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Frontiers in Immunology 2023To systematically compare the efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR). (Meta-Analysis)
Meta-Analysis
AIM
To systematically compare the efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR).
METHODS
PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to March 2, 2023. Outcomes included symptom scores (SSs), medication scores (MSs), symptom and medication scores (SMSs), new sensitizations, development of asthma, improvement, and treatment-related adverse events (TRAEs). The quality of the included studies was assessed by the modified Jadad scale and Newcastle-Ottawa scale (NOS). Meta-regression was carried out to explore the source of heterogeneity. Subgroup analysis was further conducted in terms of study design [randomized controlled trials (RCTs), cohort studies], allergen [house dust mites (HDMs), grass pollen], treatment duration (≥ 24, 12-23 or < 12 months), allergen immunotherapy (AIT) modality (drops or tablets), and AIT protocol [continuous, pre-seasonal, co-seasonal, or after the grass pollen season (GPS)]. Sensitivity analysis was conducted for all outcomes. A Bayesian framework and a Monte Carlo Markov Chain (MCMC) model were developed for indirect comparison.
RESULTS
Totally 50 studies with 10813 AR children were included, with 4122 treated with SLIT, 1852 treated with SCIT, and 4839 treated with non-SLIT or non-SCIT therapy. For direct comparison, the SLIT group had a similar SS to the SCIT group [pooled standardized mean difference (SMD): 0.41, 95% confidence interval (CI): -0.46, 1.28, = 0.353]. Comparable MSs were observed in the SLIT and SCIT groups (pooled SMD: 0.82, 95%CI: -0.88, 2.53, = 0.344). For indirect comparison, no significant differences were found in SSs (pooled SMD: 1.20, 95% credibility interval (CrI): -1.70, 4.10), MSs (pooled SMD: 0.57, 95%CrI: -1.20, 2.30), SMSs (pooled SMD: 1.80, 95%CrI: -0.005, 3.60), new sensitizations [pooled relative risk (RR): 0.34, 95%CrI: 0.03, 3.58], and development of asthma (pooled RR: 0.68, 95%CrI: 0.01, 26.33) between the SLIT and SCIT groups; the SLIT group illustrated a significantly lower incidence of TRAEs than the SCIT group (pooled RR: 0.17, 95%CrI: 0.11, 0.26).
CONCLUSION
Considering both efficacy and safety, SLIT might be a more favorable AIT than SCIT in the treatment of pediatric AR, which may serve as a decision-making reference for clinicians.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42023460693).
Topics: Child; Humans; Allergens; Asthma; Desensitization, Immunologic; Pollen; Rhinitis, Allergic; Immunotherapy; Sublingual Immunotherapy
PubMed: 38162647
DOI: 10.3389/fimmu.2023.1274241 -
BMC Infectious Diseases Dec 2023Scrub typhus is a bacterial mite-borne disease associated with poor clinical outcomes if not treated adequately. The study aimed to compare the time to defervescence,... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Scrub typhus is a bacterial mite-borne disease associated with poor clinical outcomes if not treated adequately. The study aimed to compare the time to defervescence, clinical failure, mortality and treatment-related adverse effects of two common drugs (doxycycline and azithromycin) used for its treatment.
METHODOLOGY
This was a systematic review and meta-analysis. All studies up to 20.03.2023 were screened for eligibility in Pubmed and Embase using a search string containing terms related to scrub typhus, doxycycline and azithromycin. After two phases of screening, all comparative studies where doxycycline and azithromycin were used to treat scrub typhus were included. The studies were critically appraised using standardised tools, and a meta-analysis was performed for time to defervescence (primary outcome), clinical failure, mortality and treatment-related adverse effects.
RESULTS
Of 744 articles from two databases, ten were included in the meta-analysis. All but two studies had a high risk of bias. The meta-analysis for time to defervescence had a high heterogeneity and did not show any significant difference between doxycycline and azithromycin arms [Mean difference of -3.37 hours (95%CI: -10.31 to 3.57), p=0.34]. When the analysis was restricted to studies that included only severe scrub typhus, doxycycline was found to have a shorter time to defervescence [mean difference of -10.15 (95%CI: -19.83 to -0.46) hours, p=0.04]. Additionally, there was no difference between the two arms concerning clinical failure, mortality and treatment-related adverse effects.
