A systematic review and meta-analysis on the rate of human schistosomiasis reinfection

Background While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity information on the global schistosomiasis reinfection rate. Objective This systematic review and meta−analysis aimed at summarizing studies that estimated the human schistosomiasis reinfection rate. Materials and methods The protocol for this review was prepared to guide authors throughout the process. However, registration was not sought. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on human schistosomiasis reinfection rate. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta−analysis was conducted using statistical R version 3.6.2 and R Studio using ′meta′ and ′metafor′ packages. Heterogeneity and publication bias of the studies were determined using Q − test and Egger′s regression test respectively. Random effect model was employed to estimate pooled reinfection rates. Results A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5 − 9 scores) quality. The overal calculated and pooled schistosomiasis reinfection rates were 36.1% (±23.3%) and 33.2% (95% CI, 26.5 − 40.5%) respectively. For intestinal schistosomiasis, the calculated and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8 − 51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3% − 29.2%) respectively. Results of subgroup analysis showed that, the type of Schistosoma species, participants age group, sample size and geographical area had influence on disparity variation in Schistosomiasis reinfection rate (p < 0.05). Conclusion Despite the control measures in place, the re-infection rate was still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing through schistosomiasis elimination and intensive programmatic strategies should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six month, intensive snails control and health education.

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A systematic review and meta-analysis on the rate of human schistosomiasis reinfection

PLoS ONE ◽

10.1371/journal.pone.0243224 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243224

Author(s):

Abdallah Zacharia ◽

Vivian Mushi ◽

Twilumba Makene

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Meta Analysis ◽

Reinfection Rate ◽

Chi Square ◽

Urogenital Schistosomiasis ◽

Intestinal Schistosomiasis ◽

Human Schistosomiasis ◽

Chi Square Test

While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity of information on the global reinfection rate of schistosomiasis. This systematic review and meta-analysis aimed at summarizing studies that estimated the reinfection rate of human schistosomiasis. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on reinfection rate of human schistosomiasis. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted using statistical R version 3.6.2 and R Studio using “meta” and “metafor” packages. Random effect model was employed to estimate pooled reinfection rates. Heterogeneity was determined using Cochran’s Q (chi-square)–test and Higgins I2 statistics. A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5–9 scores) quality. The overal mean and pooled reinfection rates of schistosomiasis were 36.1% (±23.3%) and 33.2% (95% CI, 26.5–40.5%) respectively. For intestinal schistosomiasis, the mean and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8–51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3%– 29.2%) respectively. Cochran’s Q (chi-square)–test and Higgins I2 statistic indicated significant heterogeneity across studies (p-values < 0.001, I2 values > 95%). Results of subgroup analysis showed that, the type of Schistosoma species, participants’ age group, sample size and geographical area had influence on disparity variation in reinfection rate of schistosomiasis (p < 0.1). Despite the control measures in place, the re-infection rate is still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing intensive programmatic strategies for schistosomiasis elimination should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six months, intensive snails control and health education.

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Mass drug administration campaigns for scabies and impetigo: protocol for a systematic review and meta-analysis

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001132 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001132

Author(s):

Pousali Ghosh ◽

Wubshet Tesfaye ◽

Avilasha Manandhar ◽

Thomas Calma ◽

Mary Bushell ◽

...

