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Frontiers in Epidemiology 2024Despite several interventions on the control of cholera, it still remains a significant public health problem in Africa. According to the World Health Organization,...
INTRODUCTION
Despite several interventions on the control of cholera, it still remains a significant public health problem in Africa. According to the World Health Organization, 251,549 cases and 4,180 deaths (CFR: 2.9%) were reported from 19 African countries in 2023. Tools exist to enhance the surveillance of cholera but there is limited evidence on their deployment and application. There is limited evidence on the harmonization of the deployment of tools for the evaluation of cholera surveillance. We systematically reviewed available literature on the deployment of these tools in the evaluation of surveillance systems in Africa.
METHOD
Three electronic databases (PubMed, Medline and Embase) were used to search articles published in English between January 2012 to May 2023. Grey literature was also searched using Google and Google Scholar. Only articles that addressed a framework used in cholera surveillance in Africa were included. The quality of articles was assessed using the appropriate tools. Data on the use of surveillance tools and frameworks were extracted from articles for a coherent synthesis on their deployment.
RESULT
A total of 13 records (5 frameworks and 8 studies) were fit for use for this study. As per the time of the study, there were no surveillance frameworks specific for the evaluation of surveillance systems of cholera in Africa, however, five frameworks for communicable diseases and public health events could be adapted for cholera surveillance evaluation. None (0%) of the studies evaluated capacities on cross border surveillance, multisectoral one health approach and linkage of laboratory networks to surveillance systems. All (100%) studies assessed surveillance attributes even though there was no synergy in the attributes considered even among studies with similar objectives. There is therefore the need for stakeholders to harmoniously identify a spectrum of critical parameters and attributes to guide the assessment of cholera surveillance system performance.
PubMed: 38933896
DOI: 10.3389/fepid.2024.1353826 -
Bulletin of the World Health... Jul 2024To conduct a systematic review on the effects of multisectoral interventions for health on health system performance. (Review)
Review
OBJECTIVE
To conduct a systematic review on the effects of multisectoral interventions for health on health system performance.
METHODS
We conducted a systematic review according to the preferred reporting items for systematic review and meta-analysis protocols. We searched for peer-reviewed journal articles in PubMed®, Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Database of Systematic Reviews on 31 August 2023 (updating on 28 February 2024). We removed duplicates, screened titles and abstracts, and then conducted a full-text eligibility and quality assessment.
FINDINGS
We identified an initial 1118 non-duplicate publications, 62 of which met our inclusion and exclusion criteria. The largest proportions of reviewed studies focused on multisectoral interventions directly related to specific health outcomes (66.1%; 41 studies) and/or social determinants of health (48.4%; 30 studies), but without explicit reference to overall health system performance. Most reviewed publications did not address process indicators (83.9%; 52/62) or discuss sustainability for multisectoral interventions in health (72.6%; 45/62). However, we observed that the greatest proportion (66.1%; 41/62) considered health system goals: health equity (68.3%; 28/41) and health outcomes (63.4%; 26/41). Although the greatest proportion (64.5%; 40/62) proposed mechanisms explaining how multisectoral interventions for health could lead to the intended outcomes, none used realistic evaluations to assess these.
CONCLUSION
Our review has established that multisectoral interventions influence health system performance through immediate improvements in service delivery efficiency, readiness, acceptability and affordability. The interconnectedness of these effects demonstrates their role in addressing the complexities of modern health care.
