-
Infectious Diseases in Obstetrics and... 2024Toxocariasis is an important health problem caused by the parasitic species () and (). Prevalence of toxocariasis in pregnant women as a vulnerable population is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxocariasis is an important health problem caused by the parasitic species () and (). Prevalence of toxocariasis in pregnant women as a vulnerable population is doubly important, and the aim of this study is to estimate the overall prevalence of toxocariasis infection in pregnant women according to the available reports.
METHODS
The present study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklists. A systematic search was carried out in international scientific databases (Google Scholar, Web of Science, ScienceDirect, Scopus, and PubMed) between 1990 and 2023. The overall prevalence of parasitic infection was estimated with a random-effects model. All analyses (overall prevalence, heterogeneity, publication bias, and sensitivity analysis) were performed with comprehensive meta-analysis (V2.2, Bio stat) software.
RESULTS
Amid the final eleven included studies, based on the random-effects model, the estimation of the pooled prevalence of spp. was 20.8% (95% CI, 9.8-38.7%). The association between the risk factors of toxocariasis and the prevalence of the disease was not statistically significant.
CONCLUSIONS
In the present study, significant prevalence was reported; however, considering the limited number of studies, it seems that the actual prevalence of the disease is higher. Therefore, it seems necessary to monitor this health problem in pregnant women.
Topics: Humans; Female; Pregnancy; Toxocariasis; Animals; Toxocara; Seroepidemiologic Studies; Pregnancy Complications, Parasitic; Prevalence; Toxocara canis
PubMed: 38682081
DOI: 10.1155/2024/1943353 -
PLoS Neglected Tropical Diseases Apr 2024Cutaneous leishmaniasis (CL) is characterized by potentially disfiguring skin ulcers carrying significant social stigma. To mitigate systemic drug exposure and reduce...
BACKGROUND
Cutaneous leishmaniasis (CL) is characterized by potentially disfiguring skin ulcers carrying significant social stigma. To mitigate systemic drug exposure and reduce the toxicity from available treatments, studies addressing new local therapeutic strategies using available medications are coming up. This review systematically compiles preclinical and clinical data on the efficacy of amphotericin B (AmB) administered locally for cutaneous leishmaniasis.
METHODOLOGY
Structured searches were conducted in major databases. Clinical studies reporting cure rates and preclinical studies presenting any efficacy outcome were included. Exclusion criteria comprised nonoriginal studies, in vitro investigations, studies with fewer than 10 treated patients, and those evaluating AmB in combination with other antileishmanial drug components.
PRINCIPAL FINDINGS
A total of 21 studies were identified, encompassing 16 preclinical and five clinical studies. Preclinical assessments generally involved the topical use of commercial AmB formulations, often in conjunction with carriers or controlled release systems. However, the variation in the treatment schedules hindered direct comparisons. In clinical studies, topical AmB achieved a pooled cure rate of 45.6% [CI: 27.5-64.8%; I2 = 79.7; p = 0.002), while intralesional (IL) administration resulted in a 69.8% cure rate [CI: 52.3-82.9%; I2 = 63.9; p = 0.06). In the direct comparison available, no significant difference was noted between AmB-IL and meglumine antimoniate-IL administration (OR:1.7; CI:0.34-9.15, I2 = 79.1; p = 0.00), however a very low certainty of evidence was verified.
CONCLUSIONS
Different AmB formulations and administration routes have been explored in preclinical and clinical studies. Developing therapeutic technologies is evident. Current findings might be interpreted as a favorable proof of concept for the local AmB administration which makes this intervention eligible to be explored in future well-designed studies towards less toxic treatments for leishmaniasis.
Topics: Leishmaniasis, Cutaneous; Amphotericin B; Humans; Antiprotozoal Agents; Administration, Topical; Treatment Outcome
PubMed: 38626196
DOI: 10.1371/journal.pntd.0012127 -
Actas Espanolas de Psiquiatria Apr 2024Toxoplasmosis is a worldwide parasitic zoonosis caused by the protozoan Toxoplasma gondii. In cases of vertical infection, and in immunosuppressed people by the human...
