Prevalence of HIV and Syphilis and their Co-infection among Men Having Sex with Men in Asia: A Systematic Review and Meta-analysis

Background: Studies found that the group of men who have sex with men (MSM) is at a very high level of risk of HIV and sexually transmitted infections (STIs) in Asian regions due to multiple reasons. Although the prevalence of HIV among general people in Asia is considered low, the prevalence of HIV and Syphilis among MSM in this region was found very high and usually, it goes unnoticed. This study aimed to inspect the prevalence and trends of HIV, Syphilis, and their co-infection among MSM in Asia. Methods: A systematic search was performed on January 5, 2021, in PubMed, MEDLINE, and Google Scholar databases. To evaluate the heterogeneity, Q-tests and were used. To explore the publication bias, Eggers' test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity. Results: A total of 2,872 articles were identified, and 66 articles of high quality were included in the final analysis. The overall prevalence of HIV among MSM and Syphilis was estimated considering 69 estimates from 66 studies whereas 19 estimates of co-infection were found in 17 studies. The pooled HIV prevalence was 8.48% (CI: 7.01-9.95) and the pooled Syphilis prevalence was 9.86% (CI: 8.30-11.41) with significant heterogeneity and publication bias. The pooled prevalence of HIV and Syphilis co-infection was 2.99% (CI: 1.70-4.27) with significant heterogeneity and no publication bias. The HIV, Syphilis, and HIV and Syphilis co-infection prevalence estimates exhibited an upward trend during 2002-2017. Conclusions: HIV, Syphilis, and their co-infection are quite prevalent among MSM in the Asia-Pacific region. Integrated and intensified intervention strategies, HIV testing, and improved access to antiretroviral treatment as well as increased awareness are needed to reduce HIV, Syphilis, and their co-infection among the discussed vulnerable group.

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Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1093 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Giacchetta ◽

M Chiavarini ◽

G Naldini ◽

R Fabiani

Keyword(s):

Systematic Review ◽

Malignant Melanoma ◽

Publication Bias ◽

Oral Contraceptives ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cutaneous Malignant Melanoma ◽

Hormonal Factors ◽

Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

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Is Routine Preoperative Esophagogastroduodenoscopy Prior to Bariatric Surgery Mandatory? Systematic Review and Meta-analysis of 10,685 Patients

Obesity Surgery ◽

10.1007/s11695-020-04672-4 ◽

2020 ◽

Vol 30 (8) ◽

pp. 3073-3083 ◽

Cited By ~ 1

Author(s):

Walid El Ansari ◽

Ayman El-Menyar ◽

Brijesh Sathian ◽

Hassan Al-Thani ◽

Mohammed Al-Kuwari ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Publication Bias ◽

Surgical Approach ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

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Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies

Bioscience Reports ◽

10.1042/bsr20160474 ◽

2017 ◽

Vol 37 (3) ◽

Cited By ~ 21

Author(s):

Xuan Du ◽

Khemayanto Hidayat ◽

Bi-Min Shi

Keyword(s):

Esophageal Cancer ◽

Abdominal Obesity ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Final Analysis ◽

Gastric Cardia Adenocarcinoma ◽

Gastroesophageal Cancer ◽

Relative Risks ◽

Increased Risk

To systematically and quantitatively review the relation of abdominal obesity, as measured by waist circumference (WC) and waist to hip ratio (WHR), to total gastroesophageal cancer, gastric cancer (GC), and esophageal cancer. PubMed and Web of Science databases were searched for studies assessing the association between abdominal obesity and gastroesophageal cancer (GC and/or esophageal cancer) up to August 2016. A random-effect model was used to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Seven prospective cohort studies – one publication included two separate cohorts – from six publications were included in the final analysis. A total of 2130 gastroesophageal cancer cases diagnosed amongst 913182 participants. Higher WC and WHR were significantly associated with increased risk of total gastroesophageal cancer (WC: RR 1.68, 95% CI: 1.38, 2.04; WHR: RR 1.49, 95% CI: 1.19, 1.88), GC (WC: RR 1.48, 95% CI: 1.24, 1.78; WHR: 1.33, 95% CI: 1.04, 1.70), and esophageal cancer (WC: RR 2.06, 95% CI: 1.30, 3.24; WHR: RR 1.99, 95% CI: 1.05, 3.75).Findings from our subgroup analyses showed non-significant positive associations between gastric non-cardia adenocarcinoma (GNCA) and both measures of abdominal adiposity, while gastric cardia adenocarcinoma (GCA) was positively associated with WC but not with WHR. On analysis restricted to studies that adjusted for body mass index (BMI), WC was positively associated with GC and esophageal cancer, whereas WHR was positively associated with risk of GC only. Although limited, the findings from our meta-analysis suggest the potential role of abdominal obesity in the etiology of gastric and esophageal cancers.