Topics: Humans; Delivery of Health Care; Social Determinants of Health
PubMed: 38933474
DOI: 10.2471/BLT.23.291246 -
Acta Ortopedica Brasileira 2024Open fractures are highly incident injuries closely related to the modern life, in which accidents caused by motor vehicles or other machines impart high energy to bone... (Review)
Review
Open fractures are highly incident injuries closely related to the modern life, in which accidents caused by motor vehicles or other machines impart high energy to bone tissue. Individual morbidity is represented by the functional impairment resultant of infection, nonunion, or vicious healing. In terms of public health, there are huge costs involved with the treatment of these fractures, particularly with their complications. One of the critical issues in managing open fractures is the use of antibiotics (ATB), including decisions about which specific agents to administer, duration of use, and ideal timing of the first prophylactic dose. Although recent guidelines have recommended starting antibiotic prophylaxis as soon as possible, such a recommendation appears to stem from insufficient evidence. In light of this, we conducted a systematic review, including studies that addressed the impact of the time to first antibiotic and the risk of infectious outcomes. Fourteen studies were selected, of which only four found that the early initiation of treatment with antibiotics is able to prevent infection. All studies had important risks of bias. The results indicate that this question remains open, and further prospective and methodologically sound studies are necessary in order to guide practices and health policies related to this matter.
PubMed: 38933354
DOI: 10.1590/1413-785220243202e263176 -
China CDC Weekly Jun 2024This study aims to perform a systematic review and meta-analysis on the global prevalence of cannabis use to inform drug prevention strategies, policy-making, and...
This study aims to perform a systematic review and meta-analysis on the global prevalence of cannabis use to inform drug prevention strategies, policy-making, and resource allocation. This study initially screened 177,843 studies published between January 1, 2000, and January 15, 2024, using peer-reviewed databases including Web of Science, PubMed, Scopus, Embase, and Cochrane Library. Ultimately, 595 studies were identified for data extraction, and 39 of these were selected as country-representative studies. Heterogeneity among the selected studies was assessed using the chi-squared test and I statistic, while sensitivity analysis was conducted to evaluate the robustness of the results. The prevalence of cannabis use varied between 0.42% and 43.90% across 33 European countries, 1.40% to 38.12% across 15 North and South American countries, 0.30% to 19.10% across 16 Asian countries, and 1.30% to 48.70% across 18 Oceania and African countries. The pooled prevalence of cannabis use was 12.0% [95% confidence interval (): 10.0, 14.3] in countries where cannabis is legalized, compared to 5.4% (95% : 4.3, 6.9) in non-legalized countries. Our findings indicate that the prevalence of cannabis use has disproportionately increased in most countries with the implementation of medical or recreational cannabis legalization policies and relevant geographic proximity. Increased efforts are needed to monitor newly cannabis-legalized countries and prevent initial use.
PubMed: 38933041
DOI: 10.46234/ccdcw2024.116 -
Vaccines Jun 2024A systematic review with a meta-analysis was performed to gather available evidence on the effectiveness of monoclonal antibody nirsevimab in the prevention of lower... (Review)
Review
A systematic review with a meta-analysis was performed to gather available evidence on the effectiveness of monoclonal antibody nirsevimab in the prevention of lower respiratory tract diseases (LRTDs) due to respiratory syncytial virus (RSV) in children and newborns (CRD42024540669). Studies reporting on real-world experience and randomized controlled trials (RCTs) were searched for in three databases (PubMed, Embase, and Scopus) until 1 May 2024. Our analysis included five RCTs, seven real-world reports, and one official report from the health authorities. Due to the cross-reporting of RCTs and the inclusion of multiple series in a single study, the meta-analysis was performed on 45,238 infants from 19 series. The meta-analysis documented a pooled immunization efficacy of 88.40% (95% confidence interval (95% CI) from 84.70 to 91.21) on the occurrence of hospital admission due to RSV, with moderate heterogeneity (I 24.3%, 95% CI 0.0 to 56.6). Immunization efficacy decreased with the overall length of the observation time (Spearman's r = -0.546, = 0.016), and the risk of breakthrough infections was substantially greater in studies with observation times ≥150 days compared to studies lasting <150 days (risk ratio 2.170, 95% CI 1.860 to 2.532). However, the effect of observation time in meta-regression analysis was conflicting ( = 0.001, 95% CI -0.001 to 0.002; = 0.092). In conclusion, the delivery of nirsevimab was quite effective in preventing hospital admissions due to LRTDs. However, further analyses of the whole RSV season are required before tailoring specific public health interventions.
