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Journal of Human Lactation : Official... Nov 2020Lactational mastitis is a maternal morbidity that affects the wellbeing of women and their babies, including through breastfeeding discontinuation.
BACKGROUND
Lactational mastitis is a maternal morbidity that affects the wellbeing of women and their babies, including through breastfeeding discontinuation.
RESEARCH AIM
To systematically review the available global literature on the frequency of lactational mastitis, and to summarize the evidence on risk factors for lactational mastitis. We also describe gaps in the evidence and identify priority areas for future research.
METHODS
We systematically searched and screened 6 databases and included 26 articles, conducted meta-analysis of disease frequency, and narratively synthesized evidence on risk factors.
RESULTS
In 11 (42%) articles researchers reported a measure of disease frequency; 5 (19%) reported risk factors, and 10 (39%) included both. Overall, the quality of studies was low, related to suboptimal measurement of disease frequency, high risk of bias, reverse causality, and incomplete adjustment for confounding. Meta-analysis was based on 3 studies (pooled incidence between birth and Week 25 postpartum: 11.1 episodes per 1,000 breastfeeding weeks; 95% CI [10.2-12.0]); with high heterogeneity across contexts and highest incidence in the first four weeks postpartum. Researchers assessed 42 potential risk factors; nipple damage was the most frequently studied and strongly associated with mastitis. There was a scarcity of studies from low-resource settings.
CONCLUSIONS
Lactational mastitis is a common condition, but the wide variability in incidence across contexts suggested that a substantial portion of this burden might be preventable. Provision of care to breastfeeding women at risk for or affected by mastitis is currently constrained due to a critical lack of high quality epidemiological evidence about its incidence and risk factors.
Topics: Adult; Breast Feeding; Female; Humans; Incidence; Infant; Lactation; Mastitis; Mothers; Risk Factors
PubMed: 32286139
DOI: 10.1177/0890334420907898 -
PloS One 2022Acute mastitis is one of the main reasons why breastfeeding women stop breastfeeding, and medication should be used with caution. Considering the uncertainty of mastitis... (Meta-Analysis)
Meta-Analysis
Acute mastitis is one of the main reasons why breastfeeding women stop breastfeeding, and medication should be used with caution. Considering the uncertainty of mastitis infection and the indications of antibiotic use, as well as the problem of drug resistance and the safety of medication during lactation, probiotics have become an alternative treatment choice. However, a meta-analysis of the effects of probiotics in preventing and treating lactational mastitis is still lacking. Therefore, we searched six electronic databases and the sites of clinical trial registration, a total of six randomized controlled trials were included in this meta-analysis, which showed that oral probiotics during pregnancy can reduce the incidence of mastitis (RR: 0.49, 95% CI: 0.35 to 0.69; p<0.0001). After oral administration of probiotics, the counts of bacteria in the milk of healthy people and mastitis patients were both significantly reduced (in healthy people: MD: -0.19, 95% CI: -0.23 to -0.16, p<0.00001; in mastitis patients: MD: -0.89, 95% CI: -1.34 to -0.43, p = 0.0001). These indicate that to a certain extent, probiotics are beneficial in reducing the incidence rate of mastitis during lactation and some related mastitis symptoms. However, high-quality multicenter clinical trials are still needed to support this result.
Topics: Anti-Bacterial Agents; Breast Feeding; Female; Humans; Lactation; Mastitis; Multicenter Studies as Topic; Probiotics; Randomized Controlled Trials as Topic
PubMed: 36084006
DOI: 10.1371/journal.pone.0274467 -
The Cochrane Database of Systematic... Sep 2020Engorgement is the overfilling of breasts with milk, often occurring in the early days postpartum. It results in swollen, hard, painful breasts and may lead to premature...
BACKGROUND
Engorgement is the overfilling of breasts with milk, often occurring in the early days postpartum. It results in swollen, hard, painful breasts and may lead to premature cessation of breastfeeding, decreased milk production, cracked nipples and mastitis. Various treatments have been studied but little consistent evidence has been found on effective interventions.