BACKGROUND
Toxoplasmosis is a worldwide parasitic zoonosis caused by the protozoan Toxoplasma gondii. In cases of vertical infection, and in immunosuppressed people by the human immunodeficiency virus (HIV) serious clinical conditions may appear, while immunocompetent people do not present symptoms. However, T. gondii infection has been linked to several mental disorders for decades.
OBJECTIVE
To substantiate the possible relationship between T. gondii and mental disorders and suggest control and prevention strategies.
MATERIAL AND METHODS
A systematic review has been carried out to analyze the relationship between T. gondii exposure (presence of IgG) and the onset of mental disorders in minors and adults. The etiopathogenic mechanisms described by the authors have also been included and the systems of surveillance, prevention and control of infection have been evaluated.
RESULTS
Several processes linked to the presence of cysts and the reactivation of the parasite in certain situations produce an immune and inflammatory response. Also, direct and indirect actions on different neurotransmitters. These mechanisms, together with other environmental and genetic factors, would predispose to different psychiatric pathologies.
CONCLUSIONS
Due to the limits of the study, no conclusions can be drawn in childhood and adolescence. However, the results of this systematic review show a possible association of schizophrenia, bipolar disorder and compulsive disorder with T. gondii infection in adults. There is a need to improve control, integrated surveillance and extend prevention measures to the entire population.
Topics: Adult; Adolescent; Humans; Toxoplasmosis; Mental Disorders; Toxoplasma; Bipolar Disorder; Schizophrenia
PubMed: 38622004
DOI: 10.62641/aep.v52i2.1658 -
Current Opinion in Obstetrics &... Jun 2024To examine impact of vaginal dysbiosis (VD), including bacterial vaginosis (BV) and aerobic vaginitis (AV) on reproductive outcomes of in vitro fertilization (IVF)... (Meta-Analysis)
Meta-Analysis
PURPOSE OF REVIEW
To examine impact of vaginal dysbiosis (VD), including bacterial vaginosis (BV) and aerobic vaginitis (AV) on reproductive outcomes of in vitro fertilization (IVF) patients.
RECENT FINDINGS
BV-bacteria (e.g. Gardnerella ) and AV-bacteria (e.g. Streptococci and Enterococci ) have been identified in the endometrium. However, there is inconclusive evidence whether IVF patients with VD have lower success rates.
SUMMARY
The present systematic review and meta-analysis of PubMed/Medline, until December 2023 included 25 studies, involving 6835 IVF patients. Overall VD was defined as an approximation of community state type IV, including BV and AV-type dysbiosis based on either molecular or microscopy methods. Outcomes were live birth rate (LBR), early pregnancy loss (EPL), clinical pregnancy rate (CPR), and biochemical pregnancy rate (BPR).Vaginal dysbiosis prevalence was 19% [1271/6835, 95% confidence interval (CI) 18-20%]. Six studies examined AV-type dysbiosis with a prevalence of 4% (26/628, 95% CI 3-6%). Vaginal dysbiosis correlates with a higher EPL [relative risk (RR) = 1.49, 95% CI 1.15-1.94] and lower CPR (RR = 0.82, 95% CI 0.70-0.95). No statistically significant impact of VD, BV, or AV was found on LBR and BPR.Thus, the association between VD and reproductive outcome remains puzzling as it is difficult to explain how VD impacts CPR and EPL but not LBR and BPR.
Topics: Humans; Female; Dysbiosis; Pregnancy; Fertilization in Vitro; Vaginosis, Bacterial; Vagina; Pregnancy Rate; Abortion, Spontaneous; Pregnancy Outcome; Vaginitis; Live Birth
PubMed: 38597377
DOI: 10.1097/GCO.0000000000000953 -
Frontiers in Public Health 2024According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs),... (Meta-Analysis)
Meta-Analysis
BACKGROUND
According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs), and 5.9 million people are at risk of acquiring STHs. Regions with the highest prevalence of STH infections include Sub-Saharan Africa, China, South America, and Asia. While there are numerous fragmented studies on STH, comprehensive information on the prevalence and geographic distribution of different species, as well as their regional variations in the context of STHs is limited. The present systematic review and meta-analysis study attempts to provide a summary of the prevalence, geographical variation, and determinants of STHs among schoolchildren aged 5 to 18 years.