PubMed: 38932369
DOI: 10.3390/vaccines12060640 -
Viruses Jun 2024The epidemiology of different respiratory viral infections is believed to be affected by prior viral infections in addition to seasonal effects. This PROSPERO-registered... (Meta-Analysis)
Meta-Analysis Review
The epidemiology of different respiratory viral infections is believed to be affected by prior viral infections in addition to seasonal effects. This PROSPERO-registered systematic review identified 7388 studies, of which six met our criteria to answer the question specifically. The purpose of this review was to compare the prevalence of sequential viral infections in those with previously documented positive versus negative swabs. The pooled prevalence of sequential viral infections over varying periods from 30-1000 days of follow-up was higher following a negative respiratory viral swab at 0.15 than following a positive swab at 0.08, indicating the potential protective effects of prior respiratory viral infections. However, significant heterogeneity and publication biases were noted. There is some evidence, albeit of low quality, of a possible protective effect of an initial viral infection against subsequent infections by a different virus, which is possibly due to broad, nonspecific innate immunity. Future prospective studies are needed to validate our findings.
Topics: Humans; Respiratory Tract Infections; Virus Diseases; Cross Protection; Prevalence
PubMed: 38932273
DOI: 10.3390/v16060982 -
Sensors (Basel, Switzerland) Jun 2024Pelvic floor dysfunction is a common problem in women and has a negative impact on their quality of life. The aim of this review was to provide a general overview of the... (Review)
Review
Pelvic floor dysfunction is a common problem in women and has a negative impact on their quality of life. The aim of this review was to provide a general overview of the current state of technology used to assess pelvic floor functionality. It also provides literature research of the physiological and anatomical factors that correlate with pelvic floor health. This systematic review was conducted according to the PRISMA guidelines. The PubMed, ScienceDirect, Cochrane Library, and IEEE databases were searched for publications on sensor technology for the assessment of pelvic floor functionality. Anatomical and physiological parameters were identified through a manual search. In the systematic review, 114 publications were included. Twelve different sensor technologies were identified. Information on the obtained parameters, sensor position, test activities, and subject characteristics was prepared in tabular form from each publication. A total of 16 anatomical and physiological parameters influencing pelvic floor health were identified in 17 published studies and ranked for their statistical significance. Taken together, this review could serve as a basis for the development of novel sensors which could allow for quantifiable prevention and diagnosis, as well as particularized documentation of rehabilitation processes related to pelvic floor dysfunctions.
Topics: Humans; Pelvic Floor; Pelvic Floor Disorders; Female; Quality of Life
PubMed: 38931784
DOI: 10.3390/s24124001 -
Nutrients Jun 2024We conducted a systematic review and meta-analysis to examine the effect of dietary intake of cocoa on anthropometric measurements, lipid and glycemic profiles, and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We conducted a systematic review and meta-analysis to examine the effect of dietary intake of cocoa on anthropometric measurements, lipid and glycemic profiles, and blood pressure levels in adults, with and without comorbidities.
METHODS
The databases used were MEDLINE (PubMed), EMBASE, Web of Science, Cochrane, LILACS, and SciELO. The eligible studies were randomized clinical trials (RCTs) involving adults undergoing cocoa consumption (cocoa extract or ≥70% cocoa dark chocolate) for ≥4 weeks that evaluated at least one of the following markers: body weight, body mass index (BMI), waist/abdominal circumference, total cholesterol, LDL-c, triglycerides, HDL-c, blood glucose, glycated hemoglobin (HbA1c), and systolic and diastolic blood pressure (SBP/DBP).
