Celiac Disease Screening in Southern and East Asia

2015 ◽  
Vol 33 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Govind K. Makharia
Keyword(s):  
Celiac Disease ◽  
Western Europe ◽  
Meta Analysis ◽  
Free Food ◽  
Absolute Number ◽  
Population Based ◽  
Medical Community ◽  
Number Of Patients ◽  
Global Epidemiology ◽  
Uncommon Disease

Until 1970s, celiac disease (CD) was considered to be an uncommon disease except in Western Europe. The global epidemiology of CD continues to evolve with improvement in the diagnostic tests, simplification of the diagnostic criteria and increase in awareness about the disease. The Asian region is currently at the crossroads of the frontier of knowledge and awareness of CD. In many Asian nations, CD is still considered to be either nonexistent or very rare. A notable exception is India, where CD has been well recognized, especially in the northern part, and 2 population-based studies have revealed a prevalence of 0.3-1.04%. Initial reports from Malaysia, China, Japan and Singapore suggest the existence of CD in these countries. Furthermore, a meta-analysis of the predisposing factors predicts a high probability of occurrence of CD in fair numbers in China. There are no formal reports on CD from Malaysia, Indonesia, Korea, Taiwan and many other nations in this region. With the impending CD epidemic in Asia, there are many challenges. Some of the efforts which are required include determination of prevalence of CD across the region, spreading of awareness among physicians and patients, training of dieticians for proper counseling and supervision of patients, creation of gluten-free food infrastructure in the food supply and creation of patient advocacy organizations. Although the absolute number of patients with CD at present is not very large, this number is expected to increase over the next few years/decades. It is thus appropriate that the medical community across Asia define the extent of the problem and get prepared to handle the impending CD epidemic.

Global epidemiology of SARS-CoV-2 infection: a systematic review and meta-analysis of standardized population-based seroprevalence studies, Jan 2020-Oct 2021

2021 ◽  
Author(s):  
Isabel Bergeri ◽  
Mairead Whelan ◽  
Harriet Ware ◽  
Lorenzo Subissi ◽  
Anthony Nardone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Population Based ◽  
Control Measures ◽  
Middle Income ◽  
Global Epidemiology ◽  
Using Data ◽  
Demographic Subgroups ◽  
Over Time

Background COVID-19 case data underestimates infection and immunity, especially in low- and middle-income countries (LMICs). We meta-analyzed standardized SARS-CoV-2 seroprevalence studies to estimate global seroprevalence. Objectives/Methods We conducted a systematic review and meta-analysis, searching MEDLINE, Embase, Web of Science, preprints, and grey literature for SARS-CoV-2 seroprevalence studies aligned with the WHO UNITY protocol published between 2020-01-01 and 2021-10-29. Eligible studies were extracted and critically appraised in duplicate. We meta-analyzed seroprevalence by country and month, pooling to estimate regional and global seroprevalence over time; compared seroprevalence from infection to confirmed cases to estimate under-ascertainment; meta-analyzed differences in seroprevalence between demographic subgroups; and identified national factors associated with seroprevalence using meta-regression. PROSPERO: CRD42020183634. Results We identified 396 full texts reporting 736 distinct seroprevalence studies (41% LMIC), including 355 low/moderate risk of bias studies with national/sub-national scope in further analysis. By April 2021, global SARS-CoV-2 seroprevalence was 26.1%, 95% CI [24.6-27.6%]. Seroprevalence rose steeply in the first half of 2021 due to infection in some regions (e.g., 18.2% to 45.9% in Africa) and vaccination and infection in others (e.g., 11.3% to 57.4% in the Americas high-income countries), but remained low in others (e.g., 0.3% to 1.6% in the Western Pacific). In 2021 Q1, median seroprevalence to case ratios were 1.9:1 in HICs and 61.9:1 in LMICs. Children 0-9 years and adults 60+ were at lower risk of seropositivity than adults 20-29. In a multivariate model using data pre-vaccination, more stringent public health and social measures were associated with lower seroprevalence. Conclusions Global seroprevalence has risen considerably over time and with regional variation, however much of the global population remains susceptible to SARS-CoV-2 infection. True infections far exceed reported COVID-19 cases. Standardized seroprevalence studies are essential to inform COVID-19 control measures, particularly in resource-limited regions.

scholarly journals Trends in Stroke Incidence in High-Income Countries in the 21st Century

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1372-1380 ◽  
Author(s):  
Linxin Li ◽  
Catherine A. Scott ◽  
Peter M. Rothwell ◽  
Keyword(s):  
United Kingdom ◽  
Incidence Rate ◽  
Meta Analysis ◽  
Temporal Trends ◽  
Absolute Number ◽  
Population Based ◽  
High Income ◽  
Stroke Incidence ◽  
The United Kingdom ◽  
Incidence Studies

