terms 'AND' and 'OR', published reports/papers were obtained and reviewed independently for inclusion.
RESULTS
Thirteen papers published in English that fulfilled the inclusion criteria were selected for the final review. The papers suggest that the risk of infection has increased over the years and this has been attributed to environmental, socio-economic and demographic factors. Furthermore, schistosomiasis is endemic in many parts of the country with infection due to Schistosoma haematobium being more prevalent than that due to S. mansoni. This review also found that S. haematobium was linked to genital lesions, thus increasing risks of contracting other diseases such as HIV and cervical cancer.
CONCLUSIONS
For both S. haematobium and S. mansoni, environmental, socio-economic, and demographic factors were influential in the transmission and prevalence of the disease and highlight the need for detailed knowledge on ecological modelling and mapping the distribution of the disease and intermediate host snails for effective implementation of control strategies.
Topics: Animals; Humans; Prevalence; Schistosoma haematobium; Schistosoma mansoni; Schistosomiasis haematobia; Schistosomiasis mansoni; Socioeconomic Factors; Zambia
PubMed: 29706131
DOI: 10.1186/s40249-018-0424-5 -
Acta Tropica May 2023Schistosoma japonicum remains endemic in China and the Philippines. Substantial progress has been made in the control of Japonicum in both China and the Philippines.... (Review)
Review
BACKGROUND
Schistosoma japonicum remains endemic in China and the Philippines. Substantial progress has been made in the control of Japonicum in both China and the Philippines. China is reaching elimination thanks to a concerted effort of control strategies. Mathematical modelling has been a key tool in the design of control strategies, in place of expensive randomised-controlled trials. We conducted a systematic review to investigate mathematical models of Japonicum control strategies in China and the Philippines.
METHODS
We conducted a systematic review on July 5, 2020, in four electronic bibliographic databases - PubMed, Web of Science, SCOPUS and Embase. Articles were screened for relevance and for meeting the inclusion criteria. Data extracted included authors, year of publication, year of data collection, setting and ecological context, objectives, control strategies, main findings, the form and content of the model including its background, type, representation of population dynamics, heterogeneity of hosts, simulation period, source of parameters, model validation and sensitivity analysis. Results After screening, 19 eligible papers were included in the systematic review. Seventeen considered control strategies in China and two in the Philippines. Two frameworks were identified; the mean-worm burden framework and the prevalence-based framework, the latter of which increasingly common. Most models considered human and bovine definitive hosts. There were mixed additional elements included in the models, such as alternative definitive hosts and the role of seasonality and weather. Models generally agreed upon the need for an integrated control strategy rather than reliance on mass drug administration alone to sustain reductions in prevalence.
CONCLUSIONS
Mathematical modelling of Japonicum has converged from multiple approaches to modelling using the prevalence-based framework with human and bovine definitive hosts and find integrated control strategies to be most effective. Further research could investigate the role of other definitive hosts and model the effect of seasonal fluctuations in transmission.
Topics: Animals; Cattle; Humans; Schistosoma japonicum; Schistosomiasis japonica; Models, Theoretical; Computer Simulation; China
PubMed: 36907291
DOI: 10.1016/j.actatropica.2023.106873 -
Acta Parasitologica Mar 2022Schistosomiasis is one of the leading chronic parasitic diseases in Ethiopia. We aimed to summarize the prevalence of S. mansoni in human and Biomphalaria snails as well... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Schistosomiasis is one of the leading chronic parasitic diseases in Ethiopia. We aimed to summarize the prevalence of S. mansoni in human and Biomphalaria snails as well as risk factors in Ethiopia.
METHODS
Literature search was carried out from Scopus, Google Scholar, Science Direct and PubMed which reported Schistosoma mansoni infection in human and Biomphalaria snails in Ethiopia. The overall prevalence was estimated by a random-effect model and heterogeneities among studies were assessed by I test.
