scholarly journals Association of indoor microbial aerosols with respiratory symptoms among under-five children: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Adekunle Gregory Fakunle ◽  
Nkosana Jafta ◽  
Rajen N. Naidoo ◽  
Lidwien A. M. Smit
Keyword(s):  
Relative Risk ◽  
Respiratory Symptoms ◽  
Meta Analysis ◽  
Random Effect ◽  
Potential Effect ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
Increased Risk ◽  
Microbial Exposure

Abstract Background Despite the recognition of the importance of indoor microbial exposures on children’s health, the role of different microbial agents in development and aggravation of respiratory symptoms and diseases is only poorly understood. This study aimed to assess whether exposure to microbial aerosols within the indoor environment are associated with respiratory symptoms among children under-5 years of age. Methods A systematic literature search was conducted on PubMed, Web of Science, GreenFILE, ScienceDirect, EMBASE and Cochrane library through February 2020. Studies that investigated the exposure–response relationship between components of the indoor microbial communities and respiratory symptoms among under-five children were eligible for inclusion. A random-effect meta-analysis was applied to estimate pooled relative risk (RR) and 95% confidence interval (CI) for study specific high versus low microbial exposures. The potential effect of individual studies on the overall estimate was evaluated using leave-one-out analysis, while heterogeneity was evaluated by I2 statistics using RevMan 5.3. Results Fifteen studies were eligible for inclusion in a meta-analysis. The pooled risk estimate suggested that increased microbial exposure was associated with an increased risk of respiratory symptoms [pooled relative risk (RR): 1.24 (1.09, 1.41), P = 0.001]. The association was strongest with exposure to a combination of Aspergillus, Penicillium, Cladosporium and Alternaria species [pooled RR: 1.73 (1.30, 2.31), P = 0.0002]. Stratified analysis revealed an increased risk of wheeze [pooled RR: 1.20 (1.05, 1.37), P = 0.007 and allergic rhinitis [RR: 1.18 (0.94, 1.98), P = 0.16] from any microbial exposure. Conclusions Microbial exposures are, in general, associated with risk of respiratory symptoms. Future studies are needed to study the indoor microbiome more comprehensively, and to investigate the mechanism of these associations.

scholarly journals Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

2020 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw
Keyword(s):  
East Africa ◽  
Associated Factors ◽  
Meta Analysis ◽  
Eastern Africa ◽  
Systemic Review ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
The Impact ◽  
National Prevalence

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.

A meta-analysis of biologic therapies on risk of new or recurrent cancer in patients with rheumatoid arthritis and a prior malignancy

Rheumatology ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 930-939 ◽  
Author(s):  
Wenhui Xie ◽  
Shiyu Xiao ◽  
Yanrong Huang ◽  
Xiaoying Sun ◽  
Dai Gao ◽  
...  
Keyword(s):  
Relative Risk ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Optimal Time ◽  
Biologic Therapies ◽  
Recurrent Cancer ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
Prior Malignancy

Abstract Objectives To explore the risk of new and recurrent cancer in adult RA patients with prior malignancy and subsequently exposed to biologic therapies. Methods Separate searches were performed of PubMed, EMBASE and Cochrane Library and conference proceedings for observational studies reporting cancer incidence or recurrence in patients with RA and prior malignancy treated with biologics and conventional synthetic DMARDs (csDMARDs). Mantel-Haenszel fixed-effects method was conducted to calculate relative risk and 95% CI. Results A total of 12 studies involving 13 598 patients and 32 473 patient-years of follow-up were included (10, 3 and 1 studies for TNF inhibitors [TNFi], rituximab and anakinra, respectively). The crude incidence of new and recurrent cancer per 1000 patient-years were 34.4 for TNFi, 32.3 for rituximab, 32.3 for anakinra and 31.8 for csDMARDs. In the quantitative meta-analysis, biologics were not associated with an increased risk of new or recurrent cancer compared with csDMARDs in patients with RA and prior cancer (TNFi: relative risk = 0.95, 95% CI = 0.83, 1.09; rituximab: relative risk = 0.89, 95% CI = 0.52, 1.53). Secondary analyses of stratification of cancer types, the interval between initiation of TNFi and prior cancer diagnosis, and duration of TNFi exposure, found similar results. Conclusion Compared with csDMARDs, there is no increased risk of developing cancer overall or some specific subtypes in RA patients with a prior cancer receiving biologics. More investigations are warranted to explore the risk of cancer development in individual cancer as well as to determine optimal time to initiate biologic therapy after the diagnosis of cancer or completion of cancer treatment.