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Effect of maternal birth positions on duration of second stage of labor: systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2620-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Marta Berta ◽

Helena Lindgren ◽

Kyllike Christensson ◽

Sollomon Mekonnen ◽

Mulat Adefris

Keyword(s):

Weighted Mean Difference ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Significant Heterogeneity ◽

Second Stage Of Labor ◽

Second Stage ◽

Birth Position ◽

Study Designs ◽

The Impact

Abstract Background It is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Therefore this review aimed to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results We identified 1680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2–34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839–30.396) minutes, with the same significant heterogeneity between the studies (I2 = 96.8%, p < 000). Conclusion The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618]

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How much is reasonable to expect about overall survival (OS) benefit when designing studies with new drugs for patients affected by castration resistant prostate cancer (CRPC)? Meta-analysis of 23 randomized clinical trials (RCT) including 17,640 patients.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e16053 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e16053-e16053

Author(s):

Francesco Massari ◽

Francesca Maines ◽

Sara Pilotto ◽

Camillo Porta ◽

Paolo Carlini ◽

...

Keyword(s):

Treatment Strategy ◽

Significant Interaction ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Phase Iii ◽

Sensitivity Analyses ◽

Significant Heterogeneity ◽

Significant Difference

e16053 Background: Treatment decision making in patients affected by CRPC is difficult because the numerous available therapeutic opportunities can significantly affect OS. To demonstrate that comparing results in absence of head-to-head studies may lead to biased survival estimations, a literature-based meta-analysis was conducted. Methods: Hazard Ratios (HR) with 95% confidence intervals (CI) were extracted and cumulated according to a random-effect model from phase III trials. Sensitivity analyses were performed according to: 1) Treatment Strategy (TS, Chemotherapy versus Hormonal versus Immunotherapy versus Other), 2) Comparison (Chemotherapy versus Placebo versus Other), and 3) Disease setting with regard to treatment with Docetaxel (DOC),. Testing for heterogeneity was performed as well. Results: A significant heterogeneity for the 3 sensitivity analyses was found (p<0.0001). The cumulative HR in favor of (any) experimental arm was 0.91 (95% CI 0.84-0.99, p=0.028). We found a significant interaction according to the chosen TS (p<0.0001), in fact a significant difference in OS was more likely to be detected in RCT evaluating hormonal drugs (HR 0.76, 95% CI 0.64-0.92, p=0.005) versus studies testing immunotherapy (HR 1.16, 95% CI 0.86-1.56, p=0.31). With regard to Comparison, a significant interaction (p<0.0001) was found in favor of RCT having placebo as control (HR 0.86, 95% CI 0.76-0.97, p=0.015), versus studies evaluating chemotherapy (HR 1.00, 95% CI 0.84, 1.19, p=0.99). A significant interaction according to DOC-treatment was also detected (p<0.0001), being the Post-DOC the Setting where a significant OS benefit was more likely to be determined (HR 0.77, 95% CI 0.66-0.90, p=0.001). Conclusions: The cross-trials interpretation in absence of formal direct comparisons may drive biased conclusions with regard to OS estimation. When designing trials to evaluate drugs (or strategies) in CRPC, the expected OS benefit must take into account the comparator, the treatment strategy and the (eventual) pre-treatment with DOC.