Background and Purpose— Population-based studies provide the most reliable data on stroke incidence. A previous systematic review of population-based studies suggested that stroke incidence in high-income countries decreased by 42% between the 1970s and early 2000s. However, it is uncertain whether this trend of steady decline has been maintained in more recent periods. Methods— Data from OCSP (Oxfordshire Community Stroke Project; 1981–1986) and OXVASC (Oxford Vascular Study; 2002–2017) along with other published population-based stroke incidence studies that reported temporal trends of stroke incidence since 1990 in high-income countries were included. Age-standardized relative incidence rate ratios were calculated for each study and then pooled with inverse-variance weighted random-effects meta-analysis. Projection estimates were calculated for the number of incident stroke patients in the United Kingdom from year 2015 to 2045. Results— In Oxfordshire, stroke incidence fell by 32% from OCSP to OXVASC, with a similar trend before or after year 2000. With the projected aging population, if the age-specific stroke incidence continued to decrease at its current rate (6% every 5 years), there would still be a 13% increase of the number of first-ever strokes in the United Kingdom up to year 2045. Incorporating the Oxfordshire data with other 12 population-based studies, stroke incidence declined steadily between the 1990s and 2010s within each study, resulting in a 28% decline over an average period of 16.5 years (pooled incidence rate ratio, 0.72 [95% CI, 0.66–0.79]; P <0.0001). The trend was the same for men (0.69 [95% CI, 0.61–0.77]; P <0.0001) and women (0.66 [95% CI, 0.59–0.74]; P <0.0001) and remained consistent after year 2010 in OXVASC. Proportion of disabling or fatal stroke also decreased over time (early versus later period, 53.6% versus 46.1%; P =0.02). Conclusions— Stroke incidence is continuing to decline with steady rate in Oxfordshire and in other high-income settings. However, the absolute number of strokes occurring is not falling.

scholarly journals Polymorphisms within the ARNT2 and CX3CR1 Genes Are Associated with the Risk of Developing Invasive Aspergillosis

2020 ◽  
Vol 88 (4) ◽  
Author(s):  
C. B. Lupiañez ◽  
M. Martínez-Bueno ◽  
J. M. Sánchez-Maldonado ◽  
J. Badiola ◽  
C. Cunha ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Meta Analysis ◽  
Additive Model ◽  
Population Based ◽  
Nucleotide Polymorphisms ◽  
Hematological Patients ◽  
Number Of Patients ◽  
Increased Risk ◽  
Life Threatening ◽  
Trait Locus

ABSTRACT Invasive aspergillosis (IA) is a life-threatening infection that affects an increasing number of patients undergoing chemotherapy or allo-transplantation, and recent studies have shown that genetic factors contribute to disease susceptibility. In this two-stage, population-based, case-control study, we evaluated whether 7 potentially functional single nucleotide polymorphisms (SNPs) within the ARNT2 and CX3CR1 genes influence the risk of IA in high-risk hematological patients. We genotyped selected SNPs in a cohort of 500 hematological patients (103 of those had been diagnosed with proven or probable IA), and we evaluated their association with the risk of developing IA. The association of the most interesting markers of IA risk was then validated in a replication population, including 474 subjects (94 IA and 380 non-IA patients). Functional experiments were also performed to confirm the biological relevance of the most interesting markers. The meta-analysis of both populations showed that carriers of the ARNT2rs1374213G, CX3CR1rs7631529A, and CX3CR1rs9823718G alleles (where the RefSeq identifier appears as a subscript) had a significantly increased risk of developing IA according to a log-additive model (P value from the meta-analysis [PMeta] = 9.8 · 10−5, PMeta = 1.5 · 10−4, and PMeta =7.9 · 10−5, respectively). Haplotype analysis also confirmed the association of the CX3CR1 haplotype with AGCGG with an increased risk of IA (P = 4.0 · 10−4). Mechanistically, we observed that monocyte-derived macrophages (MDM) from subjects carrying the ARNTR2rs1374213G allele or the GG genotype showed a significantly impaired fungicidal activity but that MDM from carriers of the ARNT2rs1374213G and CX3CR1rs9823718G or CX3CR1rs7631529A alleles had deregulated immune responses to Aspergillus conidia. These results, together with those from expression quantitative trait locus (eQTL) data browsers showing a strong correlation of the CX3CR1rs9823718G allele with lower levels of CX3CR1 mRNA in whole peripheral blood (P = 2.46 · 10−7) and primary monocytes (P = 4.31 · 10−7), highlight the role of the ARNT2 and CX3CR1 loci in modulating and predicting IA risk and provide new insights into the host immune mechanisms involved in IA development.