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Assessment Tool ◽

Statistical Tests ◽

Meta Analysis ◽

Grey Literature ◽

Random Effect ◽

Systematic Evaluation ◽

Clear Understanding

IntroductionScabies is recognised as a neglected tropical disease, disproportionately affecting the most vulnerable populations around the world. Impetigo often occurs secondarily to scabies. Several studies have explored mass drug administration (MDA) programmes, with some showing positive outcomes—but a systematic evaluation of such studies is yet to be reported. The main aim of this systematic review is to generate comprehensive evidence on the effect and feasibility of MDA programmes in reducing the burden of scabies and impetigo.Methods and analysisA systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Electronic databases to be searched will include CINAHL EBSCOhost, Medline Ovid, ProQuest, Science Direct, PubMed and SCOPUS. In addition, grey literature will be explored via the Australian Institute of Health and Welfare, Australian Indigenous HealthInfoNet, Informit, OaIster database and WHO. No language restrictions will be applied. All treatment studies following an MDA protocol, including randomised/quasi-controlled trials, and prospective before–after interventional studies, will be considered. The main outcome is the change in prevalence of scabies and impetigo The Cochrane collaboration risk of bias assessment tool will be used for assessing the methodological quality of studies. A random-effect restricted maximum likelihood meta-analysis will be performed to generate pooled effect (OR) using STATA V.16. Appropriate statistical tests will be carried out to quantify heterogeneity between studies and publication bias.Ethics and disseminationEthical approval is not required since data will be extracted from published works. The findings will be communicated to the scientific community through a peer-reviewed journal publication. This systematic review will present an evidence on the effect of MDA interventions on scabies and impetigo, which is instrumental to obtain a clear understanding of the treatments widely used in these programmes.PROSPERO registration numberCRD42020169544,

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PREVALENCE THRESHOLDS THAT SHOULD BE APPLIED IN SCHISTOSOMIASIS MASS DRUG ADMINISTRATION PRGROGRAMMES: SYSTEMATIC REVIEW AND META-ANALYSIS

10.1101/2021.05.10.21256643 ◽

2021 ◽

Author(s):

Anthony Danso-Appiah ◽

Amadou Djirmay Garba ◽

Nathan C Lo ◽

Massimiliano Orso ◽

Kwadwo Owusu Akuffo ◽

...

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Meta Analysis ◽

Risk Of Bias ◽

Sensitivity Analyses ◽

School Age Children ◽

School Age ◽

Intensity Of Infection ◽

Global Prevalence

Background WHO-recommended prevalence thresholds for deciding schistosomiasis mass drug administration (MDA) are based on anecdotal evidence and unclear. Objectives This systematic review and meta-analysis commissioned by the WHO, as part of its new schistosomiasis evidence-based guideline development, was to generate a single and global prevalence threshold that should be applied in MDA programmes. Methods We searched several databases from 1979 to 31st March 2021 without language restriction. Two reviewers selected studies, extracted data and assessed the risk of bias using relevant risk of bias tools and resolved disagreements through discussion. The review followed the PRISMA guidelines. Data were analysed and presented as prevalence reduction (PR) and relative risk (RR) for dichotomous outcomes or mean difference for continuous outcomes with their 95% confidence intervals (CIs). Meta-regression of observations on prevalence rates and intensity of infection of MDA programmes and sensitivity analyses to assess the robustness of the results to the risk of bias components were performed. Evidence on benefits, harms, values, preferences, compliance, acceptability, equity and feasibility were also assessed. The overall level of evidence was graded using GRADE. Results Out of 1,232 studies retrieved, 38 studies met our inclusion criteria and 34 studies were included in the meta-analysis. No direct relation was observed between prevalence and intensity of infection. Praziquantel reduced prevalence of S. haematobium in school age children (SAC) at 12 months (RR 0.38, 95% CI 0.28 to 0.52; 8 studies, n=37,868); at 24 months (RR 0.30; 95% CI 0.30 to 0.52; 7 studies; n=37107); at 36 months (RR 0.39, 95% CI 0.21 to 0.71; 5 studies, n=28,146). There was no significant reduction in prevalence at 48 months (2 studies, n=10,954). For S. mansoni, there were reductions in prevalence at 12 months (RR 0.56, 95% CI 0.46 to 0.69; 14 studies, n=86,073); 24 months (RR 0.46; 95% CI 0.32 to 0.66; 14 studies; n=83,721);36 months (RR 0.44, 95% CI 0.33 to 0.58; 7 studies, n=70,933) and at 48 months (RR 0.25, 95% CI 0.11 to 0.59; 5 studies; n=27,483). Further analyses were performed from a series of created prevalence thresholds of 5%, 10%, 15%, 20%, 30% and ≥40% which showed differences in effect of MDA when each of the thresholds was applied. For annual MDA of school age children (SAC), school-based treatment (SBT) appears to perform better than community-wide treatment (CWT) in terms of prevalence reduction. For the different schistosome species, the model suggests, using the same prevalence threshold, it will take shorter time to reach elimination for S. haematobium than S. mansoni; annual MDA using SBT approach for S. haematobium will require about 10 years to achieve elimination whereas it will take over 10 years to around 15 years to achieve elimination for S. mansoni. Conclusion The evidence presented in this systematic review suggests that 10% prevalence should be used as the global prevalence threshold for implementing MDA in endemic countries.