OBJECTIVES
To determine the effectiveness and safety of different treatments for engorgement in breastfeeding women.
SEARCH METHODS
On 2 October 2019, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP), and reference lists of retrieved studies.
SELECTION CRITERIA
All types of randomised controlled trials and all forms of treatment for breast engorgement were eligible.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for eligibility, extracted data, conducted 'Risk of bias' assessment and assessed the certainty of evidence using GRADE.
MAIN RESULTS
For this udpate, we included 21 studies (2170 women randomised) conducted in a variety of settings. Six studies used individual breasts as the unit of analysis. Trials examined a range of interventions: cabbage leaves, various herbal compresses (ginger, cactus and aloe, hollyhock), massage (manual, electromechanical, Oketani), acupuncture, ultrasound, acupressure, scraping therapy, cold packs, and medical treatments (serrapeptase, protease, oxytocin). Due to heterogeneity, meta-analysis was not possible and data were reported from single trials. Certainty of evidence was downgraded for limitations in study design, imprecision and for inconsistency of effects. We report here findings from key comparisons. Cabbage leaf treatments compared to control For breast pain, cold cabbage leaves may be more effective than routine care (mean difference (MD) -1.03 points on 0-10 visual analogue scale (VAS), 95% confidence intervals (CI) -1.53 to -0.53; 152 women; very low-certainty evidence) or cold gel packs (-0.63 VAS points, 95% CI -1.09 to -0.17; 152 women; very low-certainty evidence), although the evidence is very uncertain. We are uncertain about cold cabbage leaves compared to room temperature cabbage leaves, room temperature cabbage leaves compared to hot water bag, and cabbage leaf extract cream compared to placebo cream because the CIs were wide and included no effect. For breast hardness, cold cabbage leaves may be more effective than routine care (MD -0.58 VAS points, 95% CI -0.82 to -0.34; 152 women; low-certainty evidence). We are uncertain about cold cabbage leaves compared to cold gel packs because the CIs were wide and included no effect. For breast engorgement, room temperature cabbage leaves may be more effective than a hot water bag (MD -1.16 points on 1-6 scale, 95% CI -1.36 to -0.96; 63 women; very low-certainty evidence). We are uncertain about cabbage leaf extract cream compared to placebo cream because the CIs were wide and included no effect. More women were satisfied with cold cabbage leaves than with routine care (risk ratio (RR) 1.42, 95% CI 1.22 to 1.64; 152 women; low certainty), or with cold gel packs (RR 1.23, 95% CI 1.10 to 1.38; 152 women; low-certainty evidence). We are uncertain if women breastfeed longer following treatment with cold cabbage leaves than routine care because CIs were wide and included no effect. Breast swelling and adverse events were not reported. Compress treatments compared to control For breast pain, herbal compress may be more effective than hot compress (MD -1.80 VAS points, 95% CI -2.07 to -1.53; 500 women; low-certainty evidence). Massage therapy plus cactus and aloe compress may be more effective than massage therapy alone (MD -1.27 VAS points, 95% CI -1.75 to -0.79; 100 women; low-certainty evidence). In a comparison of cactus and aloe compress to massage therapy, the CIs were wide and included no effect. For breast hardness, cactus and aloe cold compress may be more effective than massage (RR 0.66, 95% CI 0.51 to 0.87; 102 women; low-certainty evidence). Massage plus cactus and aloe cold compress may reduce the risk of breast hardness compared to massage alone (RR 0.38, 95% CI 0.25 to 0.58; 100 women; low-certainty evidence). We are uncertain about the effects of compress treatments on breast engorgement and cessation of breastfeeding because the certainty of evidence was very low. Among women receiving herbal compress treatment, 2/250 experienced skin irritation compared