Air-travel related TB incident follow up – effectiveness and outcomes: a systematic review

BackgroundThe World Health Organization (WHO) recommends following up passengers following possible exposure to a case of infectious tuberculosis (TB) during air travel. This is known to be time consuming and difficult, and increasingly so with higher numbers of flights and passengers to and from countries with high TB endemicity each year.ObjectivesThis paper systematically reviews the literature on contact tracing investigations following a plane exposure to active pulmonary TB. Evidence for in-flight transmission was assessed by reviewing the positive results of contacts without prior risk factors for latent TB.Data sources & EligibilityA search of Medline, EMBASE, BIOSIS, Cochrane Library and Database of Systematic Reviews was carried out, with no restrictions on study design, index case characteristics, duration of flight or publication date.ResultsTwenty-two papers were included, with a total of 469 index cases and 15 889 contacts. Only 26.4% of all contacts identified completed screening following exposure. The yield of either a single positive tuberculin skin test (TST) or a TST conversion attributable to in-flight transmission is between 0.19% (95%CI 0.13–0.27) and 0.74% (95%CI 0.61–0.88) of all contacts identified (0.00%, 95%CI 0.00–0.00 and 0.13%, 95%CI 0.00–0.61 in random effects meta-analysis).LimitationsThe main limitation is heterogeneity of reporting.Conclusions and implications of key findingsThe evidence behind the criteria for initiating investigations is weak and it has been widely demonstrated that active screening of contacts is labour intensive and unlikely to be effective. Based on our findings, formal comprehensive contact tracing may be of limited utility following a plane exposure.

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Decreased Mortality in Coronavirus Disease 2019 Patients Treated With Tocilizumab: A Rapid Systematic Review and Meta-analysis of Observational Studies

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1445 ◽

2020 ◽

Cited By ~ 12

Author(s):

Jishnu Malgie ◽

Jan W Schoones ◽

Bart G Pijls

Keyword(s):

Side Effects ◽

Meta Analysis ◽

Risk Difference ◽

World Health ◽

Cochrane Library ◽

Control Group ◽

Number Needed To Treat ◽

Receptor Antagonists ◽

Increased Risk ◽

Health Organization

Abstract Background We systematically reviewed the literature to answer the following research questions: (1) Does interleukin 6 (IL-6) (receptor) antagonist therapy reduce mortality in coronavirus disease 2019 (COVID-19) patients compared to patients not treated with IL-6 (receptor) antagonists; and (2) is there an increased risk of side effects in COVID-19 patients treated with IL-6 (receptor) antagonists compared to patients not treated with IL-6 (receptor) antagonists? Methods We systematically searched PubMed, PMC PubMed Central, Medline, World Health Organization COVID-19 Database, Embase, Web of Science, Cochrane Library, Emcare, and Academic Search Premier (through 30 June 2020). Random effects meta-analysis was used to pool the risk ratios and risk differences of individual studies. Risk of bias was appraised using the Methodological Index for Non-randomized Studies (MINORS) checklist. Results The search strategy retrieved 743 unique titles, of which 10 studies (all on tocilizumab [TCZ]) comprising 1358 patients were included. Nine of 10 studies were considered to be of high quality. Meta-analysis showed that the TCZ group had lower mortality than the control group. The risk ratio was 0.27 (95% confidence interval [CI], .12–.59) and the risk difference was 12% (95% CI, 4.6%–20%) in favor of the TCZ group. With only a few studies available, there were no differences observed regarding side effects. Conclusions Our results showed that mortality was 12% lower for COVID-19 patients treated with TCZ compared with those not treated with TCZ. The number needed to treat was 11, suggesting that for every 11 (severe) COVID-19 patients treated with TCZ, 1 death is prevented. These results require confirmation by randomized controlled trials.

