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BMJ Clinical Evidence Jul 2014The definition of severe recurrent throat infections is arbitrary, but recent criteria have defined severe tonsillitis as: five or more episodes of true tonsillitis a... (Review)
Review
INTRODUCTION
The definition of severe recurrent throat infections is arbitrary, but recent criteria have defined severe tonsillitis as: five or more episodes of true tonsillitis a year; symptoms for at least 1 year; and episodes that are disabling and prevent normal functioning. Diagnosis of acute tonsillitis is clinical, and it can be difficult to distinguish viral from bacterial infections. Rapid antigen testing has a very low sensitivity in the diagnosis of bacterial tonsillitis, but more accurate tests take longer to deliver results. Bacteria are cultured from few people with tonsillitis. Other causes include infectious mononucleosis from Epstein-Barr virus infection, cytomegalovirus, toxoplasmosis, HIV, hepatitis A, and rubella.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of tonsillectomy in children and adults with acute recurrent or chronic throat infections? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 15 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: cold-steel tonsillectomy and diathermy tonsillectomy.
Topics: Electrocoagulation; Humans; Tonsillectomy; Tonsillitis
PubMed: 25051184
DOI: No ID Found -
BMJ Clinical Evidence Aug 2013Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy.... (Review)
Review
INTRODUCTION
Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy. About five per 1000 non-immune pregnant women may acquire toxoplasma infection, with a 10% to 100% risk of transmission to the baby. Risks of transmission to the baby are higher later in pregnancy, but risks of infection causing harm to the baby are greater earlier in pregnancy.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects on mother and baby of treating toxoplasmosis during pregnancy to reduce risk of vertical transmission and treat fetal infection? What are the effects of treating toxoplasmosis in neonates infected with toxoplasmosis prenatally? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found six systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiparasitic drugs in pregnancy, and antiparasitic drugs in neonates.
Topics: Antibodies, Monoclonal; Antiparasitic Agents; Antiprotozoal Agents; Communicable Diseases; Genome, Protozoan; Humans; Models, Biological; Mothers; Protein Multimerization; Pyrimethamine; Toxoplasmosis, Congenital; United States Food and Drug Administration
PubMed: 23987732
DOI: No ID Found -
PLoS Neglected Tropical Diseases Feb 2015Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis.
METHODS
A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%.
PRINCIPAL FINDINGS
Six studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27-3.9), p = 0.005.
CONCLUSIONS
Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy.
Topics: Chronic Disease; Epilepsy; Humans; Middle Aged; Odds Ratio; Risk Factors; Toxoplasma; Toxoplasmosis
PubMed: 25695802
DOI: 10.1371/journal.pntd.0003525 -
BMJ Clinical Evidence Jun 2010Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy.... (Review)
Review
INTRODUCTION
Infection with Toxoplasma gondii is asymptomatic or mild in immunocompetent people and leads to lifelong immunity, but it can have serious consequences in pregnancy. About five per 1000 non-immune pregnant women may acquire toxoplasma infection, with a 10% to 100% risk of transmission to the baby. Risks of transmission to the baby are higher later in pregnancy, but risks of infection causing harm to the baby are greater earlier in pregnancy.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects on mother and baby of treating toxoplasmosis during pregnancy? What are the effects of treating toxoplasmosis in neonates exposed to toxoplasmosis prenatally? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found seven systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiparasitic drugs in pregnancy, and antiparasitic drugs in neonates.
Topics: Acute Disease; Antiparasitic Agents; Humans; Incidence; Pregnancy Complications, Parasitic; Toxoplasma; Toxoplasmosis; Toxoplasmosis, Congenital
PubMed: 21418689
DOI: No ID Found -
Advanced Biomedical Research 2022Toxoplasmosis is a disease caused by and one-third of the world's population has antibodies. Due to this issue, the aim of this study was to assess the mean prevalence... (Review)
Review
BACKGROUND
Toxoplasmosis is a disease caused by and one-third of the world's population has antibodies. Due to this issue, the aim of this study was to assess the mean prevalence and odds ratios of infection and epidemiological features of neonatal infection worldwide.
MATERIALS AND METHODS
We performed a meta-analysis and systematic review of published studies reporting infection using the PubMed, MEDLINE, Web of Science, EMBASE, and Scopus electronic databases through January 1999 to December 2020, regarding diagnostic tests, and prevalence data of infection among the newborn population. The pooled prevalence of with a 95% confidence interval (CI) was calculated using the random-effects models.