scholarly journals Prevalence of low-grade inflammation in depression: a systematic review and meta-analysis of CRP levels

2019 ◽  
Vol 49 (12) ◽  
pp. 1958-1970 ◽  
Author(s):  
Emanuele Felice Osimo ◽  
Luke James Baxter ◽  
Glyn Lewis ◽  
Peter B. Jones ◽  
Golam M. Khandaker
Keyword(s):  
Odds Ratio ◽  
Antidepressant Treatment ◽  
Meta Analysis ◽  
Population Based ◽  
Low Grade ◽  
Healthy Controls ◽  
Number Of Patients ◽  
Pubmed Database ◽  
Show Evidence ◽  
Low Grade Inflammation

AbstractBackgroundPeripheral low-grade inflammation in depression is increasingly seen as a therapeutic target. We aimed to establish the prevalence of low-grade inflammation in depression, using different C-reactive protein (CRP) levels, through a systematic literature review and meta-analysis.MethodsWe searched the PubMed database from its inception to July 2018, and selected studies that assessed depression using a validated tool/scale, and allowed the calculation of the proportion of patients with low-grade inflammation (CRP >3 mg/L) or elevated CRP (>1 mg/L).ResultsAfter quality assessment, 37 studies comprising 13 541 depressed patients and 155 728 controls were included. Based on the meta-analysis of 30 studies, the prevalence of low-grade inflammation (CRP >3 mg/L) in depression was 27% (95% CI 21–34%); this prevalence was not associated with sample source (inpatient, outpatient or population-based), antidepressant treatment, participant age, BMI or ethnicity. Based on the meta-analysis of 17 studies of depression and matched healthy controls, the odds ratio for low-grade inflammation in depression was 1.46 (95% CI 1.22–1.75). The prevalence of elevated CRP (>1 mg/L) in depression was 58% (95% CI 47–69%), and the meta-analytic odds ratio for elevated CRP in depression compared with controls was 1.47 (95% CI 1.18–1.82).ConclusionsAbout a quarter of patients with depression show evidence of low-grade inflammation, and over half of patients show mildly elevated CRP levels. There are significant differences in the prevalence of low-grade inflammation between patients and matched healthy controls. These findings suggest that inflammation could be relevant to a large number of patients with depression.

scholarly journals First snap-shot meta-analysis to estimate the prevalence of serum antibodies to SARS-CoV-2 in humans

2020 ◽  
Author(s):  
Ali Rostami ◽  
Mahdi Sepidarkish ◽  
Mariska Leeflang ◽  
Seyed Mohammad Riahi ◽  
Malihe Nourollahpour Shiadeh ◽  
...  
Keyword(s):  
Western Europe ◽  
Climatic Factors ◽  
Communicable Disease ◽  
Meta Analysis ◽  
Population Based ◽  
Health Concern ◽  
World Population ◽  
Serum Antibodies ◽  
Eligibility Criteria ◽  
Socio Demographic Factors

Background: COVID-19 is arguably the number-one public health concern worldwide, and efforts are now escalating to control its spread. Objective: In this study, we undertake a meta-analysis to estimate the global and regional anti-SARS-CoV-2 seroprevalence rates in humans and assess whether seroprevalence associates with geographical, climatic and socio-demographic factors. Data sources: We systematically reviewed PubMed, Scopus, Embase, medRxiv and bioRxiv for peer-reviewed articles or preprints (up to 14 August 2020). Study eligibility criteria: Population-based studies describing prevalence of anti-SARS-CoV-2 serum antibodies in general people. Participants: general people who were tested for prevalence of anti-SARS-CoV-2 serum antibodies. Interventions: There were no interventions. Methods: We used random-effects model to estimate pooled seroprevalence, and then extrapolated these findings to the global population (for 2020). Sub-group and meta-regression analyses explored potential sources of heterogeneity in the data and relationships between seroprevalence and socio-demographic, geographical and climatic factors. Results: In total, 47 serological studies involving 399,265 people from 23 countries met the inclusion criteria. The pooled seroprevalence of SARS-CoV-2 in general people was estimated at 3.38% (95% CI, 3.05%-3.72%; 15,879/399,265). On a regional basis, we determined seroprevalence estimates of 5.27% (3.97-6.57%) in Northern Europe; 4.41% (2.20-6.61%) in Southern Europe; 4.41% (3.03-5.79%) in North America; 3.17% (1.96-4.38%) in Western Europe; 2.02% (1.56-2.49%) in the Eastern Asia; and 1.45% (0.95-1.94%) in South America. Extrapolating to the 2020 world population, we estimated that 263,565,606 individuals had been exposed or infected with SARS-CoV-2 at the first wave of the pandemic. A significantly higher seroprevalence was related to higher income levels and human development indices, higher geographical latitudes and lower mean environmental temperatures. Interpretation This study reinforces that SARS-CoV-2 infection is a very rapidly-spreading communicable disease and calls for routine surveys to constantly monitor temporal changes in seroprevalence around the globe.