CONCLUSION
The current data from studies with a high risk of bias did not find statistically significant differences in clinical outcomes between doxycycline and azithromycin for scrub typhus.
Topics: Humans; Azithromycin; Doxycycline; Anti-Bacterial Agents; Scrub Typhus; Patients; Drug-Related Side Effects and Adverse Reactions
PubMed: 38110855
DOI: 10.1186/s12879-023-08893-7 -
International Journal For Parasitology.... Dec 2023Sarcoptic mange, caused by , is a disease that affects many species of mammals, including several wild ungulate species in the region of the European Alps, especially... (Review)
Review
Sarcoptic mange, caused by , is a disease that affects many species of mammals, including several wild ungulate species in the region of the European Alps, especially the Alpine chamois and the Alpine ibex, which act as parasite reservoirs. Here records of mange in alpine wild ungulates and its spread over time across the eastern parts of the European Alps are reviewed. First cases were recorded from Austria in 1824, and epizootic outbreaks have been described since then from the mountainous regions of Austria (mostly Tyrol, Carinthia, and Styria), Germany (Bavaria), Italy (Udine and Trentino) and Slovenia. Switzerland, by contrast, has so far been free of mange except for cases in wild boar, indicating that this species is not a reservoir host of sarcoptic mites for other ungulate species in the European Alps, and that, so far, the disease in ruminant ungulates is restricted to the eastern and central parts of the Alps. Mutual transmission among wild and domestic ruminants is possible and, together with the protection of vulnerable wildlife, is also a reason for monitoring and, if necessary, intervention to contain mange outbreaks.
PubMed: 37854272
DOI: 10.1016/j.ijppaw.2023.10.003 -
The Science of the Total Environment Jan 2024Arguably the most ecologically and economically valuable pollinators worldwide, honey bees play a significant role in food production and enrich biodiversity through... (Review)
Review
Arguably the most ecologically and economically valuable pollinators worldwide, honey bees play a significant role in food production and enrich biodiversity through pollination. Varroa destructor is an invasive ectoparasitic mite that attacks and feeds on European honey bee, Apis mellifera. Because literature on the effectiveness and sustainability of various treatment modalities available for Varroa mite control in honey bee colonies are scattered, this scoping review was conducted to serve as a guiding document with a focus on: (1) identifying the detrimental impact Varroa mites have on the European honey bee; (2) determining current methods for Varroa mite control and their limitations; (3) examining current market landscape and key players in the pesticide market; and (4) identifying opportunities for more sustainable Varroa mite control methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, 397 articles published between 1998 and 2022 were screened; of which 65 articles were retained using inclusion/exclusion criteria, which were systematically analyzed in-depth, information extracted, and included in this scoping review. The results suggest that Varroa mites are one of the predominant causes of global honey bee decline as they lack natural resistance to Varroa mites, thereby negatively affecting honey bee reproduction and immunity, killing broods, and transmitting pathogenic viruses to colonies. Further, our findings suggest that: apiarists have many options for Varroa control, but no method has proven to be effective, safe and nonpersistent in the environment; adoption of nano-pesticides and development of sustainable alternatives to traditional pesticides are key drivers for growing pesticide market; and nano-pesticides may have potential to serve as an effective, safe and non-ecopersistent pesticide for Varroa mite and associated virus control. In conclusion, this review highlights an unmet need for effective and sustainable control strategies and tools for Varroa mite and virus control.
Topics: Bees; Animals; Varroidae; Pesticides; Immunity, Innate; Host-Parasite Interactions
PubMed: 37778563
DOI: 10.1016/j.scitotenv.2023.167492 -
The British Journal of Dermatology Jan 2024Treatment failure is considered to be an important factor in relation to the increase in scabies incidence over the last decade. However, the regional and temporal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Treatment failure is considered to be an important factor in relation to the increase in scabies incidence over the last decade. However, the regional and temporal differences, in addition to the predictors of therapy failure, are unclear.