RESULTS
A total of thirty eligible articles were included. The estimated global prevalence rate was 44% (95% CI: 29%-0.58%); the highest prevalence rate was in America 47% (95% CI: 30%-64%), followed by Europe 41% (95% CI: 26%-57%) and Asia 33% (95% CI: 4%-61%). In this study, despite our careful analysis of possible modifiers, the heterogeneity was significant ( = 0.000). The publication bias was not significant based on the results of Egger's ( = 0.918) and Begg's tests ( = 0.230).
CONCLUSION
Based on the results of this study, infection can be a serious concern in newborns around the world. Therefore, further research is needed to provide better strategies to screen and diagnose infection in neonates and determine the risk factors associated with the prevalence of infection in neonates worldwide.
PubMed: 36393825
DOI: 10.4103/abr.abr_24_21 -
BMJ Clinical Evidence Oct 2009The definition of severe recurrent throat infections is arbitrary, but recent criteria have defined severe tonsillitis as: five or more episodes of true tonsillitis a... (Review)
Review
INTRODUCTION
The definition of severe recurrent throat infections is arbitrary, but recent criteria have defined severe tonsillitis as: five or more episodes of true tonsillitis a year; symptoms for at least 1 year; and episodes that are disabling and prevent normal functioning. Diagnosis of acute tonsillitis is clinical, and it can be difficult to distinguish viral from bacterial infections. Rapid antigen testing has a very low sensitivity in the diagnosis of bacterial tonsillitis, but more accurate tests take longer to deliver results. Bacteria are cultured from few people with tonsillitis. Other causes include infectious mononucleosis from Epstein-Barr virus infection, cytomegalovirus, toxoplasmosis, HIV, hepatitis A, and rubella.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of tonsillectomy in children and adults with acute recurrent or chronic throat infections? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 10 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: cold-steel tonsillectomy and diathermy tonsillectomy.
Topics: Acute Disease; Humans; Recurrence; Tonsillitis; United States Food and Drug Administration
PubMed: 21718574
DOI: No ID Found -
Journal of Infection and Public Health 2017During recent years, implication of rodents in the epidemiology of Toxoplasma gondii is overlooked in Iran; thus, we performed a systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis Review
During recent years, implication of rodents in the epidemiology of Toxoplasma gondii is overlooked in Iran; thus, we performed a systematic review and meta-analysis to evaluate the prevalence of toxoplasmosis in rodents of Iran. For this purpose, following the general methodology recommended for systematic reviews and meta-analysis, 5 English and 3 Persian databases were explored from 1 January 2000 till 10 September 2016 using related keywords. Finally, 9 out of 291 citations were met to be included in this study. Due to significant heterogeneity, the random-effects model was conducted (I=93.55%). During the years, 661 rodents were trapped, and 121 of them were identified positive for T. gondii 15% (95% CI=5-27). Moreover, overall prevalence using direct microscopic examination (1/230), PCR-based techniques (41/246) and serological tests (83/437) was obtained 0.1% (95% CI=0.0-1.5), 18% (95% CI=4-39) and 15% (95% CI=3-33), respectively. Our study revealed the prevalence of toxoplasmosis in rodents is remarkable. Considering this fact, they play a key role in the life cycle of T. gondii and should not be neglected. Further surveys is needed to better recognize the role of various rodent species in distribution of toxoplasmosis.
Topics: Animals; Iran; Rodent Diseases; Rodentia; Toxoplasmosis, Animal
PubMed: 28237696
DOI: 10.1016/j.jiph.2017.01.021 -
Journal of Tropical Medicine 2024To understand how congenital toxoplasmosis (CT) diagnosis has evolved over the years, we performed a systematic review and meta-analysis to summarize the kind of... (Review)
Review
OBJECTIVE
To understand how congenital toxoplasmosis (CT) diagnosis has evolved over the years, we performed a systematic review and meta-analysis to summarize the kind of analysis that has been employed for CT diagnosis.
