Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Embase, PubMed, Web of Science, Cochrane and MedRix were searched for potentially relevant articles. All included papers were assessed for the quality using modified jadad scale and Newcaste-ottawa scale for randomized controlled trial (RCT) and non – RCT, respectively. We used a Q test and Egger test to assess the heterogeneity and publication bias among studies, respectively. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 12 papers consisting of three cross-sectional studies, one prospective study, five retrospective studies, and two RCT studies were included in our analysis. Of them, a total of 1,937 patients treated with CCP and 3,405 patients without CCP were involved.. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without the CCP had a 1.32 times higher risk of mortality than those treated with the CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, reduces the mortality rate among COVID-19 patients.

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Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis

F1000Research ◽

10.12688/f1000research.36396.3 ◽

2021 ◽

Vol 10 ◽

pp. 64

Author(s):

Shinta Oktya Wardhani ◽

Jonny Karunia Fajar ◽

Laksmi Wulandari ◽

Gatot Soegiarto ◽

Yeni Purnamasari ◽

...

Keyword(s):

Standard Treatment ◽

Controlled Trial ◽

Meta Analysis ◽

Group Analysis ◽

Adjunctive Treatment ◽

Cross Sectional ◽

Risk Of Mortality ◽

Jadad Scale ◽

Newcastle Ottawa Scale ◽

Ottawa Scale

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Embase, PubMed, Web of Science, Cochrane and MedRix were searched for potentially relevant articles. All included papers were assessed for the quality using modified Jadad scale and Newcastle-Ottawa scale for randomized controlled trial (RCT) and non – RCT, respectively. We used a Q test and Egger test to assess the heterogeneity and publication bias among studies, respectively. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 12 papers consisting of three cross-sectional studies, one prospective study, five retrospective studies, and three RCT studies were included in our analysis. Of them, a total of 1,937 patients treated with CCP and 3,405 patients without CCP were included. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without CCP had a 1.32 times higher risk of mortality than those treated with CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, could reduce the mortality rate among COVID-19 patients.

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Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis

F1000Research ◽

10.12688/f1000research.36396.1 ◽

2021 ◽

Vol 10 ◽

pp. 64

Author(s):

Shinta Oktya Wardhani ◽

Jonny Karunia Fajar ◽

Laksmi Wulandari ◽

Gatot Soegiarto ◽

Yeni Purnamasari ◽

...

Keyword(s):

Mortality Rate ◽

Infectious Diseases ◽

Adjunctive Therapy ◽

Standard Treatment ◽

Meta Analysis ◽

Group Analysis ◽

Mortality Rates ◽

Adjunctive Treatment ◽

Bibliographic Databases ◽

Risk Of Mortality

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Four bibliographic databases and a preprint database were searched for potentially relevant articles. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 1,937 patients treated with CCP and 3,405 patients without CCP retrieved from 12 studies were included. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without the CCP had a 1.32 times higher risk of mortality than those treated with the CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, reduces the mortality rate among COVID-19 patients.

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Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000514471 ◽

2021 ◽

pp. 1-11

Author(s):

Diego Urrunaga-Pastor ◽

Diego Chambergo-Michilot ◽

Fernando M. Runzer-Colmenares ◽

Josmel Pacheco-Mendoza ◽

Vicente A. Benites-Zapata

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

High Altitude ◽

Web Of Science ◽

Meta Analysis ◽

Cross Sectional ◽

Language Restriction ◽

Newcastle Ottawa Scale ◽

Meta Analyses ◽

Ottawa Scale

Introduction: Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. Methods: We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Results: Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, I2: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, I2: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, I2: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. Conclusions: The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

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Recognition and Participation of Colorectal Cancer Screening in Turkey: Meta-analysis of Literature