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Apple intake and cancer risk: a systematic review and meta-analysis of observational studies

Public Health Nutrition ◽

10.1017/s136898001600032x ◽

2016 ◽

Vol 19 (14) ◽

pp. 2603-2617 ◽

Cited By ~ 8

Author(s):

Roberto Fabiani ◽

Liliana Minelli ◽

Patrizia Rosignoli

Keyword(s):

Cancer Risk ◽

Oral Cavity ◽

Publication Bias ◽

Observational Studies ◽

Statistical Tests ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Case Control ◽

Risk Of Cancer

AbstractObjectiveConflicting results on the association between fruit consumption and cancer risk have been reported. Little is known about the cancer preventive effects of different fruit types. The present meta-analysis investigates whether an association exists between apple intake and cancer risk.DesignRelevant observational studies were identified by literature search (PubMed, Web of Science and Embase). A random-effect model was used to estimate the cancer risk in different anatomical sites. Between-study heterogeneity and publication bias were assessed using adequate statistical tests.ResultsTwenty case–control (three on lung, five on colorectal, five on breast, two on oesophageal, three on oral cavity, two on prostate and one each on pancreas, bladder, larynx, ovary, kidney and brain cancer) and twenty-one cohort (seven on lung, two on colorectal, three on breast and one each on oesophageal, pancreas, bladder, kidney, endometrial, head–neck, urothelial and stomach cancer) studies met the inclusion criteria. Comparing the highest v. lowest level of apple consumption, the reduction of lung cancer risk was statistically highly significant in both case–control (OR=0·75; 95% CI 0·63, 0·88; P=0·001, I2=0 %) and cohort studies (relative risk=0·89; 95% CI 0·84, 0·94; P<0·001, I2=53 %). Instead, in the case of colorectal (OR=0·66; 95% CI 0·54, 0·81; P<0·001, I2=55%), breast (OR=0·79; 95% CI 0·73, 0·87; P<0·001, I2=1 %) and overall digestive tract (OR=0·50; 95% CI 0·36, 0·69; P<0·001, I2=90 %) cancers a significant preventive effect of apples was found only in case–control studies while prospective studies indicated no effect. No evidence of publication bias could be detected for colorectal, oral cavity, oesophageal and breast cancer. However, some confounding effects may be present and related to the consumption of other fruit which have not been considered as adjusting factors.ConclusionsThe present meta-analysis indicates that consumption of apples is associated with a reduced risk of cancer in different anatomical sites.

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Obesity as a Predictor for Adverse Outcomes Among COVID-19 Patients: A Meta-Analysis

10.21203/rs.3.rs-111047/v1 ◽

2020 ◽

Author(s):

Pranta Das ◽

Nandeeta Samad ◽

Abdul-Aziz Seidu ◽

Richard Gyan Aboagye ◽

Justice Kanor Tetteh ◽

...

Keyword(s):

Severe Obesity ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Final Analysis ◽

Adverse Outcomes ◽

Icu Admission ◽

Inverse Variance ◽

Severely Obese ◽

Model Inverse

Abstract Background: The 2019 Severe Acute Respiratory Syndrome Coronavirus (COVID-19) is an unexpected pandemic causing mortalities across all ages. However, the severity of its health implications is mostly reported in persons with chronic health conditions with obesity being identified as one of the leading predisposing factors in acquiring the novel virus and developing its adverse complications. This meta-analysis sought to determine the estimated association between obesity and adverse outcomes among COVID-19 patients. Methods: We followed the recommended PRISMA guidelines in executing this study. A systematic literature search was conducted in PubMed, Google Scholar, and ScienceDirect for published literature between December 1, 2019, and October 2, 2020. The data for the study were pooled from studies that contained the search terms "Obesity" AND (COVID-19 or 2019-nCoV or Coronavirus or SARS-CoV-2) AND ("ICU admission" OR "Hospitalization" OR "Disease severity" OR "Invasive mechanical ventilator" OR "Death" OR "Mortality"). All the online searches were supplemented by reference screening of retrieved studies for additional literature. The pooled odds ratio (OR) and confidence intervals (CI) from the retrieved studies were calculated using the random effect model (Inverse-Variance method). Findings: A total of five (5) studies with a combined sample size of 335,192 patients were included in the meta-analysis. The pooled OR from the final analysis showed that patients who are severely obese were more likely to experience adverse outcome (death or ICU admission or needing IMV or hospitalization) compared to the normal patients [OR = 2.81, 95% CI = 2.33 – 3.40, I2 = 29%].Conclusion: Severe obesity is a risk factor in developing adverse outcomes among COVID-19 patients. The finding of the study signifies promotive, preventive, and curative attention to be accorded patients diagnosed with severe obesity and COVID-19.

