scholarly journals A Systemic Review and Meta-analysis of the Leading Pathogens Causing Neonatal Sepsis in Developing Countries

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Desalegne Amare Zelellw ◽  
Getenet Dessie ◽  
Endalkachew Worku Mengesha ◽  
Melashu Balew Shiferaw ◽  
Masresha Mela Merhaba ◽  
...  

Background. Neonatal sepsis is one of the major public health problems globally, particularly, in developing countries. Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli are the common pathogens for neonatal sepsis in developing countries. However, the pooled estimate of common pathogens causing neonatal sepsis in developing countries is still unknown. Therefore, this study is aimed at computing the pooled proportion of the leading cause of pathogens for neonatal sepsis in developing countries. Methods. We strictly followed the Preferred Reporting Items for Systemic Reviews and Meta-analysis guidelines to report this systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science, CINAHL, Science Direct, and other search engines such as Google Scholar, Africa Journals Online, and Hinari were used to obtain studies related to the leading cause of pathogens for neonatal sepsis in developing countries. The search was done from October 1 to December 30, 2018, by considering both published and gray literature. Studies were evaluated based on the PRISMA guideline checklist by using their titles, abstracts, and full texts. Studies were extracted using Microsoft Excel spreadsheets, and STATA software version 14 was used to analyze data. Heterogeneity between studies was checked based on Cochran’s Q -test and the corresponding I 2 statistic test. Results. The pooled prevalence of the leading cause of pathogens of neonatal sepsis in developing countries were Klebsiella (26.36%), Staphylococcus aureus (23.22%), Coagulase-negative Staphylococcus (23.22%), and Escherichia coli (15.30%). Common pathogens were varied across regions; for instance, pooled isolated Coagulase-negative Staphylococcus was 25.98% in Africa, 16.62% in Asia, and 36.71% in Latin America, and Klebsiella was 29.80% in Africa, 23.21% in Asia, and 22.00% in Latin America. Also, Staphylococcus aureus was 27.87% in Africa and 18.28% in Asia, and Escherichia coli was 22.97% in Asia and 9.43% in Africa. Conclusions. This study highlights that the more prevalent common isolated pathogens in developing countries were Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli, Klebsiella, and Staphylococcus aureus pathogens were predominantly high in Africa as compared to other Asian and Latin American countries. At the same time, Coagulase-negative Staphylococcus was more prevalent in Latin America compared to other regions. Escherichia coli is more dominant in Asia as compared to Africa and Latin America.

2018 ◽  
Vol 3 (1) ◽  
pp. 370-376
Author(s):  
Arun Giri ◽  
Vijay Kumar Sah ◽  
Bikash Sharma Poudel ◽  
Niraj Niraula ◽  
Raju Sedai

Introduction: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. The clinical signs and symptoms of neonatal sepsis are non specific and blood culture report is considered gold standard for confirmation of neonatal sepsis. Organisms and their sensitivity pattern vary from place to place. The confirmation of diagnosis and management of neonatal sepsis is challenging and time consuming.Objective: The aim of this study was to find incidence of blood culture proven sepsis in suspected early onset neonatal sepsis, find out sensitivity pattern of isolated organism and to find association of risk factors and clinical signs and symptoms with blood culture proven sepsis.Methodology: Prospective study was conducted in Nobel Medical College, Biratnagar from November 2016 to November 2017. Sample size was calculated to be 300 and blood culture was sent of each neonates admitted with suspected early onset neonatal sepsis before giving neonates with first dose of antibiotics and report of 72 hours was taken into consideration.Results: Out of 300 cases of suspected early onset neonatal sepsis 70.3% presented with lethargy, followed by other symptoms like poor feeding, respiratory distress, fever, hypothermia, feeding intolerance, abnormal body movement and abdominal distension. Low birth weight neonates, preterm neonates, prolonged duration of per vaginal leaking and low platelets count were significantly associated with blood culture proven sepsis in this study. Incidence of blood culture positive sepsis in suspected early onset neonatal sepsis was 27%. Coagulase negative Staphylococcus aureus(21%) was predominant organism isolated followed by Klebsiella Pneumonia, Pseudomonas, Escherichia coli. All of the isolated Klebsiella and Pseudomonas and 86% of Escherichia coli were found to be resistant to ampicillin. All isolated Coagulase negative Staphylococcus aureus were sensitive to vancomycin.Conclusion: Coagulase negative Staphyloccus aureus was predominant organism detected but majority of organisms were gram negative organisms. High resistance to ampicillin was found and cefotaxime was also less sensitive to isolated organism. Vancomycin was found to be sensitive to all isolated Staphylococcus aureus and coagulase negative Staphylococcus aureus. Amikacin was highly sensitive among causative organisms isolated. BJHS 2018;3(1)5 : 370-376