European Journal of Public Health ◽

10.1093/eurpub/ckz186.711 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

S Aydoğan ◽

S Metintaş ◽

M F Önsüz

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

English Language ◽

Meta Analysis ◽

Group Analysis ◽

Fecal Occult Blood ◽

Screening Methods ◽

Double Blind ◽

Cross Sectional ◽

Crc Screening

Abstract Background The aim of the study was to perform a systematic review and meta-analysis of studies about the proportion of recognition of fecal occult blood test (FOBT) and colonoscopy (CS) methods and participation to them in any period of life for colorectal cancer (CRC) screening in Turkey. Methods PubMed, Web of Science, Google Scholar, Turkey Citation Index and YOK Thesis Center databases were screened both in Turkish and English language to identify relevant studies and key words ’colorectal cancer’, ’colon cancer’, ’cancer screening’, ’information’, ’attitude’, ’behavior’, ’awareness’ and ’Turkey’ were. Criteria for inclusion in the analysis were; conducted in Turkey, original and cross-sectional, conducted CRC risky groups (having CRC in the first degree patients and 50 and above age), studies that give the number of participants and number of taking FOBT and CS screening in any period of their lives and/or the number of knowing them. The studies that met the criteria were read as double blind. The data were entered into the Open Meta Analyst demo program. Because of p < 0.001 in the heterogeneity test, random effects model was used in group analysis of the articles. The proportion and 95% confidence interval of knowing and taking FOBT and CS were calculated from the total number of cases. Results A total of 1176 articles were reached in first review. Duplications and inappropriated studies were eliminated, and 52 studies were selected. Eight studies about recognition FOBT, 16 about participation FOBT, 9 about recognition CS and 17 about participation CS were taken in analysis. After analysis it was found that 1315 of 4334 individuals (19.3%, 95%CI:6.6-32.1) recognized to FOBT, 1174 of 6825 individuals (13.2%, 8.0-18.5) participated to FOBT, 2197 of 5728 individuals (31.7%, 18.2-45.2) recognized to CS and 913 of 8860 individuals (10.0%, 8.1-12.0) participated to CS. Conclusions The proportion of recognition and participation to FOBT and CS were found less than expected. Key messages The proportion of recognition and participation CRC screening methods is low in risky groups. Awareness and participation of screening should be increased in risky groups.

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Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

Allergy Asthma & Clinical Immunology ◽

10.1186/s13223-021-00613-7 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Saad Alhumaid ◽

Abbas Al Mutair ◽

Zainab Al Alawi ◽

Ali A. Rabaan ◽

Raghavendra Tirupathi ◽

...

Keyword(s):

Systematic Review ◽

Controlled Trial ◽

Meta Analysis ◽

Case Series ◽

Incidence Rates ◽

Effect Sizes ◽

Cross Sectional ◽

Randomized Controlled ◽

Pooled Prevalence ◽

History Of

Abstract Background Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. Objectives To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p = < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p = < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. Conclusion The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination.

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Effect of HIV Infection on Mortality in Patients with Tuberculosis in Asia: A Meta-Analysis

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.01.52 ◽

2020 ◽

Author(s):

Liza Laela Abida ◽

◽

Bhisma Murti ◽

Hanung Prasetya ◽

◽

...

Keyword(s):

Hiv Infection ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Cross Sectional ◽

Risk Of Mortality ◽

Hiv Mortality ◽

Keywords Hiv

ABSTRACT Background: TB/HIV coinfectioned remains the leading cause of mortality among people living with HIV (PLHIV). The purpose of this study was to explore the effect of HIV infection on mortality in patients with tuberculosis in Asia. Subjects and Method: This was meta-analysis and systematic review. The study was conducted by collecting published studies from Google Scholar, PubMed, Springer Link, Hindawi, Clinical Key, and ProQuest databases, from 2010 to 2020. Keywords used “HIV” AND “mortality” OR “HIV Mortality” OR “Tuberculosis Mortality” AND “cross sectional” AND “adjusted odd ratio”. The inclusion criteria were full text, using English or Indonesian language, using cross-sectional study design, and reporting adjusted odds ratio. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using random effect model run on Review Manager 5.3. Results: 5 studies in Asia (Thailand, China, Malaysia, and Oman) were included for this study. Meta analysis study reported that HIV elevated the risk of mortality in patients with tuberculosis (aOR= 3.45; 95% CI= 1.14 to 10.45; p = 0.030). Conclusion: HIV elevates the risk of mortality in patients with tuberculosis. Keywords: HIV, mortality, Tuberculosis Correspondence: Liza Laela Abida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085640115633. DOI: https://doi.org/10.26911/the7thicph.01.52

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Efficacy and safety of tocilizumab in the management of COVID-19: A systematic review and meta-analysis of observational studies

10.1101/2021.01.27.21250599 ◽

2021 ◽

Author(s):