to 0/250 in the hot compress group (moderate-certainty evidence). Breast swelling and women's opinion of treatment were not reported. Medical treatments compared to placebo Protease may reduce breast pain (RR 0.17, 95% CI 0.04, 0.74; low-certainty evidence; 59 women) and breast swelling (RR 0.34, 95% CI 0.15 to 0.79; 59 women; low-certainty evidence), whereas serrapeptase may reduce the risk of engorgement compared to placebo (RR 0.36, 95% CI 0.14 to 0.88; 59 women; low-certainty evidence). We are uncertain if serrapeptase reduces breast pain or swelling, or if oxytocin reduces breast engorgement compared to placebo, because the CIs were wide and included no effect. No women experienced adverse events in any of the groups receiving serrapeptase, protease or placebo (low-certainty evidence). Breast induration/hardness, women's opinion of treatment and breastfeeding cessation were not reported. Cold gel packs compared to control For breast pain, we are uncertain about the effectiveness of cold gel packs compared to control treatments because the certainty of evidence was very low. For breast hardness, cold gel packs may be more effective than routine care (MD -0.34 points on 1-6 scale, 95% CI -0.60 to -0.08; 151 women; low-certainty evidence). It is uncertain if women breastfeed longer following cold gel pack treatment compared to routine care because the CIs were wide and included no effect. There may be little difference in women's satisfaction with cold gel packs compared to routine care (RR 1.17, 95% CI 0.97 to 1.40; 151 women; low-certainty evidence). Breast swelling, engorgement and adverse events were not reported.
AUTHORS' CONCLUSIONS
Although some interventions may be promising for the treatment of breast engorgement, such as cabbage leaves, cold gel packs, herbal compresses, and massage, the certainty of evidence is low and we cannot draw robust conclusions about their true effects. Future trials should aim to include larger sample sizes, using women - not individual breasts - as units of analysis.
Topics: Acupuncture Therapy; Brassica; Breast Diseases; Cryotherapy; Female; Humans; Lactation Disorders; Massage; Mastodynia; Oxytocin; Peptide Hydrolases; Phytotherapy; Plant Leaves; Pregnancy; Randomized Controlled Trials as Topic; Ultrasonic Therapy
PubMed: 32944940
DOI: 10.1002/14651858.CD006946.pub4 -
The Cochrane Database of Systematic... Sep 2020Despite the health benefits of breastfeeding, initiation and duration rates continue to fall short of international guidelines. Many factors influence a woman's decision... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Despite the health benefits of breastfeeding, initiation and duration rates continue to fall short of international guidelines. Many factors influence a woman's decision to wean; the main reason cited for weaning is associated with lactation complications, such as mastitis. Mastitis is an inflammation of the breast, with or without infection. It can be viewed as a continuum of disease, from non-infective inflammation of the breast to infection that may lead to abscess formation.
OBJECTIVES
To assess the effectiveness of preventive strategies (for example, breastfeeding education, pharmacological treatments and alternative therapies) on the occurrence or recurrence of non-infective or infective mastitis in breastfeeding women post-childbirth.
SEARCH METHODS
We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (3 October 2019), and reference lists of retrieved studies.
SELECTION CRITERIA
We included randomised controlled trials of interventions for preventing mastitis in postpartum breastfeeding women. Quasi-randomised controlled trials and trials reported only in abstract form were eligible. We attempted to contact the authors to obtain any unpublished results, wherever possible. Interventions for preventing mastitis may include: probiotics, specialist breastfeeding advice and holistic approaches. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and assessed the certainty of the evidence using GRADE.