scholarly journals Incidence of Respiratory Symptoms for Residents Living Near a Petrochemical Industrial Complex: A Meta-Analysis

2020 ◽  
Vol 17 (7) ◽  
pp. 2474
Author(s):  
Wen-Wen Chang ◽  
Hathaichon Boonhat ◽  
Ro-Ting Lin
Keyword(s):  
Respiratory Symptoms ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Random Effect ◽  
Study Groups ◽  
Industrial Complex ◽  
Residential Exposure ◽  
Increased Risk ◽  
Subgroup Analyses ◽  
Meta Analyses

The air pollution emitted by petrochemical industrial complexes (PICs) may affect the respiratory health of surrounding residents. Previous meta-analyses have indicated a higher risk of lung cancer mortality and incidence among residents near a PIC. Therefore, in this study, a meta-analysis was conducted to estimate the degree to which PIC exposure increases the risk of the development of nonmalignant respiratory symptoms among residents. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically identify, select, and critically appraise relevant research. Finally, we identified 16 study groups reporting 5 types of respiratory symptoms: asthma, bronchitis, cough, rhinitis, and wheezing. We estimated pooled odds ratios (ORs) using random-effect models and investigated the robustness of pooled estimates in subgroup analyses by location, observation period, and age group. We determined that residential exposure to a PIC was significantly associated with a higher incidence of cough (OR = 1.35), wheezing (OR = 1.28), bronchitis (OR = 1.26), rhinitis (OR = 1.17), and asthma (OR = 1.15), although the latter two associations did not reach statistical significance. Subgroup analyses suggested that the association remained robust across different groups for cough and bronchitis. We identified high heterogeneity for asthma, rhinitis, and wheezing, which could be due to higher ORs in South America. Our meta-analysis indicates that residential exposure to a PIC is associated with an increased risk of nonmalignant respiratory symptoms.

scholarly journals β lactam monotherapy versus β lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials

BMJ ◽  
2004 ◽  
Vol 328 (7441) ◽  
pp. 668 ◽  
Author(s):  
Mical Paul ◽  
Ishay Benuri-Silbiger ◽  
Karla Soares-Weiser ◽  
Leonard Leibovici
Keyword(s):  
Relative Risk ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Randomised Trials ◽  
Intention To Treat ◽  
Relative Risks ◽  
Development Of Resistance

AbstractObjective To compare β lactam monotherapy with β lactam-aminoglycoside combination therapy for severe infections.Data sources Medline, Embase, Lilacs, Cochrane Library, and conference proceedings, to 2003; references of included studies; contact with all authors. No restrictions, such as language, year of publication, or publication status.Study selection All randomised trials of β lactam monotherapy compared with β lactam-aminoglycoside combination therapy for patients without neutropenia who fulfilled criteria for sepsis.Data selection Two reviewers independently applied selection criteria, performed quality assessment, and extracted the data. The primary outcome assessed was all cause fatality by intention to treat. Relative risks were pooled with the random effect model (relative risk < 1 favours monotherapy).Results 64 trials with 7586 patients were included. There was no difference in all cause fatality (relative risk 0.90, 95% confidence interval 0.77 to 1.06). 12 studies compared the same β lactam (1.02, 0.76 to 1.38), and 31 studies compared different β lactams (0.85, 0.69 to 1.05). Clinical failure was more common with combination treatment overall (0.87, 0.78 to 0.97) and among studies comparing different β lactams (0.76, 0.68 to 0.86). There was no advantage to combination therapy among patients with Gram negative infections (1835 patients) or Pseudomonas aeruginosa infections (426 patients). There was no difference in the rate of development of resistance. Nephrotoxicity was significantly more common with combination therapy (0.36, 0.28 to 0.47). Heterogeneity was not significant for these comparisons.Conclusions In the treatment of sepsis the addition of an aminoglycoside to β lactams should be discouraged. Fatality remains unchanged, while the risk for adverse events is increased.