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Trend of Soil Transmitted Helminths in Ethiopian children: A Systematic Review and Meta-analysis (2000-2018)

10.21203/rs.2.22956/v1 ◽

2020 ◽

Author(s):

Getaneh Alemu ◽

Feleke Mekonnen ◽

Mezgebu Nega ◽

Chalachew Muluneh

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Meta Analysis ◽

Parasite Prevalence ◽

National Goal ◽

Soil Transmitted Helminths ◽

Pooled Prevalence ◽

Meta Regression ◽

Over Time

Abstract Background: Ethiopia is one of the tropical countries with heavy burden of soil transmitted helminths. As a result, the nation has been implementing mass drug administration, water, sanitation and hygiene and health extension programs in order to control those parasites. Hence, updated data about the prevalence and trend of parasites over time has pivotal role to assess the success of existing control programs. Methods: Studies conducted between 2000 and 2018 were searched from PubMed, Google Scholar and local journals for systematic review and meta-analysis following PRISMA guideline and checklist. Eligible studies were selected based on pre-set inclusion and exclusion criteria. The quality of included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis (CMA 2.0) was used to calculate the pooled prevalence and meta-regression was run to assess trend of parasite prevalence over time.Results: Thirty-eight studies recruiting 16,266 participants were included in the review. The pooled prevalence of intestinal prevalence was 52.0% (95%CI: 44.4-59.5). Amhara region was with the highest prevalence (60.3%; 95%CI: 50.1-69.6). Among soil transmitted helminths, Ascaris lumbricoides (11.2%; 95%CI: 8.4-14.8) was with the highest pooled prevalence followed by hookworms (10.4%; 95%CI:7.9-13.7) and Trichiuris trichiura (3.6%; 95%CI: 2.4-5.4). Meta-regression analysis revealed that all soil transmitted helminths didn’t show significantly decreasing trend over time (p>0.05). Conclusion: Despite various control efforts have been made, soil transmitted helminths are with high distribution and their prevalence is not significantly decreasing in Ethiopia. Hence, other control approaches like community led sanitation should be integrated with mass drug administration in order to achieve the national goal of soil transmitted helminths elimination by 2025.

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Worldwide Prevalence of Small Ruminant Lentiviruses in Sheep: A Systematic Review and Meta-Analysis

Animals ◽

10.3390/ani11030784 ◽

2021 ◽

Vol 11 (3) ◽

pp. 784

Author(s):

Ricardo de Miguel ◽

Marta Arrieta ◽

Ana Rodríguez-Largo ◽

Irache Echeverría ◽

Raúl Resendiz ◽

...