MAIN RESULTS
We included 10 trials (3034 women). Nine trials (2395 women) contributed data. Generally, the trials were at low risk of bias in most domains but some were high risk for blinding, attrition bias, and selective reporting. Selection bias (allocation concealment) was generally unclear. The certainty of evidence was downgraded due to risk of bias and to imprecision (low numbers of women participating in the trials). Conflicts of interest on the part of trial authors, and the involvement of industry funders may also have had an impact on the certainty of the evidence. Most trials reported our primary outcome of incidence of mastitis but there were almost no data relating to adverse effects, breast pain, duration of breastfeeding, nipple damage, breast abscess or recurrence of mastitis. Probiotics versus placebo Probiotics may reduce the risk of mastitis more than placebo (risk ratio (RR) 0.51, 95% confidence interval (CI) 0.35 to 0.75; 2 trials; 399 women; low-certainty evidence). It is uncertain if probiotics reduce the risk of breast pain or nipple damage because the certainty of evidence is very low. Results for the biggest of these trials (639 women) are currently unavailable due to a contractual agreement between the probiotics supplier and the trialists. Adverse effects were reported in one trial, where no woman in either group experienced any adverse effects. Antibiotics versus placebo or usual care The risk of mastitis may be similar between antibiotics and usual care or placebo (RR 0.37, 95% CI 0.10 to 1.34; 3 trials; 429 women; low-certainty evidence). The risk of mastitis may be similar between antibiotics and fusidic acid ointment (RR 0.22, 95% CI 0.03 to 1.81; 1 trial; 36 women; low-certainty evidence) or mupirocin ointment (RR 0.44, 95% CI 0.05 to 3.89; 1 trial; 44 women; low-certainty evidence) but we are uncertain due to the wide CIs. None of the trials reported adverse effects. Topical treatments versus breastfeeding advice The risk of mastitis may be similar between fusidic acid ointment and breastfeeding advice (RR 0.77, 95% CI 0.27 to 2.22; 1 trial; 40 women; low-certainty evidence) and mupirocin ointment and breastfeeding advice (RR 0.39, 95% CI 0.12 to 1.35; 1 trial; 48 women; low-certainty evidence) but we are uncertain due to the wide CIs. One trial (42 women) compared topical treatments to each other. The risk of mastitis may be similar between fusidic acid and mupirocin (RR 0.51, 95% CI 0.13 to 2.00; low-certainty evidence) but we are uncertain due to the wide CIs. Adverse events were not reported. Specialist breastfeeding education versus usual care The risk of mastitis (RR 0.93, 95% CI 0.17 to 4.95; 1 trial; 203 women; low-certainty evidence) and breast pain (RR 0.93, 95% CI 0.36 to 2.37; 1 trial; 203 women; low-certainty evidence) may be similar but we are uncertain due to the wide CIs. Adverse events were not reported. Anti-secretory factor-inducing cereal versus standard cereal The risk of mastitis (RR 0.24, 95% CI 0.03 to 1.72; 1 trial; 29 women; low-certainty evidence) and recurrence of mastitis (RR 0.39, 95% CI 0.03 to 4.57; 1 trial; 7 women; low-certainty evidence) may be similar but we are uncertain due to the wide CIs. Adverse events were not reported. Acupoint massage versus routine care Acupoint massage probably reduces the risk of mastitis compared to routine care (RR 0.38, 95% CI 0.19 to 0.78;1 trial; 400 women; moderate-certainty evidence) and breast pain (RR 0.13, 95% CI 0.07 to 0.23; 1 trial; 400 women; moderate-certainty evidence). Adverse events were not reported. Breast massage and low frequency pulse treatment versus routine care Breast massage and low frequency pulse treatment may reduce risk of mastitis (RR 0.03, 95% CI 0.00 to 0.21; 1 trial; 300 women; low-certainty evidence). Adverse events were not reported.
AUTHORS' CONCLUSIONS
There is some evidence that acupoint massage is probably better than routine care, probiotics may be better than placebo, and breast massage and low frequency pulse treatment may be better than routine care for preventing mastitis. However, it is important to note that we are aware of at least one large trial investigating probiotics whose results have not been made public, therefore, the evidence presented here is incomplete. The available evidence regarding other interventions, including breastfeeding education, pharmacological treatments and alternative therapies, suggests these may be little better than routine care for preventing mastitis but our conclusions are uncertain due to the low certainty of the evidence. Future trials should recruit sufficiently large numbers of women in order to detect clinically important differences between interventions and results of future trials should be made publicly available.