scholarly journals Metabolomics Signatures in Type 2 Diabetes: A Systematic Review and Integrative Analysis

2019 ◽  
Vol 105 (4) ◽  
pp. 1000-1008 ◽  
Author(s):  
Yue Sun ◽  
Hao-Yu Gao ◽  
Zhi-Yuan Fan ◽  
Yan He ◽  
Yu-Xiang Yan
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Metabolic Pathways ◽  
Meta Analysis ◽  
Random Effect ◽  
Bioinformatic Analysis ◽  
Cochrane Library ◽  
Isoleucine Leucine ◽  
Increased Risk

Abstract Objective Metabolic signatures have emerged as valuable signaling molecules in the biochemical process of type 2 diabetes (T2D). To summarize and identify metabolic biomarkers in T2D, we performed a systematic review and meta-analysis of the associations between metabolites and T2D using high-throughput metabolomics techniques. Methods We searched relevant studies from MEDLINE (PubMed), Embase, Web of Science, and Cochrane Library as well as Chinese databases (Wanfang, Vip, and CNKI) inception through 31 December 2018. Meta-analysis was conducted using STATA 14.0 under random effect. Besides, bioinformatic analysis was performed to explore molecule mechanism by MetaboAnalyst and R 3.5.2. Results Finally, 46 articles were included in this review on metabolites involved amino acids, acylcarnitines, lipids, carbohydrates, organic acids, and others. Results of meta-analysis in prospective studies indicated that isoleucine, leucine, valine, tyrosine, phenylalanine, glutamate, alanine, valerylcarnitine (C5), palmitoylcarnitine (C16), palmitic acid, and linoleic acid were associated with higher T2D risk. Conversely, serine, glutamine, and lysophosphatidylcholine C18:2 decreased risk of T2D. Arginine and glycine increased risk of T2D in the Western countries subgroup, and betaine was negatively correlated with T2D in nested case-control subgroup. In addition, slight improvements in T2D prediction beyond traditional risk factors were observed when adding these metabolites in predictive analysis. Pathway analysis identified 17 metabolic pathways may alter in the process of T2D and metabolite-related genes were also enriched in functions and pathways associated with T2D. Conclusions Several metabolites and metabolic pathways associated with T2D have been identified, which provide valuable biomarkers and novel targets for prevention and drug therapy.

scholarly journals Prevalence and factors associated with malaria among under-five children in Ethiopia: A Systematic review and Meta-analysis Protocol

2020 ◽  
Author(s):  
Abay Woday ◽  
Mulluken Dessalegn ◽  
Setognal Birara ◽  
Kusse Urmale
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Statistical Significance ◽  
Grey Literature ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
Pooled Prevalence

Abstract Background: The Sub-Saharan African countries have been carried 80% of the global burden of malaria. Consequently, malaria is still the leading cause of under-five mortality in developing nations. In Ethiopia, studies conducted regarding prevalence and associated factors of malaria among under five children are inconsistently reported and highly variable.Objective: to determine the pooled prevalence and associated factors of malaria among under five children in Ethiopia. Methods: The protocol for this review is registered at PROSPERO with registration number: CRD42020157886. A comprehensive search of the following electronic databases were made using: MEDLINE, EMBASE, CINAHL, Scopus, web science, HINARI, Cochrane library, Google Scholar and maternity & infant care databases as well as grey literature uploaded at Ethiopian Health Development Journal were searched until May 2020. The quality of studies will be assessed using Joanna Briggs Institute (JBI) checklist. All identified observational studies reporting the prevalence of malaria and associated factors among under five children in Ethiopia will be considered. Three reviewers will screen all retrieved articles, conduct data extraction, and then critically appraise all identified studies. The analysis of data will be done using STATA 14.0 statistical software. We will determine the pooled prevalence and determinants of malaria among under five children using random effect model with effect size and 95% confidence interval. Heterogeneity among the included studies will be assessed through the Cochrane Q-test statistics and I2 test. Furthermore, publication bias will be checked using funnel plot and egger’s test. Finally, statistical significance level will be declared at a p-value less than 0.05. Discussion: The result from this systematic review will inform and guide health policy planners and researchers on the burden, and determinants of under five children malaria in Ethiopia. To our knowledge, this is the first systematic review in Ethiopia. We will synthesize the findings to generate up-to-date knowledge on malaria among under five children in Ethiopia.