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Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis

British Journal of General Practice ◽

10.3399/bjgp17x692525 ◽

2017 ◽

Vol 67 (663) ◽

pp. e684-e691 ◽

Cited By ~ 19

Author(s):

Ruth Victoria Pritchett ◽

Amanda J Daley ◽

Kate Jolly

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Aerobic Exercise ◽

Meta Analysis ◽

Risk Of Bias ◽

World Health ◽

Cochrane Library ◽

Group Exercise ◽

Postpartum Depressive Symptoms ◽

Health Organization

BackgroundThere is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent.AimTo assess the effectiveness of aerobic exercise on postpartum depressive symptoms.Design and settingSystematic review and meta-analysis. There was no restriction to study site or setting.MethodThe databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched. Titles and abstracts, then full-text articles, were screened against inclusion criteria: RCTs measuring depressive symptoms in mothers ≤1 year postpartum; and interventions designed to increase aerobic exercise compared with usual care or other comparators. Included studies were assessed using the Cochrane Collaboration’s risk of bias tool. Meta-analysis was conducted. Pre-planned subgroup analyses explored heterogeneity.ResultsThirteen RCTs were included, with 1734 eligible participants. Exercise significantly reduced depressive symptoms when all trials were combined (standardised mean difference −0.44; 95% confidence interval = −0.75 to −0.12). Exploration of heterogeneity did not find significant differences in effect size between women with possible depression and in general postpartum populations; exercise only and exercise with co-interventions; and group exercise and exercise counselling.ConclusionThis systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias.

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Cerebral function imaging of acupuncture treatment for stroke: A protocol for systematic review and meta-analysis

10.21203/rs.3.rs-344710/v1 ◽

2021 ◽

Author(s):

Yihao Zhou ◽

Jing Shi ◽

Gan Huang ◽

Zhilin Huang ◽

Sifeng Feng ◽

...

Keyword(s):

Systematic Review ◽

Acupuncture Treatment ◽

Meta Analysis ◽

Brain Regions ◽

Scientific Basis ◽

World Health ◽

Cochrane Library ◽

Action Mechanism ◽

Stroke Treatment ◽

Health Organization

Abstract Background: Stroke is one of the most common causes of death and is the main cause of persistent and acquired disability in adults worldwide. Acupuncture is recommended as an alternative and complementary strategy for stroke treatment by the World Health Organization as it can significantly improve patients' quality of life. However, the central nervous system (CNS) mechanism of acupuncture treatment of stroke is unclear. The aim of this study is explore the effective pathway and action mechanism of acupuncture treatment for stroke on the CNS.Methods: The following databases will be searched by electronic methods: PubMed; Medline; Embase; Cochrane Library; Chinese National Knowledge Infrastructure; VIP Database; Wan-fang Data; Chinese Biomedical Database. All of them will be retrieved from the establishment date of the electronic database to December 2020, all included studies will be evaluated risk of bias by the Cochrane Handbook. Spatial coordinates of the Montreal Neurological Institute of activated brain regions will be the primary outcome. The systematic review will be conducted with the use of SDM v5.141 software for voxel meta-analysis in this study.Results: This study will obtain the correlation between the activated brain regions of acupuncture treatment for stroke.Conclusion: This study will explore the effective pathway and action mechanism of acupuncture, and provide a reliable scientific basis for the treatment of stroke by acupuncture.PROSPERO registration number: CRD42021231329.

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Horticultural Therapy in Patients With Dementia: A Systematic Review and Meta-Analysis

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317519883498 ◽

2019 ◽

Vol 35 ◽

pp. 153331751988349 ◽

Cited By ~ 1

Author(s):

Li-Chin Lu ◽

Shao-Huan Lan ◽

Yen-Ping Hsieh ◽

Yea-Yin Yen ◽

Jong-Chen Chen ◽

...

Keyword(s):

Systematic Review ◽

Psychological Health ◽

Psychological Symptoms ◽

Meta Analysis ◽

World Health ◽

Cochrane Library ◽

Horticultural Therapy ◽

Dementia Patients ◽

Standard Mean Difference ◽

Health Organization

Background: World Health Organization has communicated that dementia as a public health priority in 2012. Behavioral and psychological symptoms of dementia are the main reason results in hospitalization of dementia patients. Horticulture is one of the favorite activity for many peoples to relax their minds. Objectives: To investigate psychological health benefits of horticulture intervention in dementia patients. Methods: The databases including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, and Ovid Medline were searched up to August 2017. Results: Twenty-three articles for systematic review, whereas 8 articles were included in meta-analysis. Meta-analysis verified the beneficial effect of horticultural therapy (HT) on agitation level (standard mean difference: −0.59; P < .00001); increase time spent on activity engagement (mean differences [MD]: 45.10%, P < .00001); decrease time for doing nothing (MD: −29.36%, P = .02). Conclusions: Patients with dementia benefit from horticultural by alleviating their degrees of agitate behaviors, increasing time of engaging in activities and decrease time of doing nothing.