Topics: Anti-Bacterial Agents; Bias; Breast Feeding; Edible Grain; Female; Fusidic Acid; Humans; Massage; Mastitis; Mupirocin; Neuropeptides; Ointments; Patient Education as Topic; Placebos; Probiotics; Randomized Controlled Trials as Topic
PubMed: 32987448
DOI: 10.1002/14651858.CD007239.pub4 -
Breast Care (Basel, Switzerland) Feb 2022Periductal mastitis (PDM) is a complex benign breast disease with a prolonged course and a high risk of recurrence after treatment. There are many available treatments...
INTRODUCTION
Periductal mastitis (PDM) is a complex benign breast disease with a prolonged course and a high risk of recurrence after treatment. There are many available treatments for PDM, but none is widely accepted. This study aims to evaluate the various treatment failure rates (TFR) of different invasive treatment measures by looking at recurrence and persistence after treatment. In this way, it sets out to inform better clinical decisions in the treatment of PDM.
METHODS
We searched PubMed, Embase, and Cochrane Library databases for eligible studies about different treatment regimens provided to PDM patients that had been published before October 1, 2019. We included original studies written in English that reported the recurrence and/or persistence rates of each therapy. Outcomes were presented as pooled TFR and 95% CI for the TFR.
RESULTS
We included 27 eligible studies involving 1,066 patients in this study. We summarized 4 groups and 10 subgroups of PDM treatments, according to the published studies. Patients treated minimally invasively (group 1) were subdivided into 3 subgroups and pooled TFR were calculated as follows: incision and drainage ( = 73; TFR = 75.6%; 95% CI 27.3-100%), incision alone ( = 74; TFR = 20.1%; 95% CI 0-59.9%), and breast duct irrigation ( = 123; TFR = 19.4%; 95% CI 0-65.0%). Patients treated with a minor excision (excision of the infected tissue and related duct; group 2) were divided into 4 subgroups and pooled TFR were calculated as follows: wound packing alone ( = 127; TFR = 2.1%; 95% CI 0-5.2%), primary closure alone ( = 66; TFR = 37.1%; 95% CI 9.5-64.8%), primary closure under antibiotic treatment cover ( = 55; TFR = 4.8%; 95% CI 0-11.4%), and additional nipple part removal ( = 232; TFR = 9.6%; 95% CI 5.8-13.4%). Patients treated with a major excision (excision of the infected tissue and the major duct; group 3) included the following 2 subgroups: patients treated with a circumareolar incision ( = 142; TFR = 7.5%; 95% CI 0.4-14.7%) and patients treated with a radial incision of the breast ( = 78; TFR = 0.6%; 95% CI 0-3.6%). Group 4 contained patients receiving different major plastic surgeries. The pooled TFR of this group ( = 86) was 3.4% (95% CI 0-7.5%).
CONCLUSION
Breast duct irrigation, which is the most minimally invasive of all of the treatment options, seemed to yield good outcomes and may be the first-line treatment for PDM patients. Minor excision methods, except for primary closure alone, might be enough for most PDM patients. Major excision, especially with radial incision, was a highly effective salvage therapy. The major plastic surgery technique was also acceptable as an alternative treatment for patients with large lesions and concerns about breast appearance. Incision and drainage and minor excision with primary closure alone should be avoided for PDM patients. Further research is still needed to better understand the etiology and pathogenesis of PDM and explore more effective treatments for this disease.