Keyword(s):

Systematic Review ◽

Small Ruminant ◽

Meta Analysis ◽

Geographical Area ◽

Small Ruminants ◽

Strong Positive Correlation ◽

Scientific Publications ◽

Serological Tests ◽

Gold Standard Method ◽

Small Ruminant Lentiviruses

Small Ruminant Lentiviruses (SRLV) are highly prevalent retroviruses with significant genetic diversity and antigenic heterogeneity that cause a progressive wasting disease of sheep called Maedi-visna. This work provides a systematic review and meta-analysis of the last 40 years (1981–2020) of scientific publications on SRLV individual and flock prevalence. Fifty-eight publications and 314 studies were included. Most articles used a single diagnostic test to estimate prevalence (77.6%), whereas articles using three or more tests were scarce (6.9%). Serological tests are more frequently used than direct methods and ELISA has progressively replaced AGID over the last decades. SRLV infection in sheep is widespread across the world, with Europe showing the highest individual prevalence (40.9%) and being the geographical area in which most studies have been performed. Africa, Asia, and North America show values between 16.7% to 21.8% at the individual level. South and Central America show the lowest individual SRLV prevalence (1.7%). There was a strong positive correlation between individual and flock prevalence (ρ = 0.728; p ≤ 0.001). Despite the global importance of small ruminants, the coverage of knowledge on SRLV prevalence is patchy and inconsistent. There is a lack of a gold standard method and a defined sampling strategy among countries and continents.

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Effects of low back pain on balance performance in elderly people: a systematic review and meta-analysis

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00263-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Le Ge ◽

Chuhuai Wang ◽

Haohan Zhou ◽

Qiuhua Yu ◽

Xin Li

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Elderly People ◽

Meta Analysis ◽

Cochrane Library ◽

Original Research ◽

Low Back ◽

Centre Of Pressure ◽

Balance Performance

Abstract Background Research suggests that individuals with low back pain (LBP) may have poorer motor control compared to their healthy counterparts. However, the sample population of almost 90% of related articles are young and middle-aged people. There is still a lack of a systematic review about the balance performance of elderly people with low back pain. This study aimed to conduct a systematic review and meta-analysis to understand the effects of LBP on balance performance in elderly people. Methods This systematic review and meta-analysis included a comprehensive search of PubMed, Embase, and Cochrane Library databases for full-text articles published before January 2020. We included the articles that 1) investigated the elderly people with LBP; 2) assessed balance performance with any quantifiable clinical assessment or measurement tool and during static or dynamic activity; 3) were original research. Two independent reviewers screened the relevant articles, and disagreements were resolved by a third reviewer. Results Thirteen case-control studies comparing balance performance parameters between LBP and healthy subjects were included. The experimental group (LBP group) was associated with significantly larger area of centre of pressure movement (P < 0.001), higher velocity of centre of pressure sway in the anteroposterior and mediolateral directions (P = 0.01 and P = 0.02, respectively), longer path length in the anteroposterior direction (P < 0.001), slower walking speed (P = 0.05), and longer timed up and go test time (P = 0.004) than the control group. Conclusion The results showed that balance performance was impaired in elderly people with LBP. We should pay more attention to the balance control of elderly people with LBP.

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Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment.

10.21203/rs.2.19785/v2 ◽

2020 ◽

Author(s):

Paul BIZIMANA ◽

Katja POLMAN ◽

Giuseppina ORTU ◽

Meryam KRIT ◽

Frédéric NSABIYUMVA ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Health Centre ◽

Health Information System ◽

Routine Data ◽

Direct Smear ◽

Incidence Data ◽

Intestinal Schistosomiasis ◽

The Impact ◽

Health Centre Level

Abstract Background : Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel have been rolled out in 11 endemic districts. The national programme relies on school-based surveys with Kato-Katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. Methods : From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts between 2011 and 2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n=11) were compared with those without (n=34). In addition, prevalence data on intestinal schistosomiasis based on Kato-Katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. Findings : In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β 2014 =-0.826, p=0.010) and 2015 (β 2015 =-1.294, p<0.001) and for the five-year period (β=-0.286, p<0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β=-0.087, p=0.219). In most of the 45 sanitary districts, the low prevalences based on Kato-Katz in schoolchildren were confirmed by low incidence rates based on direct smear in the health centres. Conclusions : National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the Point-of-care Circulating Cathodic Antigen assay are desirable. Keywords : Direct smear, Health centre, Mass drug administration, Monitoring, Praziquantel, Routine data, Schistosomiasis, Burundi