scholarly journals The Impact of Delirium On Prognosis In Stroke: A Systematic Review and Meta-Analyses of Observational Studies

2021 ◽  
Author(s):  
jing zhang ◽  
xin wang ◽  
jie wang ◽  
kai liu ◽  
tao he ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Length Of Hospital Stay ◽  
Clinical Problem ◽  
Cochrane Library ◽  
Inpatient Mortality ◽  
Increased Risk ◽  
The Impact

Abstract Background The outcomes of post-stroke delirium are inconsistent. Therefore, we conduct a meta-analysis to provide a comprehensive description of the impact of delirium on the outcomes including including length of hospital stay and inpatient mortality after stroke. Methods We searched electronic databases including PubMed, Google scholar, Web of Science and Cochrane Library databases up to April, 2021. Fixed-effect or random-effect model was used to summary odds ratio (OR) and mean difference (MD ) with 95% confidence interval (CI). Results 13 individual studies with total of 3592 patients met the inclusion criteria. The summary results revealed that stroke patients with delirium increased risk of inpatient mortality (OR = 6.35, 95% CI: 4.35–9.25, p < 0.0001), and had longer length of hospital stay (MD = 5.93, 95% CI: 2.79–9.07, p < 0.0001) compared to non-delirious patients. Conclusions Delirium is associated with unfavorable outcomes in patients with stroke, particularly in higher inpatient mortality and longer length of stay. We should pay more attention to this clinical problem and managed appropriately to prevent poor prognosis.

scholarly journals The association between osteopontin and tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242702
Author(s):  
Dongguang Wang ◽  
Xiang Tong ◽  
Lian Wang ◽  
Shijie Zhang ◽  
Jizhen Huang ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Elevated Serum ◽  
Disease Diagnosis ◽  
Cochrane Library ◽  
Severity Assessment ◽  
China National Knowledge Infrastructure ◽  
Potential Biomarker ◽  
Increased Risk

Objective We examined the data reported in the studies for comparison of osteopontin (OPN) levels in tuberculosis and healthy participants, and to discuss whether OPN could be extended to disease diagnosis, severity assessment and therapeutic effect monitering. Methods A systematic literature search was conducted in PubMed, EMBASE, Scopus, the Cochrane Library, Web of Science, the China National Knowledge Infrastructure (CNKI) and WanFang databases. The pooled risk estimates were shown in standardized mean difference (SMD) with 95% confidence interval (CI) for OPN levels. The random effect model was used according to the test of heterogeneity among studies. Subgroup analyses and meta-regression models were performed to identify the possible sources of heterogeneity. Results 17 retrospective studies with 933 tuberculosis participants and 786 healthy controls were finally included in this article. In the primary meta-analysis, higher serum/plasma OPN levels were found in tuberculosis patients (SMD = 2.58, 95%CI = 2.09~3.08, P<0.001). Besides, pooled results from positive acid-fast bacilli (AFB) staining and imaging-severe tuberculosis group demonstrated higher OPN concentrations (SMD = 0.90, 95%CI = 0.58~1.21, P<0.001; SMD = 1.11, 95%CI = 0.90~1.33, P<0.001; respectively), and OPN levels decreased after two months of standard anti-tuberculosis therapy (SMD = 2.10, 95%CI = 1.36~2.85, P<0.001). Conclusions Elevated serum/plasma OPN levels may be associated with an increased risk of tuberculosis, while further well-designed studies are needed. Moreover, OPN could be considered as a potential biomarker for tuberculosis surveillance and severity assessment.

scholarly journals Association between proton-pump inhibitors and the risk of gastric cancer: a systematic review with meta-analysis