PubMed: 35355704
DOI: 10.1159/000514419 -
PeerJ 2022Bovine mastitis is the commonest episode of infection in the dairy industry, which often occurs after damage of epithelial cells lining the teat duct. It is ranked as... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Bovine mastitis is the commonest episode of infection in the dairy industry, which often occurs after damage of epithelial cells lining the teat duct. It is ranked as the second most important cause of milk production loss directly and a devastating disease with a higher incidence leading to the culling of dairy cows. Thus, this systematic review and meta-analysis is aimed to quantitatively estimate the current status of mastitis in general and bacterial mastitis particular in Ethiopia.
METHODS
A literature search was carried from major databases and indexing services including PubMed, Google Scholar, Science Direct. Also, local institution repositories were searched to retrieve unpublished MSc and PhD theses. All studies were included addressing the prevalence of mastitis and bacterial isolates conducted in Ethiopia. Microsoft Excel was used to extract data and was imported to R Studio for the analyses. The random-effects model at a 95% confidence level was used for pooled estimates of outcomes. The degree of heterogeneity was computed by Higgins's I statistics. Publication bias was checked by using the funnel plots of standard error augmented by Begg's and Egger's tests.
RESULTS
A total of 46 studies with 15,780 cows were included in this study. All studies have collected 18,478 suspected samples for bacterial isolation. While pooled prevalence estimate of mastitis was 47.6%, the bacterial isolates pooled prevalence was 33.1%. The bacterial mastitis was 6.5% in cows infected by clinical patients and was 28.3% subclinical patients. The common isolates were , species, , , , Coagulase Negative and species. A univariate meta-regression analysis evidenced that the type of mastitis and management system was a possible source of heterogeneity (-value = 0.001).
CONCLUSION
The pooled prevalence of bacterial mastitis in Ethiopian dairy cattle was high. The analysis showed bacterial pathogens like , , species and Coagulase Negative are majorly accounted for bovine mastitis in Ethiopia. Therefore, the highly prevalent and commonly isolated pathogens cause contagious mastitis which require immediate attention by dairy producers to put under control by devising robust mastitis prevention and control interventions.
Topics: Female; Animals; Cattle; Humans; Mastitis, Bovine; Ethiopia; Coagulase; Milk; Staphylococcal Infections; Bacteria; Staphylococcus; Staphylococcus aureus; Streptococcal Infections
PubMed: 35547189
DOI: 10.7717/peerj.13253 -
Veterinary World 2023Mastitis is an important disease that can reduce milk production and farmer income as well as negatively affect human health. This study aimed to summarize dairy...
BACKGROUND AND AIM
Mastitis is an important disease that can reduce milk production and farmer income as well as negatively affect human health. This study aimed to summarize dairy mastitis in Indonesia, both subclinical mastitis (SCM) and clinical mastitis (CM), and its prevalence in different provinces, the diagnostic methods, and the animal species.
MATERIALS AND METHODS
Relevant studies on mastitis in dairy animals in Indonesia were obtained from PubMed, Scopus, ProQuest, Google Scholar, and Garuda. The title and abstract were screened for the eligibility of the studies. The full text of the selected studies was assessed and the data were extracted for analysis. To determine the pooled estimate of the prevalence of mastitis, a random-effects model was performed using the "Meta" and "Metaphor" packages in the R software version 4.2.2. The heterogeneity of several characteristics (mastitis type, provinces, animal species, and diagnostic methods) was evaluated through subgroup meta-analysis. Meta-regression analysis was conducted to assess the trend of mastitis prevalence reports over time. Publication bias was evaluated using Egger's test and a funnel plot.