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Prevalence and determinants of alcohol use among adults living with HIV/AIDS in Ethiopia: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-020-01402-w ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Birhanie Mekuriaw ◽

Zelalem Belayneh ◽

Alemayehu Molla ◽

Tsegaye Mehare

Keyword(s):

Systematic Review ◽

Alcohol Use ◽

Associated Factors ◽

Meta Analysis ◽

Geographical Location ◽

World Health ◽

Cochrane Library ◽

Cross Sectional ◽

Health Organization ◽

Hiv Aids

Abstract Background Alcohol use is a challenging problem which attributes to more than 5% of the overall global burden of disease. It is more common among persons with HIV infection than the general population. Although there are separate studies regarding people with HIV/AIDS in Ethiopia, their results are highly variable and discrepant. The objectives of this study will be to evaluate the prevalence of alcohol use and to identify its associated factors among people with HIV/AIDS in Ethiopia. Methods A systematic search of electronic databases (from inception onwards) of PubMed/MEDLINE, Embase, PsycINFO, and Cochrane Library will be conducted. Moreover, grey literatures will be searched from different sources (such as Google Scholar, OpenGrey, and World Health Organization websites). Reference lists of the selected articles will also be searched manually. Observational studies (cross-sectional, case-control, cohort) reporting the prevalence of alcohol use and/or its associated factors among adults with HIV/AIDS in Ethiopia will be included. The primary outcomes will be the prevalence of alcohol use among HIV/AIDS population. Secondary outcomes will be the determinants of alcohol use described in the included studies. Two reviewers will independently screen all citations and full-text articles and extract data. The studies’ methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct a random effects meta-analysis of observational data. Heterogeneity of primary studies will be assessed using the I2 test. Prevalence estimates will be stratified according to gender, age, and geographical location. Small-study effects (publication bias) also will be examined. Discussion Our systematic review and meta-analysis will prevail the pooled prevalence of alcohol use and its determinants among people with HIV/AIDS in Ethiopia. The finding of this study will be helpful to design appropriate preventive and interventional strategies for alcohol use among people with HIV/AIDS. This can have direct or indirect policy responses and clinical implications. Systematic review registration PROSPERO CRD42019132524

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Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-020-77739-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Mahalul Azam ◽

Rina Sulistiana ◽

Martha Ratnawati ◽

Arulita Ika Fibriana ◽

Udin Bahrudin ◽

...

Keyword(s):

Meta Analysis ◽

Severe Disease ◽

Disease Onset ◽

World Health ◽

Cochrane Library ◽

Younger Age ◽

Patients With Diabetes ◽

Health Organization ◽

The Cochrane Library ◽

Clinical Trials Registry

AbstractPresent study aimed to estimate the incidence of recurrent SARS-CoV-2 RNA positivity after recovery from COVID-19 and to determine the factors associated with recurrent positivity. We searched the PubMed, MedRxiv, BioRxiv, the Cochrane Library, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry for studies published to June 12, 2020. Studies were reviewed to determine the risk of bias. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Fourteen studies of 2568 individuals were included. The incidence of recurrent SARS-CoV-2 positivity was 14.8% (95% confidence interval [CI] 11.44–18.19%). The pooled estimate of the interval from disease onset to recurrence was 35.4 days (95% CI 32.65–38.24 days), and from the last negative to the recurrent positive result was 9.8 days (95% CI 7.31–12.22 days). Patients with younger age and a longer initial illness were more likely to experience recurrent SARS-CoV-2 positivity, while patients with diabetes, severe disease, and a low lymphocyte count were less likely to experience. Present study concluded that the incidence of recurrent SARS-CoV-2 positivity was 14.8% suggesting further studies must be conducted to elucidate the possibility of infectious individuals with prolonged or recurrent RNA positivity.