OBJECTIVES
We aimed to conduct a systematic review of the prevalence of treatment failure in patients with scabies and investigation of associated factors.
METHODS
We searched MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, Global Health and the Cochrane Central Register of Controlled Trials from inception to August 2021 for randomized and quasi-randomized trials, in addition to observational studies that enrolled children or adults diagnosed with confirmed or clinical scabies treated with permethrin, ivermectin, crotamiton, benzyl benzoate, malathion, sulfur or lindane, and measured treatment failure or factors associated with treatment failure. We performed a random effects meta-analysis for all outcomes reported by at least two studies.
RESULTS
A total of 147 studies were eligible for inclusion in the systematic review. The overall prevalence of treatment failure was 15.2% [95% confidence interval (CI) 12.9-17.6; I2 = 95.3%, moderate-certainty evidence] with regional differences between World Health Organization regions (P = 0.003) being highest in the Western Pacific region (26.9%, 95% CI 14.5-41.2). Oral ivermectin (11.8%, 95% CI 8.4-15.4), topical ivermectin (9.3%, 95% CI 5.1-14.3) and permethrin (10.8%, 95% CI 7.5-14.5) had relatively lower failure prevalence compared with the overall prevalence. Failure prevalence was lower in patients treated with two doses of oral ivermectin (7.1%, 95% CI 3.1-12.3) compared with those treated with one dose (15.2%, 95% CI 10.8-20.2; P = 0.021). Overall and permethrin treatment failure prevalence in the included studies (1983-2021) increased by 0.27% and 0.58% per year, respectively. Only three studies conducted a multivariable risk factor analysis; no studies assessed resistance.
CONCLUSIONS
A second dose of ivermectin showed lower failure prevalence than single-dose ivermectin, which should be considered in all guidelines. The increase in treatment failure over time hints at decreasing mite susceptibility for several drugs, but reasons for failure are rarely assessed. Ideally, scabicide susceptibility testing should be implemented in future studies.
Topics: Adult; Child; Humans; Administration, Oral; Hexachlorocyclohexane; Ivermectin; Malathion; Permethrin; Scabies; Treatment Failure
PubMed: 37625798
DOI: 10.1093/bjd/ljad308 -
Vector Borne and Zoonotic Diseases... Dec 2023is a zoonotic intracellular pathogen that requires parasitism in eukaryotic cells to reproduce. In recent years, tsutsugamushi disease reported in many places... (Meta-Analysis)
Meta-Analysis
is a zoonotic intracellular pathogen that requires parasitism in eukaryotic cells to reproduce. In recent years, tsutsugamushi disease reported in many places nationwide has crossed the Yangtze River, continuously, spreading to the North China. Now this phenomenon has aroused people's attention. In this study, meta-analysis was used to analyze the infection of rodents (vectors) in China, to clarify the transmission rule of . This study included literature from six databases (PubMed, Web of Science, Science Direct, Wanfang, CNKI, and VIP). A total of 55 articles were included in the study from 610 retrieved articles. The total infection rate of in rodents was 5.5% (1206/20,620, 95% confidence interval [CI]: 0.0553-0.0617). The prevalence of in rodents before 2013 (7.73%, 95% CI: 4.11-12.37) was higher than after 2013 (2.11%, 95% CI: 0.64-4.41). spread among a variety of rodents, among which (13.3%, 95% CI: 4.33-26.26), (5.69%, 95% CI: 1.37-12.72), and (5.32%, 95% CI: 2.26-9.58) infection rate was higher. Kawasaki (8.32%, 95% CI: 1.42-20.17), Karp (7.36%, 95% CI: 2.62-14.22), Kato (2.54%, 95% CI: 0.08-8.28), and Gilliam (2.13%, 95% CI: 0.42-5.09) were the main prevalent genotypes in China. The prevalence of in rodents was seasonal, increasing gradually in summer (2.39%, 95% CI: 0.46-5.77), peaking in autumn (4.59%, 95% CI: 1.15-10.16), and then declining. The positive rate of immunofluorescence assay (25.07%, 95% CI: 8.44-46.88) was the highest among the detection methods, and it was statistically significant ( < 0.05). Based on the subgroup of geographical factors and climatic factors, the probability of infection in rodents was the highest when the temperature >19℃ (8.20%, 95% CI: 1.22-20.52), the altitude <100 millimeters (7.23%, 95% CI: 3.45-12.26), the precipitation >700 millimeters (12.22%, 95% CI: 6.45-19.50), and the humidity 60-70% (7.80%, 95% CI: 4.17-12.44). Studies have shown that rodents carrying are common. People should prevent and control rodents in life and monitor rodents carrying for a long time.