RESULTS
A total of 735 studies were retrieved for the title and abstract screening, which resulted in the final selection of 37 studies with a total of 6050 samples for meta-analysis. The pooled estimate of mastitis prevalence in dairy animals in Indonesia was 59.44% (95% confidence interval [CI], 52.39%-66.49%). Based on mastitis type, SCM had a significantly higher prevalence than CM (58.24% [95% CI, 51.26%-65.23%] vs. 3.31% [95% CI, 1.42%-5.19%]). No significant difference was observed in the analysis of other subgroups. Among provinces, Central Java had the highest prevalence (66.62% [95% CI, 49.37%-83.87%]), whereas Yogyakarta had the lowest (41.77% [95% CI, 14.96%-68.58%]). Based on animal species, cow and goat had a prevalence of 63.42% (95% CI, 55.97%-70.86%) and 44.96% (95% CI, 28.26%-61.66%), respectively. Based on the diagnostic method, the California mastitis test resulted in 60.08% (95% CI, 52.11%-68.06%) and the Institut Pertanian Bogor test, 56.00% (95% CI, 41.20%-70.81%). No significant change in the prevalence of mastitis in Indonesia was observed from 2003 to 2022.
CONCLUSION
This study demonstrates that the pooled estimate of mastitis prevalence in dairy animals in Indonesia is >50%. Based on subgroup analysis, SCM had a higher prevalence than CM; however, the prevalence between provinces, detection methods, and animal species in the 2003-2022 periods was not significantly different. A mastitis control strategy needs to be developed to reduce the prevalence of mastitis and further loss in milk production.
PubMed: 37621553
DOI: 10.14202/vetworld.2023.1380-1389 -
The Breast Journal 2023Idiopathic granulomatous mastitis is a rare and benign disease that primarily affects young women of reproductive age. Various factors have been suggested as possible... (Meta-Analysis)
Meta-Analysis Review
Idiopathic granulomatous mastitis is a rare and benign disease that primarily affects young women of reproductive age. Various factors have been suggested as possible causes, including pregnancy, breastfeeding, history of taking birth control pills, hyperprolactinemia, smoking, and history of trauma. Due to unknown etiology, opinions on its treatment have varied, resulting in differing recurrence rates and side effects. Therefore, conducting a comprehensive systematic review and meta-analysis can aid in understanding the causes and recurrence of the disease, thereby assisting in the selection of effective treatment and improving the quality of life. A systematic literature review was conducted using predefined search terms to identify eligible studies related to risk factors and recurrence up to June 2022 from electronic databases. Data were extracted and subjected to meta-analysis when applicable. A total of 71 studies with 4735 patients were included. The mean age of the patients was 34.98 years, and the average mass size was 4.64 cm. About 3749 of these patients (79.17%) were Caucasian. Patients who mentioned a history of pregnancy were 92.65% with 76.57%, 22.7%, and 19.7% having a history of breastfeeding, taking contraceptive pills, and high prolactin levels, respectively. Around 5.6% of patients had previous trauma. The overall recurrence rate was 17.18%, with recurrence rates for treatments as follows: surgery (22.5%), immunosuppressive treatment (14.7%), combined treatment (14.9%), antibiotic treatment (6.74%), and observation (9.4%). Only antibiotic and expectant treatments had significant differences in recurrence rates compared to other treatments ( value = 0.023). In conclusion, factors such as Caucasian race, pregnancy and breastfeeding history, and use of contraceptive hormone are commonly associated with the disease recurrence. Treatment should be tailored based on symptom severity and patient preference, with surgery or immunosuppressive options for recurrence.