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047122
Author(s):  
Andrés Godoy-Cumillaf ◽  
Bruno Bizzozero-Peroni ◽  
Grant R Tomkinson ◽  
Javier Brazo-Sayavera

IntroductionPhysical fitness (PF) is an important indicator of health in children and adolescents. Internationally, test batteries have been used to assess overall PF. In Latin America, however, while PF has been widely measured, there is no accepted test battery, making it difficult to monitor and/or compare the PF levels of Latin children. The aim of this study, therefore, is to systematically review and potentially meta-analyse the peer-reviewed literature regarding the assessment of PF in Latin American children and adolescents.Methods and analysisThis systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. The systematic literature search will be performed in MEDLINE, Scopus, SciELO, EMBASE, Cochrane Library, Web of Science, SPORTDiscus, LILACS and Latindex (Spanish) to locate articles published up to April 2021. Eligible studies will include both descriptive and analytic study designs. Meta-analyses are planned for sufficiently homogeneous PF outcomes with regard to statistical and methodological characteristics. Narrative syntheses are planned for PF outcomes that are considered to be too heterogeneous. The statistical program STATA V.15 will be used for meta-analyses, with subgroup analyses performed according to the characteristics of included studies.Ethics and disseminationThis systematic review and meta-analysis protocol is designed to provide updated evidence on the PF of Latin American children and adolescents. Findings from this review may be useful for teachers, researchers and other professionals responsible for paediatric fitness and health promotion/surveillance. The results will be disseminated through peer-reviewed scientific publications, conferences, educational talks and infographics.PROSPERO registration numberCRD42020189892.


Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 545
Author(s):  
Paramanandham Krishnamoorthy ◽  
Kuralayanapalya P. Suresh ◽  
Kavitha S. Jayamma ◽  
Bibek R. Shome ◽  
Sharanagouda S. Patil ◽  
...  

In this study, the major mastitis pathogen prevalence in the cattle and buffalo of the world was estimated by a meta-analysis. Staphylococcus (S) species, Streptococcus (St) species, and Escherichia coli (Ec) prevalence studies reported during 1979–2019 were collected using online databases, and offline resources. A meta-analysis of these data was done with the meta package in R-Software. The Staphylococcus aureus was the major mastitis pathogen, mostly causing subclinical mastitis, Ec causing clinical mastitis and St causing subclinical and clinical mastitis. The pooled prevalence estimates of S, St, and Ec were 28%, 12%, and 11% in the world from 156, 129, and 92 studies, respectively. The S, St, and Ec prevalences were high in Latin America (51%), Oceania (25%), and Oceania (28%), respectively. Higher S, St, and Ec prevalences were observed by molecular methods, signifying high sensitivity and usefulness for future studies. Among bacterial species, S. aureus (25%) followed by coagulase-negative Staphylococcus species (20%), Escherichia coli (11%), St. agalactiae (9%), St. uberis (9%) were the important pathogens present in the milk of the world. We hypothesize that there is a urgent need to reduce mastitis pathogen prevalence by ensuring scientific farm management practices, proper feeding, therapeutic interventions to augment profits in dairying, and improving animal and human health.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Akira Sekikawa ◽  
Nobutake Hirooka ◽  
Abhishek Vishnu ◽  
Vashudha Ahuja ◽  
Emmanuel Sampene ◽  
...  