2021 ◽  
Vol 14 ◽  
pp. 175628482110514
Author(s):  
Daniel Segna ◽  
Nele Brusselaers ◽  
Damian Glaus ◽  
Niklas Krupka ◽  
Benjamin Misselwitz
Keyword(s):  
Gastric Cancer ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Meta Analysis ◽  
Random Effect ◽  
Significant Risk ◽  
Case Control ◽  
Cochrane Library ◽  
Increased Risk ◽  
Statistical Heterogeneity

Introduction: The use of proton-pump inhibitors (PPI) may be associated with an increased risk of gastric cancer (GC). Objective: To review and meta-analyse available literature investigating the association between PPI use and GC risk. Methods: Two independent reviewers systematically searched Ovid MEDLINE, EMBASE, and Cochrane Library (inception to July 2020) for case-control and cohort studies assessing the association between PPI use and GC according to a predefined protocol in PROSPERO (CRD42018102536). Reviewers independently assessed study quality, extracted data, and meta-analysed available and newly calculated odds ratios (ORs) using a random-effects model, and stratified for GC site (cardia versus non-cardia) and PPI duration (<1 year, 1–3 years, >3 years). Results: We screened 2,396 records and included five retrospective cohort and eight case-control studies comprising 1,662,881 individuals in our meta-analysis. In random-effect models, we found an increased GC risk in PPI users [OR: 1.94, 95% confidence interval (95% CI): 1.47–2.56] with high statistical heterogeneity ( I2 = 82%) and overall moderate risk of bias. Stratified analyses indicated a significant risk increase in non-cardia (OR: 2.20, 95% CI: 1.44–3.36, I2 = 77%) with a similar non-significant trend in cardia regions (OR: 1.77, 95% CI: 0.72–4.36, I2 = 66%). There was no GC increase with longer durations of PPI exposure (<1 year: OR: 2.29, 95% CI: 2.13–2.47, I2 = 0%; 1–3 years: OR: 1.46, 95% CI: 0.53–4.01, I2 = 35%; >3 years: OR: 2.08, 95% CI: 0.56–7.77, I2 = 61%). Conclusion: We found a twofold increased GC risk among PPI users, but this association does not confirm causation and studies are highly heterogeneous. PPI should only be prescribed when strictly indicated.

scholarly journals Magnitude and Predictors of Pneumonia among Under-Five Children in Ethiopia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yoseph Merkeb Alamneh ◽  
Fentahun Adane
Keyword(s):  
Tract Infection ◽  
Vitamin A ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Vitamin A Supplementation ◽  
Under Five ◽  
Under Five Children

Background. Pneumonia is currently the leading cause of morbidity and mortality among under-five children in developing countries, including Ethiopia. Although these problems are easily preventable and treatable, it contributes to more than 18% of deaths of under-five children every year in Ethiopia. Regardless of these facts, there is a paucity of information regarding the magnitude and its predictors of pneumonia in Ethiopia. Therefore, the main objective of this review is to determine the pooled magnitude of pneumonia and its predictors among under-five children in Ethiopia. Methods. The international databases such as MEDLINE/PubMed, EMBASE, Google Scholar, and Science Direct were scientifically explored. Articles were also searched by examining the gray literature on institutional databases and by reviewing reference lists of already identified articles. We considered all primary studies reporting the magnitude of pneumonia among under-five children and its predictors in Ethiopia. We retrieved all necessary data by using a standardized data extraction format spreadsheet. STATA 14 statistical software was used to analyze the data, and Cochrane’s Q test statistics and I2 test were used to assess the heterogeneity between the studies. Significant variability was found between the studies in such a way that a random-effect model was used. Result. The pooled magnitude of pneumonia among under-five children was 20.68% (I2 = 97.9%; P≤0.001) out of 12 studies in Ethiopia. Children who have unvaccinated (OR = 2.45), food cooking in the main house (OR = 2.46), vitamin A supplementation status (OR = 2.85), malnutrition (OR = 2.98), mixed breastfeeding (OR = 2.46), and child history of respiratory tract infection (OR = 4.11) were potential determinates of pneumonia. Conclusion and Recommendations. This review showed that the magnitude of pneumonia was relatively high. Hence, appropriate intervention on potential determinates such as health education on exclusive breastfeeding and nutrition, place of food cooking, increased immunization and vitamin A supplementation, and early control of respiratory tract infection was recommended to prevent those risk factors.

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