RESULTS
A total of 178,251 participants and 1,097 snails were tested for the presence of S. mansoni in the eligible studies. The pooled prevalence of S. mansoni was 32.5% (95% CI 28.0-37.0) and 15.9% (95% CI - 5.6-37.5) in human and Biomphalaria snails in Ethiopia, respectively. The highest pooled prevalence was 43.2% (95% CI 27.3-59.1) in South Nations and National Peoples region while the lowest pooled prevalence was 25% (95% CI 19.3-30.7) observed in the Afar region. Interestingly, the pooled prevalence of S. mansoni declined from 40.7% (95% CI 33-48.4) to 22.4% (95% CI 18.5-26.3) after the launching of mass drug administration (MDA). The analysis of risk factors showed that swimming habit (OR, 2.78; 95% CI 2.35-3.21) and participation in irrigation (OR, 2.69; 95% CI 1.45-3.73) were independent predictors for S. mansoni infection.
CONCLUSION
This study revealed that about one-third of human and nearly 16% of Biomphalaria snails were infected with S. mansoni in Ethiopia. This review indicated that the prevalence of S. mansoni declined after the implementation of MDA. This study highlights the importance of further integrated approaches for better control of schistosomiasis in Ethiopia.
Topics: Animals; Biomphalaria; Ethiopia; Humans; Prevalence; Risk Factors; Schistosoma mansoni; Schistosomiasis mansoni; Snails
PubMed: 34259986
DOI: 10.1007/s11686-021-00449-6 -
PloS One 2020While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection... (Meta-Analysis)
Meta-Analysis
While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity of information on the global reinfection rate of schistosomiasis. This systematic review and meta-analysis aimed at summarizing studies that estimated the reinfection rate of human schistosomiasis. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on reinfection rate of human schistosomiasis. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted using statistical R version 3.6.2 and R Studio using "meta" and "metafor" packages. Random effect model was employed to estimate pooled reinfection rates. Heterogeneity was determined using Cochran's Q (chi-square)-test and Higgins I2 statistics. A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5-9 scores) quality. The overal mean and pooled reinfection rates of schistosomiasis were 36.1% (±23.3%) and 33.2% (95% CI, 26.5-40.5%) respectively. For intestinal schistosomiasis, the mean and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8-51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3%- 29.2%) respectively. Cochran's Q (chi-square)-test and Higgins I2 statistic indicated significant heterogeneity across studies (p-values < 0.001, I2 values > 95%). Results of subgroup analysis showed that, the type of Schistosoma species, participants' age group, sample size and geographical area had influence on disparity variation in reinfection rate of schistosomiasis (p < 0.1). Despite the control measures in place, the re-infection rate is still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing intensive programmatic strategies for schistosomiasis elimination should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six months, intensive snails control and health education.
Topics: Animals; Biometry; Humans; Praziquantel; Reinfection; Schistosoma; Schistosomiasis
PubMed: 33270752
DOI: 10.1371/journal.pone.0243224 -
Parasitology Jul 2018We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of... (Meta-Analysis)
Meta-Analysis
We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.
Topics: Animals; Biomphalaria; Brazil; Environment; Feces; Humans; Income; Parasite Egg Count; Prevalence; Risk Factors; Schistosoma mansoni; Schistosomiasis mansoni; Socioeconomic Factors
PubMed: 29295718
DOI: 10.1017/S0031182017002268 -
Infectious Disorders Drug Targets 2022Co-infection of schistosomiasis and malaria with hepatitis B virus (HBV) and hepatitis C virus (HCV) are common in countries where schistosomiasis and malaria are... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Co-infection of schistosomiasis and malaria with hepatitis B virus (HBV) and hepatitis C virus (HCV) are common in countries where schistosomiasis and malaria are endemic.
OBJECTIVE
The present systematic review and meta-analysis was conducted to assess the prevalence of malaria/hepatitis viruses and Schistosoma/hepatitis viruses' co-infections.