scholarly journals Prevalence of Dementia in Older Adults in Central and Eastern Europe: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 (2) ◽  
pp. 191-210
Author(s):  
Blerta Cenko ◽  
Emilia Ozgo ◽  
Penny Rapaport ◽  
Naaheed Mukadam
Keyword(s):  
Systematic Review ◽  
Eastern Europe ◽  
Western Europe ◽  
Central And Eastern Europe ◽  
Meta Analysis ◽  
Population Based ◽  
European Countries ◽  
Dementia Prevalence ◽  
Eastern European Countries ◽  
Prevalence Of Dementia

Data on dementia prevalence in Europe are primarily based on studies from Western Europe. Central and Eastern European countries differ from Western European countries in their average income and other socioeconomic and health factors that are relevant for dementia risk. We, therefore, conducted a systematic review of population-based studies on prevalence of dementia in Central and Eastern Europe. We searched in electronic databases from the date of inception up to July 2019, updated in October 2020. We hand-searched references of included articles and contacted experts in each country to identify further articles. We combined studies by meta-analysis where possible. Ten population-based studies (n = 30,268) met inclusion criteria. We meta-analysed seven studies (n = 11,994). The selected studies were conducted across 5 countries with no studies identified for the vast majority of countries in this region. Prevalence of all-cause dementia was 6.7% (95% CI 5.1–8.2) in those aged 60 or over, and 7.1% (95% CI 5.1–9.2) in those aged 65 and over. Prevalence rates were similar to those in Western Europe, but are increasing over time, compared with the patterns of reduction in age-specific prevalence in Western Europe.

scholarly journals Month of Birth and Mental Disorders: A Population‐Based Study and Validation Using Global Meta‐Analysis

2021 ◽  
Author(s):  
Chih‐Wei Hsu ◽  
Ping‐Tao Tseng ◽  
Yu‐Kang Tu ◽  
Pao‐Yen Lin ◽  
Chi‐Fa Hung ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Meta Analysis ◽  
Population Based ◽  
Month Of Birth ◽  
Population Based Study

scholarly journals The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 666
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Marzieh Saei Ghare Naz ◽  
Razieh Bidhendi Yarandi ◽  
Samira Behboudi-Gandevani
Keyword(s):  
Systematic Review ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Meta Analysis ◽  
Population Based ◽  
Maternal Outcomes ◽  
Care Providers ◽  
Iadpsg Criteria ◽  
The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

scholarly journals Sense of Purpose in Life Is Associated with Lower Risk of Incident Dementia: A Meta-Analysis

2021 ◽  
pp. 1-10
Author(s):  
Angelina R. Sutin ◽  
Damaris Aschwanden ◽  
Martina Luchetti ◽  
Yannick Stephan ◽  
Antonio Terracciano
Keyword(s):  
Lower Risk ◽  
Meta Analysis ◽  
Random Effect ◽  
Purpose In Life ◽  
Population Based ◽  
Primary Data ◽  
Or Education ◽  
Total N ◽  
Sense Of Purpose ◽  
Incident Dementia

Background: A sense of purpose in life has been associated with healthier cognitive outcomes across adulthood, including risk of dementia. The robustness and replicability of this association, however, has yet to be evaluated systematically. Objective: To test whether a greater sense of purpose in life is associated with lower risk of dementia in four population-based cohorts and combined with the published literature. Methods: Random-effect meta-analysis of prospective studies (individual participant data and from the published literature identified through a systematic review) that examined sense of purpose and risk of incident dementia. Results: In six samples followed up to 17 years (four primary data and two published; total N = 53,499; n = 5,862 incident dementia), greater sense of purpose in life was associated with lower dementia risk (HR = 0.77, 95%CI = 0.73–0.81, p <  0.001). The association was generally consistent across cohorts (I2 = 47%), remained significant controlling for clinical (e.g., depression) and behavioral (e.g., physical inactivity) risk factors, and was not moderated by age, gender, or education. Conclusion: Sense of purpose is a replicable and robust predictor of lower risk of incident dementia and is a promising target of intervention for cognitive health outcomes.

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