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Maternal immune activation generates anxiety in offspring: A translational meta-analysis

Translational Psychiatry ◽

10.1038/s41398-021-01361-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Laiana A. Quagliato ◽

Ursula de Matos ◽

Antonio E. Nardi

Keyword(s):

Anxiety Disorders ◽

Immune Activation ◽

Synapse Formation ◽

Meta Analysis ◽

Fetal Brain ◽

World Health ◽

Cochrane Library ◽

Future Research ◽

Maternal Immune Activation ◽

Health Organization

AbstractMaternal immune activation (MIA) during pregnancy is recognized as an etiological risk factor for various psychiatric disorders, such as schizophrenia, major depressive disorder, and autism. Prenatal immune challenge may serve as a “disease primer” for alteration of the trajectory of fetal brain development that, in combination with other genetic and environmental factors, may ultimately result in the emergence of different psychiatric conditions. However, the association between MIA and an offspring’s chance of developing anxiety disorders is less clear. To evaluate the effect of MIA on offspring anxiety, a systematic review and meta-analysis of the preclinical literature was conducted. We performed a systematic search of the PubMed, Web of Science, PsycINFO, and Cochrane Library electronic databases using the PRISMA and World Health Organization (WHO) methodologies for systematic reviews. Studies that investigated whether MIA during pregnancy could cause anxiety symptoms in rodent offspring were included. Overall, the meta-analysis showed that MIA induced anxiety behavior in offspring. The studies provide strong evidence that prenatal immune activation impacts specific molecular targets and synapse formation and function and induces an imbalance in neurotransmission that could be related to the generation of anxiety in offspring. Future research should further explore the role of MIA in anxiety endophenotypes. According to this meta-analysis, MIA plays an important role in the pathophysiological mechanisms of anxiety disorders and is a promising therapeutic target.

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Effect of electromagnetic field on abortion: A systematic review and meta-analysis

Open Medicine ◽

10.1515/med-2021-0384 ◽

2021 ◽

Vol 16 (1) ◽

pp. 1628-1641

Author(s):

Masumeh Ghazanfarpour ◽

Zahra Atarodi Kashani ◽

Reza Pakzad ◽

Fatemeh Abdi ◽

Fatemeh Alsadat Rahnemaei ◽

...

Keyword(s):

Pregnant Women ◽

New Technologies ◽

Meta Analysis ◽

World Health ◽

Cochrane Library ◽

Factors Affecting ◽

Increased Risk ◽

Newcastle Ottawa Scale ◽

Meta Regression ◽

Health Organization

Abstract Background The increasing use of new technologies by pregnant women inevitably exposes them to the risks of the electromagnetic fields (EMFs). According to the World Health Organization, EMFs are the major sources of pollutants which harm human health. This study was aimed to evaluate the effects of EMF exposure on abortion. Methods Web of Science, Cochrane Library, MEDLINE, PubMed, EMBASE, Scopus, and Google Scholar were searched until 2021. Pooled odds ratio (OR) with 95% confidence interval (CI) was estimated using a random-effects model. Heterogeneity was explored using Cochran’s Q test and I 2 index. A meta-regression method was employed to investigate the factors affecting heterogeneity between the studies. The Newcastle-Ottawa scale was used to assess the credibility of the studies. Results Eligible studies (N = 17) were analyzed with a total of 57,693 participants. The mean maternal age (95% CI) was 31.06 years (27.32–34.80). Based on meta-analysis results, the pooled estimate for OR of EMF with its effects was 1.27 (95% CI: 1.10–1.46). According to the results of meta-regression, sample size had a significant effect on heterogeneity between studies (p: 0.030), but mother’s age and publication year had no significant effect on heterogeneity (p-value of bothwere >0.05). No publication bias was observed. Conclusion Exposure to EMFs above 50 Hz or 16 mG is associated with 1.27× increased risk of abortion. It may be prudent to advise women against this potentially important environmental hazard. Indeed, pregnant women should receive tailored counselling.