Topics: Pregnancy; Female; Humans; Adult; Granulomatous Mastitis; Quality of Life; Breast Neoplasms; Neoplasm Recurrence, Local; Immunosuppressive Agents; Anti-Bacterial Agents; Contraceptive Agents; Recurrence
PubMed: 37794976
DOI: 10.1155/2023/9947797 -
Veterinary Medicine International 2022Bovine mastitis remains a major prevalent disease in cattle and places a significant economic burden on the global dairy industry. The goal of this systematic review and... (Review)
Review
Bovine mastitis remains a major prevalent disease in cattle and places a significant economic burden on the global dairy industry. The goal of this systematic review and meta-analysis was to examine the overall prevalence of mastitis and its associated risk factors among dairy cows. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, and other sources from Google Engine and University Library Databases. "Prevalence," "bovine mastitis," "clinical mastitis," "subclinical mastitis," "associated factors," "dairy cows," and "Ethiopia" were search terms used for this study. For critical appraisal, PRISMA 2009 was applied. Heterogeneity and publication bias were evaluated using Cochran's , inverse variance ( ), and funnel plot asymmetry tests. A random-effects model was used to calculate the pooled burden of mastitis and its associated factors among dairy cows, along with the parallel odds ratio (OR) and 95% confidence interval (CI). A total of 6438 dairy cows were included in the 17 eligible studies for this meta-analysis. The overall pooled prevalence of mastitis among dairy cows in Ethiopia was 43.60% (95% CI: 34.71, 52.49), of which 12.59% (95% CI: 7.18, 18.00) and 32.21% (95% CI: 24.68, 39.74) were clinical and subclinical cases, respectively. Of the regions, the highest and lowest pooled prevalence estimates of mastitis among dairy cows were 49.90% (95% CI: 31.77, 68.03) and 25.09% (95% CI: 3.86, 46.32) in the Oromia and Amhara regions, respectively. The highest pooled prevalence estimate in the study period was recorded between 2017 and 2022, with a pooled prevalence estimate of 46.83% (95% CI: 35.68, 57.97), followed by the study period from 2005 to 2016, with a pooled prevalence estimate of 39.97% (95% CI: 25.50, 54.44). Gram-positive bacteria (84.70%) were the most prevalent mastitis-causing agents compared with Gram-negative bacteria (15.30%). Breed (AOR: 2.17, 95% CI: 1.44, 2.90), lactation stage (AOR: 1.59, 95% CI: 1.04, 2.15), parity (AOR: 3.31, 95% CI: 1.69, 4.94), history of mastitis (AOR: 3.56, 95% CI: 2.40, 4.71), floor type (AOR: 1.59, 95% CI: -0.16, 3.34), and teat injury (AOR: 6.98, 95% CI: 0.33, 13.64) were factors significantly associated with mastitis among dairy cows in Ethiopia. Early diagnosis and proper medication, as well as implementing appropriate prevention and control measures, are necessary for the management of mastitis in dairy cows.
PubMed: 36164492
DOI: 10.1155/2022/7775197 -
Veterinaria Italiana Dec 2022Considering the high prevalence of subclinical mastitis and its impacts on milk production, thematic studies are need to provide strategic data for its control. This...
Considering the high prevalence of subclinical mastitis and its impacts on milk production, thematic studies are need to provide strategic data for its control. This study aimed at investigating the most frequent microorganisms associated with subclinical mastitis in dairy cows in Brazil through compiling the occurrence of the etiological agents and their sensitivity to antibiotics. The systematic review includes articles published between 2009 and 2019. Fiftyseven articles evaluating 22,287 milk samples were selected. The number of publications and the sample size were not homogeneous among Brazilian regions. Most of the studies and sampling were conducted in Rio Grande do Sul, whereas no studies were found in some states in the north and mid‑west regions. The most frequent pathogen was Staphylococcus spp. It was isolated in all studies and had an average prevalence of 49% in the analyzed samples. Resistance to penicillin was the most frequent microbial resistance found in Brazil, with an average of 66% among the isolates evaluated. Moreover, bacterial resistance to cephalexin, cefoperazone, erythromycin, gentamicin, neomycin, penicillin, tetracycline, and trimethoprim increased over the research period. Given the territorial extension, the etiological diversity, and the lack of studies with a representative sample, the compilation of scientific data must be interpreted with caution. Regions where a greater number of studies were conducted and with numerous samples, such as the South, provided a comprehensive scenario that is closer to reality. Nevertheless, although decision making on the farm cannot be replaced by scientific studies, it can be supported by such efforts.
Topics: Animals; Cattle; Female; Anti-Bacterial Agents; Brazil; Cattle Diseases; Mastitis, Bovine; Penicillins
PubMed: 37303139
DOI: 10.12834/VetIt.2601.17023.2