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Impact of seven years of mass drug administration and recrudescence of Schistosoma haematobium infections after one year of treatment gap in Zanzibar: Repeated cross-sectional studies

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009127 ◽

2021 ◽

Vol 15 (2) ◽

pp. e0009127

Author(s):

Lydia Trippler ◽

Shaali Makame Ame ◽

Jan Hattendorf ◽

Saleh Juma ◽

Salum Abubakar ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Odds Ratio ◽

Schistosoma Haematobium ◽

Treatment Gap ◽

Urogenital Schistosomiasis ◽

Cross Sectional ◽

Reagent Strips ◽

One Year ◽

Low Prevalence

Background Considerable progress towards the elimination of urogenital schistosomiasis was made by the Zanzibar Elimination of Schistosomiasis Transmission project from 2012 till 2016, when biannual praziquantel mass drug administration (MDA) alone or with additional snail control or behaviour change interventions were implemented. Annual MDA was continued in 2017 and 2018, but not in 2019, imposing a 16-month treatment gap. We monitored the Schistosoma haematobium prevalence from 2012 till 2020 and assessed recrudescence patterns with focus on 2020. Methodology Repeated cross-sectional surveys were conducted from 2011/12 till 2020 in 90 communities and 90 schools in Zanzibar. Annually, around 4,500 adults and up to 20,000 schoolchildren were surveyed. The S. haematobium prevalence was detected by urine filtration and reagent strips. In 2020, risk factors for infection were investigated using generalized estimated equation models. Principal findings In adults, the apparent S. haematobium prevalence was 3.9% in 2011 and 0.4% in 2020. In schoolchildren, the prevalence decreased from 6.6% in 2012 to 1.2% in 2019 with vicissitudes over the years. Prominent recrudescence of infection from 2.8% in 2019 to 9.1% (+225%) in 2020 was observed in 29 schools with historically moderate prevalences (≥10%). Compared with 2019, reinfection in 2020 was particularly striking in boys aged 9–16 years. Being male was a risk factor for infection in 2020 (adults: odds ratio (OR): 6.24, 95% confidence interval (95% CI): 1.96–19.60; schoolchildren: OR: 2.06, 95% CI: 1.52–2.78). Living near to a natural freshwater body significantly increased the odds of infection in adults (OR: 2.90, CI: 1.12–7.54). Conclusions/Significance After 11 rounds of MDA over 7 years and a 16-month treatment gap, the urogenital schistosomiasis prevalence considerably rebounded in hotspot areas. Future elimination efforts in Zanzibar should focus on re-intensifying MDA plus additional interventions in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted surveillance-response.

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COVID-19 and Influenza Co-infection: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.681469 ◽

2021 ◽

Vol 8 ◽

Author(s):

Masoud Dadashi ◽

Saeedeh Khaleghnejad ◽

Parisa Abedi Elkhichi ◽

Mehdi Goudarzi ◽

Hossein Goudarzi ◽

...

Keyword(s):