Introduction: Although marine n-3 fatty acids are believed to be cardioprotective through their anti-arrhythmic, anti-thrombotic, anti-atherogenic and other effects, results from recent meta-analyses of marine n-3 fatty acids on cardiovascular disease (CVD) are controversial. We performed a meta-analysis of marine n-3 fatty acids on CVD outcomes in randomized clinical trials (RCTs) to test the hypothesis that marine n-3 fatty acids are anti-atherogenic. We also tested the hypothesis that such benefit is dose-dependent. Methods: A systematic review of English language articles using PubMed, EMBASE and Cochrane Library through Aug 2012 was performed selecting RCTs evaluating the effect of marine n-3 fatty acids intake for 2 years or more on cardiovascular diseases, coronary disease, arteriosclerosis, cardiac imaging techniques, and carotid artery ultrasound. Descriptive and quantitative information was extracted. Odds ratios were calculated for cardiac event outcome. Correlation coefficients were obtained from studies of which outcome is intima-media thickness (IMT) and coronary lumen diameter (CD). We converted the estimates into a single effect size; the log odds ratio and its corresponding standard error. Results: Of 14,236 citations retrieved, 13 studies were selected, including studies reporting IMT (n=3) and CD (n=2) and major CVD events (n=8). Overall, marine n-3 fatty acids significantly reduced atherosclerotic CVD (RR 0.94: 95%CI 0.90 to 0.99, p<0.05). There was no evidence of heterogeneity (p=0.65) or publication bias (p=0.37, Begg’s test). A sub-analysis among 8 studies of major CVD events showed the similar results (RR 0.94: 95% CI 0.89 to 0.99, p<0.05). Another sub-analysis among 4 studies excluding sudden cardiac death as an outcome showed RR of 0.91 (95% CI 0.82 to 1.02, p=0.097). A meta-regression analysis shows that dose of marine n-3 fatty acids was inversely associated with CVD outcome, although the association was not statistically significant (p=0.06). Conclusions: The result of our meta-analysis supports a modest anti-atherogenic effect of marine n-3 fatty acids. This benefit may be proportional to the amount of marine n-3 fatty acids consumed.


2020 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.


2020 ◽  
Author(s):  
Qian Zhang ◽  
Xiaofei Wang ◽  
Peipei Ge ◽  
Aizhen Hu ◽  
Xuexun Li

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitor which is a type of drug used for the treatment of diabetes mellitus, has been reported by many trials that it could be beneficial for patients with established heart failure. A meta-analysis on this subject could obtain more reliable estimates of the efficacy and safety outcomes. Methods A systematic review and meta-analysis of randomized, placebo-controlled trials of SGLT2 inhibitor in patients with heart failure was conducted. We searched PubMed, Cochrane Library, and Web of Science for trials published from inception to March, 2018. PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to conduct the review. For quality assessment of included studies. The methodological quality of the included trials was assessed using the Cochrane tool for assessing randomized clinical trials (RCT). Efficacy outcomes included hospitalization for heart failure and all-cause death. Safety outcomes consisted of serious adverse event (SAE) and volume depletion. Results We included data from 5 identified studies and 8775 patients (aged 64.9, female 29.8%). A total of 3930 (44.8%) patients were known to have diabetes mellitus. Compared with placebo, SGLT2 inhibitor decrease the incidence of hospitalization for heart failure (RR 0.692; 95%CI, 0.611-0.784 P<0.001), and all-cause death (RR 0.824; 95%CI, 0.736-0.922 P=0.001). The incidence of SAE in patients with a treatment of SGLT2 inhibitor was low (RR 0.869; 95%CI, 0.779-0.970 P=0.012). SGLT2 inhibitor didn’t increase the incidence of volume depletion (RR1.165, 95%CI, 0.977-1.390 P=0.089). Conclusion Our results confirm that SGLT2 inhibitor is effective and safe for patients with heart failure regardless of presence of diabetes mellitus.


2018 ◽  
Vol 52 (1) ◽  
Author(s):  
Henry Winston C. Li ◽  
Maria Ana Louise M. Naidas ◽  
Karen Anjela M. Mondragon ◽  
Ruter M. Maralit

Objective. To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) in improving minimal hepatic encephalopathy in adult patients with liver cirrhosis. Methods. A search in PubMed, Cochrane Library, Google Scholar, and Medline was made obtaining four qualified randomized controlled trials. Studies included adult cirrhotic patients with minimal hepatic encephalopathy measured by the number connection test (NCT-A, B), figure connection test (FCT-A, B), picture completion, block design test, and critical flicker frequency (CFF) testing with a cut-off score of <39Hz. Methodologic assessment of studies was performed using Cochrane Collaboration Risk of Bias Tool and Review Manager (RevMan) version 5.3 for statistical analysis. Results. Of the 29 studies identified, 4 fulfilled the inclusion criteria, which entailed analysis of 238 participants (LOLA: 116, Control: 122). Three out of the four studies were used in meta-analysis and one study was analyzed separately due to a difference in the neuropsychometric measure. The metaanalysis favored experimental group (LOLA), with a mean difference of 2.29 (95% CI 0.72 – 3.86), p-value = 0.004, and an I2 of 18%. Conclusion. LOLA provided great potential in managing encephalopathy since treating earlier related to better survival and prevention of disease progression. The results of our study supported such evidence and its use may be encouraged.