MATERIALS AND METHODS
Relevant published studies on the co-infection of malaria and Schistosoma spp. with HBV and HCV were retrieved via international databases (PubMed, Scopus, Web of Science, and Google Scholar). Regarding meta-analysis, the random-effect model was employed by forest plot with a 95% of confidence interval (CI).
RESULTS
A total of 22 studies, including 15 studies with malaria/hepatitis viruses' co-infection and 7 studies with Schistosoma/hepatitis viruses' co-infection met the eligibility criteria. The co-infection of malaria/HCV and malaria/HBV in different populations were 15% (95% CI, 0-77%) and 5% (95% CI, 1-10%), respectively. Moreover, Schistosoma/HCV and Schistosoma/HBV co infection were detected in 7% (95% CI, 0-54%) and 2% (95% CI, 0-7%), respectively.
CONCLUSION
The overlaps between Schistosoma spp. and malaria with hepatitis B and C viruses in endemic countries with lower income levels were high, which deserve further attention.
Topics: Animals; Coinfection; Hepacivirus; Hepatitis B; Hepatitis B virus; Hepatitis C; Hepatitis Viruses; Humans; Malaria; Prevalence; Schistosoma; Schistosomiasis
PubMed: 35388763
DOI: 10.2174/1871526522666220406122742 -
PLoS Neglected Tropical Diseases Jan 2018By means of meta-analysis of information from all relevant epidemiologic studies, we examined the hypothesis that Schistosoma infection in school-aged children (SAC) is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
By means of meta-analysis of information from all relevant epidemiologic studies, we examined the hypothesis that Schistosoma infection in school-aged children (SAC) is associated with educational loss and cognitive deficits.
METHODOLOGY/PRINCIPAL FINDINGS
This review was prospectively registered in the PROSPERO database (CRD42016040052). Medline, Biosis, and Web of Science were searched for studies published before August 2016 that evaluated associations between Schistosoma infection and cognitive or educational outcomes. Cognitive function was defined in four domains-learning, memory, reaction time, and innate intelligence. Educational outcome measures were defined as attendance and scholastic achievement. Risk of bias (ROB) was evaluated using the Newcastle-Ottawa quality assessment scale. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated to compare cognitive and educational measures for Schistosoma infected /not dewormed vs. uninfected/dewormed children. Sensitivity analyses by study design, ROB, and sequential exclusion of individual studies were implemented. Thirty studies from 14 countries, including 38,992 SAC between 5-19 years old, were identified. Compared to uninfected children and children dewormed with praziquantel, the presence of Schistosoma infection and/or non-dewormed status was associated with deficits in school attendance (SMD = -0.36, 95%CI: -0.60, -0.12), scholastic achievement (SMD = -0.58, 95%CI: -0.96, -0.20), learning (SMD = -0.39, 95%CI: -0.70, -0.09) and memory (SMD = -0.28, 95%CI: -0.52, -0.04) tests. By contrast, Schistosoma-infected/non-dewormed and uninfected/dewormed children were similar with respect to performance in tests of reaction time (SMD = -0.06, 95%CI: -0.42, 0.30) and intelligence (SMD = -0.25, 95%CI: -0.57, 0.06). Schistosoma infection-associated deficits in educational measures were robust among observational studies, but not among interventional studies. The significance of infection-associated deficits in scholastic achievement was sensitive to ROB. Schistosoma infection-related deficits in learning and memory tests were invariant by ROB and study design.
CONCLUSION/SIGNIFICANCE
Schistosoma infection/non-treatment was significantly associated with educational, learning, and memory deficits in SAC. Early treatment of children in Schistosoma-endemic regions could potentially mitigate these deficits.
TRIAL REGISTRATION
ClinicalTrials.gov CRD42016040052.
Topics: Adolescent; Animals; Anthelmintics; Child; Child, Preschool; Cognition; Cognitive Dysfunction; Humans; Intelligence; Learning Disabilities; Memory; Memory Disorders; Memory and Learning Tests; Praziquantel; Reaction Time; Schistosoma; Schistosomiasis
PubMed: 29329293
DOI: 10.1371/journal.pntd.0005524