Systematic Review ◽

Case Reports ◽

Influenza Infection ◽

Meta Analysis ◽

Clinical Manifestations ◽

Case Series ◽

Influenza Viruses ◽

Original Research ◽

Respiratory Pathogens ◽

Prevalence Studies

Background and Aim: Co-infection of COVID-19 with other respiratory pathogens which may complicate the diagnosis, treatment, and prognosis of COVID-19 emerge new concern. The overlap of COVID-19 and influenza, as two epidemics at the same time can occur in the cold months of the year. The aim of current study was to evaluate the rate of such co-infection as a systematic review and meta-analysis.Methods: A systematic literature search was performed on September 28, 2019 for original research articles published in Medline, Web of Science, and Embase databases from December 2019 to September 2020 using relevant keywords. Patients of all ages with simultaneous COVID-19 and influenza were included. Statistical analysis was performed using STATA 14 software.Results: Eleven prevalence studies with total of 3,070 patients with COVID-19, and 79 patients with concurrent COVID-19 and influenza were selected for final evaluation. The prevalence of influenza infection was 0.8% in patients with confirmed COVID-19. The frequency of influenza virus co-infection among patients with COVID-19 was 4.5% in Asia and 0.4% in the America. Four prevalence studies reported the sex of patients, which were 30 men and 31 women. Prevalence of co-infection with influenza in men and women with COVID-19 was 5.3 and 9.1%, respectively. Eight case reports and 7 case series with a total of 123 patients with COVID-19 were selected, 29 of them (16 men, 13 women) with mean age of 48 years had concurrent infection with influenza viruses A/B. Fever, cough, and shortness of breath were the most common clinical manifestations. Two of 29 patients died (6.9%), and 17 out of 29 patients recovered (58.6%). Oseltamivir and hydroxychloroquine were the most widely used drugs used for 41.4, and 31% of patients, respectively.Conclusion: Although a low proportion of COVID-19 patients have influenza co-infection, however, the importance of such co-infection, especially in high-risk individuals and the elderly, cannot be ignored. We were unable to report the exact rate of simultaneous influenza in COVID-19 patients worldwide due to a lack of data from several countries. Obviously, more studies are needed to evaluate the exact effect of the COVID-19 and influenza co-infection in clinical outcomes.

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Cryptosporidium animal species in Iran: a systematic review and meta-analysis

Tropical Medicine and Health ◽

10.1186/s41182-020-00278-9 ◽

2020 ◽

Vol 48 (1) ◽

Author(s):

Mousa Motavalli Haghi ◽

Zohreh Khorshidvand ◽

Salman Khazaei ◽

Faezeh Foroughi-Parvar ◽

Hossein Sarmadian ◽

...

Keyword(s):

Systematic Review ◽

Animal Species ◽

Meta Analysis ◽

Economic Loss ◽

Forest Plot ◽

Original Research ◽

Significance Level ◽

Severe Diarrhea ◽

System Defect ◽

Cattle And Sheep

Abstract Background Cryptosporidiosis is an acute and short-term infection which can lead to severe diarrhea (intestinal cryptosporidiosis) associated with a persistent cough in the host with immune system defect. This systematic review and meta-analysis was conducted to estimate the prevalence of animal Cryptosporidium species and the corresponding epidemiological aspects in Iran. Methods In this study, all original research articles relating to the animal cryptosporidiosis in Iran were collected from reliable databases using keywords. A meta-analysis was conducted separately for each subgroup, and heterogeneity among the studies was performed using the Q and I2 tests. Furthermore, it should be noticed that the significance level in the statistical analysis with the Comprehensive Meta-analysis software was considered to be less than 0.05. Finally, meta-analysis results were shown in forest plot with a 95% CI. Results In total, 4795 studies were included in the initial screening. Duplicated or non-original studies and the ones which did not meet our considered criteria were excluded from the list. Out of the 100 articles included in our first list for the meta-analysis, 40, 16, 13, 10, 9, 7, and 5 were done on cattle and calves, birds, dogs, sheep, rodents, camels, and horses, respectively. The prevalence rate of cryptosporidiosis among the birds, horses, rodents, camels, dogs, cattle, and sheep in Iran was estimated to be 7.5%, 19.5%, 20.8%, 8.4%, 4.9%, 14.4%, and 9.1%, respectively. Conclusion The different Cryptosporidium species have been found in different regions of Iran. Geographical region, climate, and domestic animals are considered as factors responsible for animal cryptosporidiosis prevalence in the area. Moreover, this parasite is zoonotic which causes disease in animals as well as humans which can result in economic loss.

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