Gollapalle L Viswanatha ◽

CH K V L S N Anjana Male ◽

Hanumanthappa Shylaja

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Standard Of Care ◽

Efficacy And Safety ◽

Risk Of Mortality ◽

Significant Difference ◽

Newcastle Ottawa Scale ◽

Soc Control ◽

Ottawa Scale

AbstractBackgroundThis systematic review and meta-analysis was aimed to evaluate the efficacy and safety of tocilizumab (TCZ) in treating severe coronavirus disease 2019 (COVID-19).MethodsThe electronic search was performed using PubMed, Scopus, CENTRAL, and Google scholar to identify the retrospective observational reports. The studies published from 01 January 2020 to 30th September 2020. Participants were hospitalized COVID-19 patients. Interventions included tocilizumab versus placebo/standard of care. The comparison will be between TCZ versus standard of care (SOC)/placebo. Inconsistency between the studies was evaluated with I2 and quality of the evidences were evaluated by Newcastle-Ottawa scale.ResultsBased on the inclusion criteria there were 24 retrospective studies involving 5686 subjects were included. The outcomes of the meta-analysis have revealed that the TCZ has reduced the mortality (M-H,RE-OR −0.11(−0.18 to −0.04) 95% CI, p =0.001, I2 =88%) and increased the incidences of super-infections (M-H, RE-OR 1.49(1.13 to 1.96) 95% CI, p=0.004, I2=47%). However, there is no significant difference in ICU admissions rate (M-H, RE-OR −0.06(−0.23 to 0.12), I2=93%), need of MV (M-H, RE-OR of 0.00(−0.06 to 0.07), I = 74%), LOS (IV −2.86(−0.91 to 3.38), I2=100%), LOS-ICU (IV: −3.93(−12.35 to 4.48), I2=100%), and incidences of pulmonary thrombosis (M-H, RE-OR 1.01 (0.45 to 2.26), I2=0%) compared to SOC/control.ConclusionBased on cumulative low to moderate certainty evidence shows that TCZ could reduce the risk of mortality in hospitalized patients. However, there is no statistically significant difference observed between the TCZ and SOC/control groups in other parameters.

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Sex Differences in Presentation of Stroke: A Systematic Review and Meta-Analysis

Stroke ◽

10.1161/strokeaha.120.034040 ◽

2021 ◽

Author(s):

Mariam Ali ◽

Hendrikus J.A. van Os ◽

Nelleke van der Weerd ◽

Jan W. Schoones ◽

Martijn W. Heymans ◽

...

Keyword(s):

Systematic Review ◽

Sex Differences ◽

Acute Stroke ◽

Transient Ischemic Attack ◽

Controlled Trial ◽

Meta Analysis ◽

Neurological Symptoms ◽

Cross Sectional ◽

Ischemic Attack ◽

Meta Analyses

Background and Purpose: Women have worse outcomes than men after stroke. Differences in presentation may lead to misdiagnosis and, in part, explain these disparities. We investigated whether there are sex differences in clinical presentation of acute stroke or transient ischemic attack. Methods: We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Inclusion criteria were (1) cohort, cross-sectional, case-control, or randomized controlled trial design; (2) admission for (suspicion of) ischemic or hemorrhagic stroke or transient ischemic attack; and (3) comparisons possible between sexes in ≥1 nonfocal or focal acute stroke symptom(s). A random-effects model was used for our analyses. We performed sensitivity and subanalyses to help explain heterogeneity and used the Newcastle-Ottawa Scale to assess bias. Results: We included 60 studies (n=582 844; 50% women). In women, headache (pooled odds ratio [OR], 1.24 [95% CI, 1.11–1.39]; I 2 =75.2%; 30 studies) occurred more frequently than in men with any type of stroke, as well as changes in consciousness/mental status (OR, 1.38 [95% CI, 1.19–1.61]; I 2 =95.0%; 17 studies) and coma/stupor (OR, 1.39 [95% CI, 1.25–1.55]; I 2 =27.0%; 13 studies). Aspecific or other neurological symptoms (nonrotatory dizziness and non-neurological symptoms) occurred less frequently in women (OR, 0.96 [95% CI, 0.94–0.97]; I 2 =0.1%; 5 studies). Overall, the presence of focal symptoms was not associated with sex (pooled OR, 1.03) although dysarthria (OR, 1.14 [95% CI, 1.04–1.24]; I 2 =48.6%; 11 studies) and vertigo (OR, 1.23 [95% CI, 1.13–1.34]; I 2 =44.0%; 8 studies) occurred more frequently, whereas symptoms of paresis/hemiparesis (OR, 0.73 [95% CI, 0.54–0.97]; I 2 =72.6%; 7 studies) and focal visual disturbances (OR, 0.83 [95% CI, 0.70–0.99]; I 2 =62.8%; 16 studies) occurred less frequently in women compared with men with any type of stroke. Most studies contained possible sources of bias. Conclusions: There may be substantive differences in nonfocal and focal stroke symptoms between men and women presenting with acute stroke or transient ischemic attack, but sufficiently high-quality studies are lacking. More studies are needed to address this because sex differences in presentation may lead to misdiagnosis and undertreatment.