METHODS
An extensive literature search was carried out using PubMed, Embase, Cinhal, and Psychinfo for studies published between 1999 and 2022 that reported the rate of STH infection in school-going children aged 5-18 years. A random effects model was employed in this meta-analysis due to expected heterogeneity. Subgroup analysis was carried out based on sex and STH species because of expected geographical variation.
RESULTS
A total of 19,725 of the 49,630 children examined were infected with STH, yielding an overall pooled prevalence of 37.16% (95% CI: 29.74-44.89). The prevalence was highest in the Western Pacific region at 50.41% (95% CI: 33.74-67.04) followed by Europe at 39.74% (95% CI: 20.40-61.0) and Africa at 37.10% (95% CI: 26.84-47.95). was found to be the most prevalent helminth with a prevalence of 24.07% (95% CI: 17.07-31.83).
CONCLUSION
The Western Pacific region is classified as a High-risk Zone (HRZ), while Southeast Asia, Africa, Europe, and the Eastern Mediterranean are classified as moderate-risk zones (MRZs). We found a 12% reduction in the pooled prevalence of STH infection from 1999 to 2012. was the predominant species among schoolchildren. Mass Drug Administration (MDA) of Albendazole tablets and improved water, sanitation, and hygiene (WASH) practices are effective in controlling and preventing STH. Ensuring their implementation and access is crucial to addressing the problem.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/#loginpage, CRD42022333341.
Topics: Animals; Child; Humans; Ascaris lumbricoides; Developing Countries; Helminthiasis; Helminths; Prevalence; Soil; Child, Preschool; Adolescent
PubMed: 38577281
DOI: 10.3389/fpubh.2024.1283054 -
Preventive Nutrition and Food Science Mar 2024Parasitic infections (PIs) remain a public health concern among school-age children living in areas of greater socioeconomic vulnerability, especially in Brazil, Russia,... (Review)
Review
Parasitic infections (PIs) remain a public health concern among school-age children living in areas of greater socioeconomic vulnerability, especially in Brazil, Russia, India, China, and South Africa. PIs can promote nutritional deficiencies, increasing the risk of anemia and impaired physical and cognitive development. Thus, fortified foods have been considered as a promising strategy for improving the nutritional status of children and preventing PI complications. This systematic review aimed to present the effects of iron-fortified foods for deworming and improving blood parameters in schoolchildren residing in areas that are vulnerable to PIs. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of randomized clinical trials addressing the use of fortified foods and micronutrients in children living in areas endemic for PIs. The PubMed, LILACS, Scopus, and Cochrane databases were searched to identify articles published between 2000 and 2020. A total of 153 records were retrieved from the databases, 10 of which were considered eligible for this study. On the basis of our analysis, most of the selected studies showed that the inclusion of fortified foods in the diet improved blood and infectious parameters. Therefore, fortified foods can be used as an important tool for controlling the adverse outcomes of PIs among children living in areas of greater vulnerability. However, more studies on this topic are needed to provide more evidence and consolidate strategies using iron-fortified food.
PubMed: 38576884
DOI: 10.3746/pnf.2024.29.1.8 -
BMC Infectious Diseases Mar 2024Annually, 175.4 million people are infected with scabies worldwide. Although parasitic infections are important nosocomial infections, they are unrecognized compared to...
BACKGROUND
Annually, 175.4 million people are infected with scabies worldwide. Although parasitic infections are important nosocomial infections, they are unrecognized compared to bacterial, fungal, and viral infections. In particular, nonspecific cutaneous manifestations of scabies lead to delayed diagnosis and frequent nosocomial transmission. Hospital-based studies on the risk factors for scabies have yet to be systematically reviewed.
METHODS
The study followed the PRISMA guidelines and was prospectively registered in PROSPERO (CRD42023363278). Literature searches were conducted in three international (PubMed, Embase, and CINAHL) and four Korean (DBpia, KISS, RISS, and Science ON) databases. We included hospital-based studies with risk estimates calculated with 95% confidence intervals for risk factors for scabies infection. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tools. Two authors independently performed the screening and assessed the quality of the studies.
