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

Author(s):  
Anthony Danso-Appiah ◽  
Amadou Djirmay Garba ◽  
Nathan C Lo ◽  
Massimiliano Orso ◽  
Kwadwo Owusu Akuffo ◽  
...  

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.

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017144 ◽  
Author(s):  
Jennette P Moreno ◽  
Lydi-Anne Vézina-Im ◽  
Elizabeth M Vaughan ◽  
Tom Baranowski

IntroductionIn previous studies, it has been found that on average, children consistently gained weight during the summer months at an increased rate compared with the 9-month school year. This contributed to an increased prevalence of overweight and obesity in children. Several obesity-related interventions have occurred during or targeting the summer months. We propose to conduct a systematic review and meta-analysis of the impact of obesity prevention and treatment interventions for school-age children conducted during the summer or targeting the summer months when children are not in school on their body mass index (BMI), or weight-related behaviours.Methods and analysesA literature search will be conducted by the first author (JPM) using MEDLINE/PubMed, Cochrane Library, Scopus, CINAHL, PsycINFO, EMBASE and Proquest Dissertations and Theses databases from the date of inception to present. Studies must examine interventions that address the modification or promotion of weight-related behaviours (eg, dietary patterns, eating behaviours, physical activity (PA), sedentary behaviour or sleep) and target school-age children (ages 5–18). The primary outcomes will be changes from baseline to postintervention and/or the last available follow-up measurement in weight, BMI, BMI percentile, standardised BMI or per cent body fat. Secondary outcomes will include changes in dietary intake, PA, sedentary behaviour or sleep. Risk of bias will be assessed using the Cochrane risk of bias tool for randomised and non-randomised studies, as appropriate.Ethics and disseminationBecause this is a protocol for a systematic review, ethics approval will not be required. The findings will be disseminated via presentations at scientific conferences and published in a peer-reviewed journal. All amendments to the protocol will be documented and dated and reported in the PROSPERO trial registry.PROSPERO registration numberCRD42016041750


2021 ◽  
Vol 5 (1) ◽  
pp. e001132
Author(s):  
Pousali Ghosh ◽  
Wubshet Tesfaye ◽  
Avilasha Manandhar ◽  
Thomas Calma ◽  
Mary Bushell ◽  
...  

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,


2014 ◽  
Vol 99 (6) ◽  
pp. 1499-1509 ◽  
Author(s):  
Brechje de Gier ◽  
Maiza Campos Ponce ◽  
Margot van de Bor ◽  
Colleen M Doak ◽  
Katja Polman

2021 ◽  
pp. 105566562110398
Author(s):  
Hope Sparks Lancaster ◽  
Kari M. Lien ◽  
Jordan Haas ◽  
Paige Ellis ◽  
Nancy J. Scherer

Objective We conducted a meta-analysis and systematic review of literature comparing pre-reading and general reading in school-age children with nonsyndromic cleft palate with or without cleft lip (NSCP/L) to their peers without NSCP/L. Methods Our literature search identified 1238 possible records. After screening we identified 11 samples for inclusion for systematic review and eight for meta-analysis. We compared 292 children with NSCP/L to 311 peers for 23 pre-reading effect sizes and 17 general reading effect sizes (EFg). We conducted a random-effects metaregression using robust variance estimation. Results On average school-age children with NSCP/L scored lower on pre-reading (EFg = −0.36) and general reading measures (EFg = −0.38) compared to their peers. We conducted post-hoc analyses on phonological awareness and word decoding effect sizes; children with NSCP/L performed lower on phonological awareness (EFg = −0.22) and word decoding (EFg = −0.39) compared to their peers. There was weak evidence that hearing status and/or speech-language functioning might moderate reading development. There was limited evidence that age or socioeconomic status moderated reading development. However, samples did not consistently report several characteristics that were coded for this project. Conclusions Our findings suggest that school-age children with NSCP/L have persistent reading problems. Further research is needed to explore reading development in children with NSCP/L, as well as the relationships among hearing, speech, language, and reading development.


Author(s):  
Joan Puig-Barberà ◽  
Sonia Tamames-Gómez ◽  
Pedro Plans-Rubio ◽  
José María Eirós-Bouza

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effec-tiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influ-enza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; ap-plied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, pub-lication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed us-ing a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season and risk of bias. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017-2018 influenza season. The arVE was 3% (-01 to 7%) in the 2018-2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.


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