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Association of human papilloma Virus infection other than cervical cancer: Systematic Review and Meta Analysis

SINET Ethiopian Journal of Science ◽

10.4314/sinet.v44i1.11 ◽

2021 ◽

Vol 44 (1) ◽

pp. 119-128

Author(s):

Habtamu Molla ◽

Habtamu Temesgen ◽

Dereje Beyene

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Human Papilloma Virus ◽

Publication Bias ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Hpv Infection ◽

Papilloma Virus ◽

Pooled Prevalence

Human Papilloma Virus (hpv) infection causes different cancer diseases. Cervical cancer is the most common hpv related disease. hpv infection also causes cancer of anus, vulva, vagina, penis, skin, bladder, prostate, breast, oral and others because the hpv virus is epithelium-tropic. But the association of hpv infection other than cervical cancer, for example breast cancer, bladder cancer, prostate cancer etc is still inconclusive. Thus, the objective of this review was to collect published information on hpv infection other than cervix to explore the pooled prevalence of hpv infection as well as related types of cancers. Publish research articles of hpv infection and cancer risks other than cervical cancer were systematically searched through Internet. The preferred reporting items for systematic review and meta-analysis guidelines were followed. Joanna Brigg’s Institute Meta-Analysis of Statistics Assessment and Review Instrument (jbi-mastari) adapted for cross sectional/case control study design was used for quality assessment of each individual study. A total of 22 studies were extracted and analyzed using stata 14. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression was performed to identify the probable source of heterogeneity. Both Egger’s and Begg’s tests were used to check publication bias. The totals of 486 studies were retrieved and 22 studies were included in this meta- analysis. The meta-analysis result showed that the pooled prevalence of hpv infection other than cervix was 34.36% (95% CI: 23.75, 44.97) with severe heterogeneity (I2 = 99.5%; p<0.001) with no publication bias. The highest pooled prevalence of hpv infection other than cervix was related to genital cancer which is 58.63% (95% CI: 51.86, 65.39), followed by oral cancer (47.15% with 95% CI: 19.67, 74.63). Although cervical cancer is primarily hpv induced cancer which well articulated with so many researches, other cancer types (based on the location of the hpv infection) are also increasing across the world based on this systematic and meta-analysis study. hpv infection increases the risk of developing cancers other than cervical cancer.

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A meta-analysis ofEntamoeba histolytica/disparin Iraq

10.1101/435495 ◽

2018 ◽

Author(s):

Khder Niazi Chalabi

Keyword(s):

Confidence Interval ◽

Entamoeba Histolytica ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Human Infection ◽