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Is Hydroxychloroquine with Azithromycin a Good Combination in COVID-19 Compared to Hydroxychloroquine Alone from Cardiac Perspective? A Systematic Review and Meta-Analysis

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v19i1.3270 ◽

2021 ◽

Vol 19 (1) ◽

pp. 1-9

Author(s):

Pravash Budhathoki ◽

Dhan Bahadur Shrestha ◽

Sitaram Khadka ◽

Era Rawal

Keyword(s):

Meta Analysis ◽

Statistical Significance ◽

World Health ◽

Cochrane Library ◽

Cardiac Events ◽

Clinical Trial Registry ◽

Risk Of Mortality ◽

Adverse Cardiac Events ◽

Quantitative Synthesis ◽

Health Organization

Background: The global spread of COVID-19 and the lack of definite treatment have caused an alarming crisis in the world. We aimed to evaluate the outcome and potential harmful cardiac effects of hydroxychloroquine and azithromycin compared to hydroxychloroquine alone for COVID-19 treatment.Methods: PubMed, Medline, Google Scholar, Cochrane Library, clinicaltrials.gov, and World Health Organization clinical trial registry were searched using appropriate keywords and identified six studies using PRISMA guidelines. The quantitative synthesis was performed using fixed or random effects for the pooling of studies based on heterogeneities.Results: The risk of mortality (RR=1.16; CI: 0.92-1.46) and adverse cardiac events (OR=1.06; CI: 0.82-1.37) demonstrated a small increment though of no significance. There were no increased odds of mechanical ventilation (OR=0.84; CI: 0.33-2.15) and significant QTc prolongation (OR=0.84, CI: 0.59-1.21). Neither the critical QTc threshold (OR=1.92, CI: 0.81-4.56) nor absolute ?QTc ?60ms (OR=1.95, CI:0.55-6.96) increased to the level of statistical significance among hydroxychloroquine and azithromycin arm compared to hydroxychloroquine alone, but the slightly increased odds need to be considered in clinical practice. Conclusions: The combination of hydroxychloroquine and azithromycin leads to small increased odds of mortality and cardiac events compared to hydroxychloroquine alone. The use of hydroxychloroquine and azithromycin led to increased odds of QT prolongation, although not statistically significant.Keywords: COVID-19; COVID-19 drug treatment; hydroxychloroquine; macrolides; severe acute respiratory syndrome coronavirus 2

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Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2109229118 ◽

2021 ◽

Vol 118 (34) ◽

pp. e2109229118

Author(s):

Pratha Sah ◽

Meagan C. Fitzpatrick ◽

Charlotte F. Zimmer ◽

Elaheh Abdollahi ◽

Lyndon Juden-Kelly ◽

...

Keyword(s):

Clinical Symptoms ◽

Prediction Interval ◽

Meta Analysis ◽

The Elderly ◽

World Health ◽

Contact Tracing ◽

Research Database ◽

Asymptomatic Infections ◽

Health Organization ◽

Effective Public Health

Quantification of asymptomatic infections is fundamental for effective public health responses to the COVID-19 pandemic. Discrepancies regarding the extent of asymptomaticity have arisen from inconsistent terminology as well as conflation of index and secondary cases which biases toward lower asymptomaticity. We searched PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020 and April 2, 2021 to identify studies that reported silent infections at the time of testing, whether presymptomatic or asymptomatic. Index cases were removed to minimize representational bias that would result in overestimation of symptomaticity. By analyzing over 350 studies, we estimate that the percentage of infections that never developed clinical symptoms, and thus were truly asymptomatic, was 35.1% (95% CI: 30.7 to 39.9%). At the time of testing, 42.8% (95% prediction interval: 5.2 to 91.1%) of cases exhibited no symptoms, a group comprising both asymptomatic and presymptomatic infections. Asymptomaticity was significantly lower among the elderly, at 19.7% (95% CI: 12.7 to 29.4%) compared with children at 46.7% (95% CI: 32.0 to 62.0%). We also found that cases with comorbidities had significantly lower asymptomaticity compared to cases with no underlying medical conditions. Without proactive policies to detect asymptomatic infections, such as rapid contact tracing, prolonged efforts for pandemic control may be needed even in the presence of vaccination.

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