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Waterpipe Use Prevalence Rate in Turkey: A Meta-analysis Study

European Journal of Public Health ◽

10.1093/eurpub/ckz186.638 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

S Aydoğan ◽

H Aygar ◽

M F Önsüz ◽

S Metintas

Keyword(s):

University Students ◽

Prevalence Rate ◽

Meta Analysis ◽

Group Analysis ◽

Cochrane Library ◽

Inclusion Criteria ◽

Community Based ◽

Double Blind ◽

Cross Sectional ◽

Waterpipe Use

Abstract Background The aim of the study was to perform a meta-analysis of studies about the waterpipe use prevalence in Turkey. Methods PubMed, Web of Science, Turkey Citation Index, TR Index and the Cochrane Library databases were screened both in Turkish and English languages to identify relevant studies by using keywords ’waterpipe use’, ’prevalence’ and ’Turkey’. Inclusion criteria; original and cross-sectional design, studies that done during and after the year 2010, studies that given the number of participants and number of people using waterpipe and studies that done in Turkey. Open Meta Analyst demo program was used to calculate the prevalence rate of the study groups. Since the articles were p < 0.001 in the heterogeneity test, prevalence rate and 95% confidence intervals were calculated from the number of cases using the random effects model in group analysis. Results As a result of first literature review 26 articles were reached. Duplications were eliminated and summaries of the remaining articles were read as double-blind. Ten studies were included in the study that were suitable for inclusion criteria and quality evaluation. Seven of the studies were conducted only in university students, while 3 were community-based. As a result of the analysis, 2399 of 8845 university students used waterpipe (31.0%; 95% CI: 27.3-34.7), while 356 of the 33,129 individuals used waterpipe (1.2%; 95% CI: 0.04-2.0) in community-based studies. Conclusions As a result of the comprehensive literature research, it was found that the studies on waterpipe use were less in literature and prevalence was higher than expected in university students. Key messages In university students, the use of waterpipe was more common than the community, and intervention studies about the use of waterpipe were needed. Waterpipe use and surveillance studies in the communities are important for taking preventive measures and monitoring health outcomes.

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Male Circumcision and Risk of HIV Transmission from Male to Women

Medicine Today ◽

10.3329/medtoday.v28i1.30967 ◽

2017 ◽

Vol 28 (1) ◽

pp. 22-26

Author(s):

Parveen Ahmed ◽

GM Farid ◽

Tania Afroz

Keyword(s):

Male Circumcision ◽

Large Scale ◽

Hiv Transmission ◽

Controlled Trial ◽

Meta Analysis ◽

Male Partner ◽

Cross Sectional Study ◽

Qualitative Synthesis ◽

Cross Sectional ◽

Female Sexual Partner

Male circumcision has proved to be protective for male to male HIV transmission. The effect of male circumcision on female partner's HIV status is still uncertain from previous studies. This systematic review aimed to assess whether circumcision status of an HIV-infected male changes the risk of HIV transmission to his female sexual partner. We analyzed findings from one randomized controlled trial and 4 cross sectional study and found no significant evidence in support of our hypothesis that male circumcision prevents HIV transmission in female. Due to high methodological and clinical heterogeneity, meta-analysis was not done. Qualitative synthesis revealed lack of existing good quality study to address this question. Four of five studies reported no association between male circumcision and HIV transmission. One cohort study reported protective effect of male circumcision on their female partner's HIV. Only one subpopulation of RCT (resume to sexual activity before wound healing) reported increased HIV transmission in female whose male partner is circumcised. Effect of male circumcision on HIV transmission is still blurred. Large scale randomized trial is needed to answer this question. Until then, the prevention programs should also emphasize other measures of HIV transmission.Medicine Today 2016 Vol.28(1): 22-26

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