Topics: Animals; Humans; Orientia tsutsugamushi; Prevalence; Trombiculidae; Scrub Typhus; Murinae; China
PubMed: 37625029
DOI: 10.1089/vbz.2023.0057 -
Parasitology Research Oct 2023Bats harbor diverse groups of ectoparasites, such as insects and mites like ticks (Ixodida). Some species of ticks with records for bats and humans have already been...
Bats harbor diverse groups of ectoparasites, such as insects and mites like ticks (Ixodida). Some species of ticks with records for bats and humans have already been reported with the occurrence of pathogens. This research article aims to document new geographical and host records of ticks infesting bats in Rio de Janeiro state, Southeastern Brazil, and provides a list of tick species associated with bats in Brazil. We counted 12 argasid ticks and five ixodid ticks associated with six individuals of bats. Larvae of Amblyomma sp., Ixodes sp., Ornithodoros sp., and Ornithodoros hasei and one nymph of Amblyomma sculptum parasitizing Artibeus obscurus, Phyllostomus hastatus, Micronycteris sp., Molossus fluminensis, and Carollia perspicillata in different localities of Rio de Janeiro state were studied. We carried out a systematic review with the descriptors: tick bat Brazil. We considered data from 42 articles in the systematic review. We compiled eleven records of Ixodidae, and 160 records of Argasidae. Ornithodoros cavernicolous were the most recorded tick species. Overall, we registered 171 tick-bat or roost-bat associations with 85 records of these infesting bats. The review also shows the occurrence of tick species associated with bats, and we present new records on ticks parasitizing bats in Brazil.
Topics: Humans; Animals; Chiroptera; Brazil; Ornithodoros; Amblyomma; Argasidae; Ixodidae
PubMed: 37597061
DOI: 10.1007/s00436-023-07935-y -
Frontiers in Pediatrics 2023Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children. (Review)
Review
BACKGROUND
Subcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children.
OBJECT
To evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite.
METHOD
We searched the databases of Cochrane Library, EMBASE and MEDLINE (from 1 January 1990 to 1 December 2022). Two reviewers independently screened studies, extracted data and critically appraised the risk of bias. We used the Revman 5 to synthesize the effect sizes.
RESULTS
We finally selected 38 eligible studies including 21 randomized controlled trials to evaluate the efficacy and safety of SCIT and 17 observational studies to assess the safety. The results revealed that short-term asthma symptom scores were declined with a standardized mean difference (SMD) of -1.19 (95% CI: -1.87, -0.50) in 12 researches with high heterogeneity. Short-term asthma medication scores were decreased with SMD -1.04 (95% CI: -1.54, -0.54) in 12 heterogeneous researches. One study showed no significant reduction in combined symptom and medication scores without providing details. No studies we reviewed reported long-term efficacy. SCIT resulted in an obviously increased risk of adverse reactions compared with placebo. For secondary outcomes, SCIT improved life quality and reduced the numbers of annual asthma attacks and allergen-specific airway hyperreactivity, but without significant improvement in pulmonary function, asthma control or hospitalization.
CONCLUSIONS
SCIT can reduce the short-term symptom scores and medication scores regardless of different treatment duration or mono/polysensitization, but with an increased incidence of local and systemic adverse effects. Further studies on pediatric asthma are needed to evaluate the long-term efficacy, and clarify the effectiveness of SCIT in specific population using mix allergen extracts or with severe asthma. Overall, it is recommended for children with mild-moderate HDM-driven allergic asthma.