METHODS
PubMed and Lilacs databases were used in order to access the kind of analysis that has been employed for CT diagnosis in several samples. Our search combined the following combining terms: "congenital toxoplasmosis" or "gestational toxoplasmosis" and "diagnosis" and "blood," "serum," "amniotic fluid," "placenta," or "colostrum." We extracted data on true positive, true negative, false positive, and false negative to generate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Random-effects models using MetaDTA were used for analysis.
RESULTS
Sixty-five articles were included in the study aiming for comparisons (75.4%), diagnosis performance (52.3%), diagnosis improvement (32.3%), or to distinguish acute/chronic infection phases (36.9%). Amniotic fluid (AF) and placenta were used in 36.9% and 10.8% of articles, respectively, targeting parasites and/or DNA. Blood was used in 86% of articles for enzymatic assays. Colostrum was used in one article to search for antibodies. In meta-analysis, PCR in AF showed the best performance for CT diagnosis based on the highest summary sensitivity (85.1%) and specificity (99.7%) added to lower magnitude heterogeneity.
CONCLUSION
Most of the assays being researched to diagnose CT are basically the same traditional approaches available for clinical purposes. The range in diagnostic performance and the challenges imposed by CT diagnosis indicate the need to better explore pregnancy samples in search of new possibilities for diagnostic tools. Exploring immunological markers and using bioinformatics tools and recombinant antigens should address the research needed for a new generation of diagnostic tools to face these challenges.
PubMed: 38419946
DOI: 10.1155/2024/1514178 -
PLoS Neglected Tropical Diseases Jun 2018Toxoplasmosis is a cosmopolitan infection caused by an intracellular obligatory protozoan, Toxoplasma gondii. Infection to this parasite in immunocompetent patients is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxoplasmosis is a cosmopolitan infection caused by an intracellular obligatory protozoan, Toxoplasma gondii. Infection to this parasite in immunocompetent patients is usually asymptomatic, but today it is believed that the infection can be a risk factor for a variety of diseases, including rheumatoid arthritis (RA). RA is an autoimmune disease and the most common type of inflammatory arthritis that is a major cause of disability. The aim of this systematic review and meta-analysis was to address the association between RA and toxoplasmosis in light of the available research.
METHODS
Based on the keywords, a systematic search of eight databases was conducted to retrieve the relevant English-language articles. Then, the studies were screened based on the inclusion and exclusion criteria. The random effect model was used to calculate the odds ratio (OR) using forest plot with 95% confidence interval (CI).
RESULTS
Overall, 4168 Individual, extracted from 9 articles were included for systematic review evaluation, with 1369 RA patients (46% positive toxoplasmosis) and 2799 individuals as controls (21% positive toxoplasmosis). Then, eight articles (10 datasets) were used for meta-analysis (1244 rheumatoid arthritis patients and 2799 controls). By random effect model, the combined OR was 3.30 (95% CI: 2.05 to 5.30) with P < 0.0001.
CONCLUSION
Although toxoplasmosis could be considered as a potential risk factor for rheumatoid arthritis, more and better quality studies are needed to determine the effect of T. gondii infection on induction or exacerbation of RA. Our study was registered at the International Prospective Register of Systematic Reviews (PROSPERO; code: CRD42017069384).
Topics: Antibodies, Protozoan; Arthritis, Rheumatoid; Humans; Odds Ratio; Prospective Studies; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis
PubMed: 29870527
DOI: 10.1371/journal.pntd.0006545 -
Pathogens and Global Health Oct 2017Toxoplasmosis is an infection caused by the intracellular protozoan parasite Toxoplasma gondii, and is associated with clinically significant infection in... (Review)
Review
Toxoplasmosis is an infection caused by the intracellular protozoan parasite Toxoplasma gondii, and is associated with clinically significant infection in immunocompromised individuals. Vertical transmission during pregnancy can manifest as congenital toxoplasmosis in the neonate, and can have serious consequences. This review aims to describe the modalities for prophylaxis of toxoplasmosis in susceptible populations, and focuses on the following: (1) prophylaxis of congenital toxoplasmosis; (2) prophylaxis of toxoplasmosis in patients with HIV/AIDS; and (3) prophylaxis of toxoplasmosis in transplant recipients.
Topics: HIV Infections; Humans; Infectious Disease Transmission, Vertical; Toxoplasmosis; Transplant Recipients
PubMed: 28948861
DOI: 10.1080/20477724.2017.1370528