Infection Prevalence ◽

Major Health Problem ◽

Pooled Prevalence ◽

Vegetables And Fruits

AbstractBackgroundAmebiasis is a major health problem caused by the protozoan parasiteEntamoeba histolyticawith a worldwide distribution, especially in developing countries. The aim of this systematic review and meta-analysis was to estimate the proportion prevalence ofE. histolytica/disparin human in Iraq.Methodology/Principal FindingsPublished studies on human infection withE. histolytica/disparin Iraq were searched in electronic databases using Google scholar, Iraqi Academic Scientific Journals (IASJ), PubMed, ScienceDirect and WHO Global Health Library (GHL). Eligible studies were cross-sectional and used fecal and/or serological methods to diagnoseE. histolytica/disparinfection in human in Iraq, and published between 1970 and July 2017. The pooled prevalence was calculated using random effect model meta-analyses with 95% confidence interval (CI). Ninety nine studies were eligible for the meta-analysis that included 117694 individuals. The pooled proportion for E. histolytica/dispar infection in Iraq was estimated at 20.61% with a 95% confidence interval (CI) of 17.83, 23.53. A high level of heterogeneity was found among the studies. The prevalence among Iraqi population ranged between 1.66 and 90.5% per study (mean: 22.36%). The pooled prevalence of infection was 58.43% (95% CI: 54.71%?62.1%) and 43.10% (95% CI: 39.66%–46.6%) for males and females respectively. Parasite screening using microscopy did not differentiate between the pathogenic and nonpathogenic species ofEntamoebaresulted in higher proportion prevalence than PCR proportion prevalence, (20.32%, 95% CI: 17.80%–22.96%) (17.57%, 95% CI: 8.07%–29.75%) respectively. Hospital based studies recorded the highest prevalence ofE. histolytica/disparinfection at 22.69% (95% CI: 19.55%–25.99%). The prevalence decreased into 18.46 (95% CI: 14.28%–23.04%) between 2010 and 2017.Conclusions/SignificanceAlthough there was a reduction in prevalence of amebiasis since 2010, the prevalence of amebiasis is still considerable in population of Iraq. Therefore, prevention strategies of fecal contamination are required to reduce the infection.Author summaryAmebiasis is the infection withEntamoeba histolyticaan invasive parasite dwelling the intestine or other organs such as liver, lungs, or skin of human. Infection with this parasite could be acquired by consumption of contaminated water, vegetables, and fruits with feces of infected human. The infection may be asymptomatic or symptomatic causing dysentery. We performed this meta-analysis to estimate the prevalence of amebiasis in the population of Iraq between 1970 and 2017. Ninety nine published studies were identified and the data were extracted from them to use in our meta-analysis and the total included individuals were 117694. The prevalence of population infection in Iraq was evaluated at 20.61%. The infection prevalence was higher in males than in females. The infection prevalence decreased during the period 2010 to 2017 in Iraqi population. This level of infection needs further efforts to eradicate amebiasis, these efforts begin with the prevention of the disease transmission through water and food and treatment of infected people. So awareness of simple hygienic principles can control the disease by boiling water and washing vegetables and fruits thoroughly.

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QuantiFERON-TB Gold In-Tube in Saudi Arabia benchmarked with other sites of the Middle East: A meta-analysis review

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10311 ◽

2018 ◽

Vol 12 (09) ◽

pp. 687-699

Author(s):

Hawra Al-Ghafli ◽

Sahal Al-Hajoj

Keyword(s):

Saudi Arabia ◽

High Risk ◽

Middle East ◽

Publication Bias ◽

Meta Analysis ◽

Skin Testing ◽

Random Effect ◽

Random Effect Model ◽

Risk Groups ◽

Tuberculin Skin Testing

Introduction: Screening for Latent Tuberculosis Infections (LTBI) constitutes a key step in health surveillance programs especially among adults of high-risk groups. To our knowledge, this is the first systematic and meta-analysis review that aims to critically assess and compare the agreement of QuantiFERON-TB Gold In-Tube (QFT-GIT) and Tuberculin Skin Testing (TST) among adults of high-risk groups in Saudi Arabia and compare results with other sites of the Middle East. Methodology: Kappa estimates were meta-analyzed using random effect model and several subgroup analyzes were performed to explain overall heterogeneity. Funnel plot, Begg’s and Egger’s tests were employed to assess overall publication bias. Results: 18 studies were meta-analyzed, comprising 5070 adults of high-risk groups. Pooled kappa estimates from Saudi Arabia (κ = 0.29, 95% CI: 0.16, 0.41) showed lower rate of agreement compared to other sites of the Middle East (κ = 0.33, 95% CI: 0.25, 0.41). However, a significant level of heterogeneity (I2 = 96.7%, p > 0.001) were identified across collected evidence. Begg’s and Egger’s tests confirmed absence of significant publication bias in this review (p = 0.49 and p = 0.16, respectively). Conclusion: This work revealed fair to poor agreement between TST and QFT-GIT, indicating that these two tests are not interchangeable in such settings. Substantial evidence is still needed before considering the sole use of QFT-GIT as an alternative to TST in these populations. Moreover, there is an urgent need for longitudinal studies in Saudi Arabia and the Middle East to accurately assess precision of LTBI diagnosis.

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