RESULTS
Thirty-one studies were included, totaling 1986 participants. Cocoa consumption showed no effects on body weight, BMI, waist circumference, triglycerides, HDL-c and HbA1c. Yet, there was a reduction in total cholesterol (-8.35 mg/dL, 95% CI -14.01; -2.69 mg/dL), LDL-c (-9.47 mg/dL, 95% CI -13.75; -5.20 mg/dL), fasting blood glucose (-4.91 mg/dL, 95% CI -8.29; -1.52 mg/dL), SBP (-2.52 mmHg, 95% CI -4.17; -0.88 mmHg), and DBP (-1.58 mmHg, 95% CI -2.54; -0.62 mmHg).
CONCLUSIONS
The consumption of cocoa showed protective effects on major cardiometabolic risk markers that have a clinical impact in terms of cardiovascular risk reduction.
Topics: Humans; Randomized Controlled Trials as Topic; Cacao; Cardiometabolic Risk Factors; Blood Pressure; Blood Glucose; Biomarkers; Glycated Hemoglobin; Cardiovascular Diseases; Chocolate; Male; Female; Adult; Body Mass Index; Body Weight; Waist Circumference; Middle Aged; Triglycerides; Diet; Lipids
PubMed: 38931273
DOI: 10.3390/nu16121919 -
Nutrients Jun 2024It is well known that the Mediterranean diet (DM) is beneficial for health, as years of research globally have confirmed. The aim of this study was to update a previous... (Review)
Review
It is well known that the Mediterranean diet (DM) is beneficial for health, as years of research globally have confirmed. The aim of this study was to update a previous systematic review that assessed the cost-effectiveness of adherence to the DM as a strategy for the prevention of degenerative diseases by evaluating the economic performance of this diet. The research approach utilized three electronic databases: PubMed, Scopus, and Web of Science. A comprehensive search was conducted to retrieve articles based on a PRISMA-compliant protocol registered in PROSPERO: CRD 42023493562. Data extraction and analysis were performed on all included studies. One thousand two hundred and eighty-two articles were retrieved, and once duplicates and irrelevant articles were removed, fifteen useful articles were reviewed. The studies indicated a clear link between dietary habits, health, and economic aspects related to dietary cost and health spending. Recognizing the significant health benefits associated with adopting DM and the potential savings on health care spending, it is important for national public health programs to consider policies that support this lifestyle.
Topics: Diet, Mediterranean; Humans; Cost-Benefit Analysis
PubMed: 38931254
DOI: 10.3390/nu16121899 -
Nutrients Jun 2024The systematic review and meta-analysis were conducted to ascertain the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among Chinese... (Meta-Analysis)
Meta-Analysis Review
The systematic review and meta-analysis were conducted to ascertain the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among Chinese pregnant women. A total of 722 articles on maternal anemia during pregnancy published between January 2010 and December 2020 were compiled, and a systematic review and meta-analysis were conducted on 57 eligible studies including 1,376,204 pregnant women to ascertain the prevalence of anemia and the prevalence in different subgroups. The results showed that the prevalence of anemia, ID, and IDA among pregnant women in China were 30.7% (95% CI: 26.6%, 34.7%), 45.6% (95% CI: 37.0%, 54.2%), and 17.3% (95% CI: 13.9%, 20.7%), respectively. All prevalence increased with the progression of the pregnancy. There were sizable regional variations in the prevalence of anemia, ID, and IDA. Generally, lower prevalence was observed in the economically more advanced eastern region of the country, while the prevalence of ID was higher in the eastern region than that in the western region. The prevalence of anemia and IDA in rural areas was higher than that in urban areas, but ID prevalence was higher in urban areas. In conclusion, the regional differences and urban-rural disparities in the prevalence of anemia indicate the need for more context-specific interventions to prevent and treat anemia. It was found that dietary factors were one of the major causes of anemia, and iron-containing supplements and nutrition counseling could be effective interventions to reduce the prevalence of anemia, ID, and IDA among Chinese pregnant women.
Topics: Humans; Female; Pregnancy; China; Prevalence; Anemia, Iron-Deficiency; Anemia; Pregnancy Complications, Hematologic; Adult; Rural Population; Urban Population; Pregnant Women
PubMed: 38931209
DOI: 10.3390/nu16121854