RESULTS
A total of 12 studies were included. Personal characteristics were categorized into demographic, economic, residential, and behavioral factors. The identified risk factors were low economic status and unhygienic behavioral practices. Being a patient in a long-term care facility or institution was an important factor. Frequent patient contact and lack of personal protective equipment were identified as risk factors. For clinical characteristics, factors were categorized as personal health and hospital environment. People who had contact with itchy others were at higher risk of developing scabies. Patients with higher severity and those with a large number of catheters are also at increased risk for scabies infection.
CONCLUSIONS
Factors contributing to scabies in hospitals range from personal to clinical. We emphasize the importance of performing a full skin examination when patients present with scabies symptoms and are transferred from settings such as nursing homes and assisted-living facilities, to reduce the transmission of scabies. In addition, patient education to prevent scabies and infection control systems for healthcare workers, such as wearing personal protective equipment, are needed.
Topics: Humans; Scabies; Cross Infection; Nursing Homes; Hospitals; Risk Factors
PubMed: 38575893
DOI: 10.1186/s12879-024-09167-6 -
PLoS Neglected Tropical Diseases Mar 2024Human myiasis is a parasitic dipteran fly infestation that infects humans and vertebrates worldwide. However, the disease is endemic in Sub-Saharan Africa and Latin...
BACKGROUND
Human myiasis is a parasitic dipteran fly infestation that infects humans and vertebrates worldwide. However, the disease is endemic in Sub-Saharan Africa and Latin America. In Sub-Saharan Africa, it is under-reported and therefore its prevalence is unknown. This systematic review aims to elucidate the prevalence of human myiasis, factors that influence the infection, and myiasis-causing fly species in SSA. The review also dwelled on the common myiasis types and treatment methods of human myiasis.
METHODS
Here, we collect cases of human myiasis in Sub-Saharan Africa based on literature retrieved from PubMed, Google Scholar and Science Direct from 1959 to 2022. A total of 75 articles and 157 cases were included in the study. The recommendations of PRISMA 2020 were used for the realization of this systematic review.
RESULTS
In total, 157 cases of human myiasis in SSA were reviewed. Eleven fly species (Cordylobia anthropophaga, Cordylobia rodhaini, Dermatobia hominis, Lucilia cuprina, Lucilia sericata, Oestrus ovis, Sarcophaga spp., Sarcophaga nodosa, Chrysomya megacephala, Chrysomya chloropyga and Clogmia albipuntum) were found to cause human myiasis in SSA. Cordylobia anthropophaga was the most prevalent myiasis-causing species of the reported cases (n = 104, 66.2%). More than half of the reported cases were from travelers returning from SSA (n = 122, 77.7%). Cutaneous myiasis was the most common clinical presentation of the disease (n = 86, 54.7%). Females were more infected (n = 78, 49.6%) than males, and there was a higher infestation in adults than young children.
CONCLUSION
The findings of this study reveals that international travelers to Sub-Saharan Africa were mostly infested therefore, we recommend that both international travelers and natives of SSA be enlightened by public health officers about the disease and its risk factors at entry points in SSA and the community level respectively. Clinicians in Sub-Saharan Africa often misdiagnose the disease and most of them lack the expertise to properly identify larvae, so we recommend the extensive use of molecular identification methods instead.
Topics: Male; Adult; Animals; Female; Child; Humans; Child, Preschool; Diptera; Myiasis; Larva; Psychodidae; Africa South of the Sahara; Calliphoridae
PubMed: 38547087
DOI: 10.1371/journal.pntd.0012027 -
Veterinary and Animal Science Jun 2024The larval stages of () are what cause the zoonotic disease known as alveolar echinococcosis (AE). Identifying the antigens that trigger immune responses during... (Review)
Review
The larval stages of () are what cause the zoonotic disease known as alveolar echinococcosis (AE). Identifying the antigens that trigger immune responses during infection is extremely important for the development of vaccines against infections. Several studies conducted in recent decades have described the specific traits of the protective antigens found in and their role in immunizing different animal hosts. The objective of the current systematic review was to summarize the findings of relevant literature on this topic and unravel the most effective vaccine candidate antigens for future research. A comprehensive search was conducted across five databases, including ProQuest, PubMed, Scopus, ScienceDirect, and Web of Science, until March 1, 2023. Two reviewers autonomously conducted the screening and evaluation of data extraction and quality assessment. In the present study, a total of 41 papers matched the criteria for inclusion. The study findings indicate that the combination of Em14-3-3 and BCG is widely considered the most often employed antigens for immunization. In addition, the study describes antigen delivery, measurement of immune responses, adjuvants, animal models, as well as routes and doses of vaccination. The research indicated that recombinant vaccines containing EMY162, EM95, and EmII/3-Em14-3-3 antigens and crude or purified antigens containing ribotan-formulated excretory/secretory antigens exhibited the most favorable outcomes and elicited protective immune responses.