2019 ◽  
Author(s):  
Berhane Fseha Teklehaimanot ◽  
Abadi kidanemariam Berhe ◽  
Gebrehiwot Gebremariam Welearegawi

AbstractIntroductionThe major global public health problems now days are diabetes especially the burden is high in low income countries including Ethiopia due to the limited resource for screening and early diagnosis of the diabetes. To prevent diabetic complications including organ damage and micro vascular complications blood glucose level should be maintained at an optimum level. However there was no pooled national picture on poor glycemic control and its associated factors.MethodsDifferent data base searching engine including PubMed, Google scholar, the Cochrane library, MEDLINE,, HINARY and African journal online (AJOL) were used. The Joanna Briggs Critical Appraisal Tools and Newcastle Ottawa scale for assessing the quality of cross sectional studies were used for quality assessment. The meta-analysis was conducted using STATA 14 software. I2 statistic and egger weighted regression were used to assess heterogeneity and publication bias.ResultsA total of 134 studies were identified from different database searching engines and other sources. After removing for duplication, absence of abstract and review of the full text 12 studies were including in the meta-analysis. The pooled prevalence of poor glycemic control among diabetic patients in Ethiopia is 64.72% with 95% confidence interval 63.16-66.28%. The sub group analysis of poor glycemic control among diabetic patients in different region of the country shows consistent and high prevalence of poor glycemic control ranging from 62.5% in Tigray region to 65.6% in Oromia region of the country. Residence, dyslipidemia and diet adherence were significantly association with poor glycemic control among diabetic patients in Ethiopia.ConclusionThe prevalence of poor glycemic control among diabetic patients was high in Ethiopia and consistent across different regions of the country. The most important factors associated with poor glycemic factor among diabetic patients were being rural residence, having dyslipidemia and not adhering to dietary plan.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Rui Li ◽  
Jae Hyup Lee

Abstract Background Various Joint-preserving therapy (JPT) methods have been performed and tried in recent decades, but their results and efficacy were inconsistent and controversial. The purpose of this study is to evaluate its effectiveness and whether there are statistical differences in treatment between different interventions based on published RCT studies. Methods Following the PRISMA-NMA checklist, Medline, EMBASE, Web of Science, and Cochrane Library databases were searched and collected related RCT studies. The sources were searched from inception up to October 30, 2020. The primary outcomes including the rate of radiographic progression and conversion to THA and the secondary outcome -Harris Hip Scores (HHS) were extracted and compared in a Network meta-analysis. Results Seventeen RCT studies involving 784 patients (918 hips) with seven interventions including CD (core decompression), CD + BG (bone graft), CD + TI (tantalum rod implantation), CD + CT (Cell therapy), CD + BG + CT, VBG (vascularized bone graft), and nonsurgical or conservative treatment for ONFH were evaluated. In the radiographic progression results, CD + CT showed a relatively better result than CD, CD + BG and non-surgical treatment, the surface under the cumulative ranking curve (SUCRA) plot displayed that CD + CT (96.4%) was the best, followed by CD (64.1%).In conversion to THA results, there were no significant differences between the JPT methods and non-surgical treatment. In HHS, there was also no significant difference, other than CD + BG showed a statistical difference than non-surgical treatment only in terms of Cis, but the SUCRA was highest in non-surgical treatment (80.5%) followed by CD + CT (72.8%). Conclusions This Net-work meta-analysis demonstrated that there was no statistical difference in the outcome of radiographic progression and conversion to THA, also in HHS, other than CD + CT showed a relatively superior result in radiographic progression than nonsurgical treatment, namely, it’s maybe an effective method for delaying disease progression or reducing disease development based on current evidence.


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