PubMed: 37397157
DOI: 10.3389/fped.2023.1137478 -
Veterinary Medicine and Science Jul 2023Honey bees and honeycomb bees are very valuable for wild flowering plants and economically important crops due to their role as pollinators. However, these insects... (Review)
Review
BACKGROUND
Honey bees and honeycomb bees are very valuable for wild flowering plants and economically important crops due to their role as pollinators. However, these insects confront many disease threats (viruses, parasites, bacteria and fungi) and large pesticide concentrations in the environment. Varroa destructor is the most prevalent disease that has had the most negative effects on the fitness and survival of different honey bees (Apis mellifera and A. cerana). Moreover, honey bees are social insects and this ectoparasite can be easily transmitted within and across bee colonies.
OBJECTIVE
This review aims to provide a survey of the diversity and distribution of important bee infections and possible management and treatment options, so that honey bee colony health can be maintained.
METHODS
We used PRISMA guidelines throughout article selection, published between January 1960 and December 2020. PubMed, Google Scholar, Scopus, Cochrane Library, Web of Science and Ovid databases were searched.
RESULTS
We have collected 132 articles and retained 106 articles for this study. The data obtained revealed that V. destructor and Nosema spp. were found to be the major pathogens of honey bees worldwide. The impact of these infections can result in the incapacity of forager bees to fly, disorientation, paralysis, and death of many individuals in the colony. We find that both hygienic and chemical pest management strategies must be implemented to prevent, reduce the parasite loads and transmission of pathogens. The use of an effective miticide (fluvalinate-tau, coumaphos and amitraz) now seems to be an essential and common practice required to minimise the impact of Varroa mites and other pathogens on bee colonies. New, alternative biofriendly control methods, are on the rise, and could be critical for maintaining honey bee hive health and improving honey productivity.
CONCLUSIONS
We suggest that critical health control methods be adopted globally and that an international monitoring system be implemented to determine honey bee colony safety, regularly identify parasite prevalence, as well as potential risk factors, so that the impact of pathogens on bee health can be recognised and quantified on a global scale.
Topics: Animals; Bees; Nosema; Pesticides; Varroidae; Animal Diseases
PubMed: 37335585
DOI: 10.1002/vms3.1194 -
Experimental Dermatology Jul 2023Common skin disorders such as acne vulgaris, rosacea and folliculitis are bothersome prevalent inflammatory diseases of hair follicles that can easily be investigated... (Review)
Review
Common skin disorders such as acne vulgaris, rosacea and folliculitis are bothersome prevalent inflammatory diseases of hair follicles that can easily be investigated bedside using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) with micrometre resolution, opening a novel era for high-resolution hair follicle diagnostics and quantitative treatment evaluation. EMBASE, PubMed and Web of Science were searched until 5 January 2023 to identify all studies imaging hair follicle characteristics by RCM and OCT for diagnosis and monitoring of treatment in hair follicle-based skin disorders. This study followed PRISMA guidelines. After inclusion of articles, methodological quality was assessed using the QUADAS-2 critical appraisal checklist. Thirty-nine in vivo studies (33 RCM and 12 OCT studies) were included. The studies focused on acne vulgaris, rosacea, alopecia areata, hidradenitis suppurativa, folliculitis, folliculitis decalvans, lichen planopilaris, discoid lupus erythemasus, frontal fibrosing alopecia and keratosis pilaris. Inter- and perifollicular morphology including number of demodex mites, hyperkeratinization, inflammation and vascular morphology could be assessed by RCM and OCT in all included skin disorders. Methodological study quality was low, and interstudy outcome variability was high. Quality assessment showed high or unclear risk of bias in 36 studies. Both RCM and OCT visualize quantitative features as size, shape, content and abnormalities of hair follicles, and have potential to support clinical diagnosis and evaluate treatment effects. However, larger studies with better methodological quality are needed to implement RCM and OCT directly into clinical practice.
Topics: Humans; Tomography, Optical Coherence; Hair; Folliculitis; Acne Vulgaris; Dermatitis; Rosacea; Hair Diseases; Alopecia Areata; Microscopy, Confocal
PubMed: 37140216
DOI: 10.1111/exd.14830