PubMed: 38516388
DOI: 10.1016/j.vas.2024.100345 -
The Lancet. Global Health Apr 2024The geographical, demographic, and socioeconomic distributions of malaria and malnutrition largely overlap. It remains unknown whether malnutrition affects the efficacy... (Meta-Analysis)
Meta-Analysis
Does acute malnutrition in young children increase the risk of treatment failure following artemisinin-based combination therapy? A WWARN individual patient data meta-analysis.
BACKGROUND
The geographical, demographic, and socioeconomic distributions of malaria and malnutrition largely overlap. It remains unknown whether malnutrition affects the efficacy of WHO-recommended artemisinin-based combination therapies (ACTs). A previous systematic review was inconclusive as data were sparse and heterogeneous, indicating that other methodological approaches, such as individual patient data meta-analysis, should be considered. The objective of this study was to conduct such a meta-analysis to assess the effect of malnutrition (wasting and stunting) on treatment outcomes in children younger than 5 years treated with an ACT for uncomplicated falciparum malaria.
METHODS
We conducted a meta-analysis of individual patient data from studies identified through a systematic review of literature published between 1980 and 2018 in PubMed, Global Health, and Cochrane Libraries (PROSPERO CRD42017056934) and inspection of the WorldWide Antimalarial Resistance Network (WWARN) repository for ACT efficacy studies, including children younger than 5 years with uncomplicated falciparum malaria. The association of either acute (wasting) or chronic (stunting) malnutrition with day 42 PCR-adjusted risk of recrudescence (ie, return of the same infection) or reinfection after therapy was investigated using Cox regression, and with day 2 parasite positivity using logistic regression.
FINDINGS
Data were included from all 36 studies targeted, 31 from Africa. Of 11 301 eligible children in 75 study sites, 11·5% were wasted (weight-for-height Z score [WHZ] <-2), and 31·8% were stunted (height-for-age Z score [HAZ] <-2). Decrease in WHZ was associated with increased risk of day 2 positivity (adjusted odds ratio 1·12, 95% CI 1·05-1·18 per unit; p=0·0002), treatment failure (adjusted hazard ratio [AHR] 1·14, 95% CI 1·02-1·26, p=0·016), and reinfection after therapy (AHR 1·09, 1·04-1·13, p=0·0003). Children with milder wasting (WHZ -2 to -1) also had a higher risk of recrudescence (AHR 1·85, 1·29-2·65, p=0·0008 vs WHZ ≥0). Stunting was not associated with reduced ACT efficacy.
INTERPRETATION
Children younger than 5 years with acute malnutrition and presenting with uncomplicated falciparum malaria were at higher risk of delayed parasite clearance, ACT treatment failure, and reinfections. Stunting was more prevalent, but not associated with changes in ACT efficacy. Acute malnutrition is known to impact medicine absorption and metabolism. Further study to inform dose optimisation of ACTs in wasted children is urgently needed.
FUNDING
Bill & Melinda Gates Foundation.
TRANSLATION
For the French translation of the abstract see Supplementary Materials section.
Topics: Child; Humans; Child, Preschool; Antimalarials; Reinfection; Artemisinins; Malaria, Falciparum; Malaria; Treatment Failure; Malnutrition; Recurrence; Growth Disorders
PubMed: 38485430
DOI: 10.1016/S2214-109X(24)00003-2