Burden of Congenital Rubella Syndrome (CRS) in Bangladesh: Systematic Review of Existing Literature and Transmission Modelling of Seroprevalence Studies

Background and Objectives: Congenital Rubella Syndrome (CRS) is the leading cause of vaccine-preventable congenital anomalies. Comprehensive country-level data on the burden of CRS in low and middle-income countries, such as Bangladesh, are scarce. This information is essential for assessing the impact of rubella vaccination programs. We aim to systematically review the literature on the epidemiology of CRS and estimate the burden of CRS in Bangladesh. Methods: We conducted a systematic review of existing literature and transmission modelling of seroprevalence studies to estimate the pre-vaccine period burden of CRS in Bangladesh. OVID Medline (1948 – 23 November 2016) and OVID EMBASE (1974 – 23 November 2016) were searched using a combination of the database-specific controlled vocabulary and free text terms. We used an age-stratified deterministic model to estimate the pre-vaccination burden of CRS in Bangladesh. Findings: Ten articles were identified, published between 2000 and 2014, including seven crosssectional studies, two case series and one analytical case-control study. Rubella seropositivity ranged from 47.0% to 86.0% among all age population. Rubella sero–positivity increased with age. Rubella seropositivity among women of childbearing age was 81.0% overall. The estimated incidence of CRS was 0·99 per 1,000 live births, which corresponds to approximately 3,292 CRS cases annually in Bangladesh. Conclusion: The estimated burden of CRS in Bangladesh during the pre-vaccination period was high. This will provide important baseline information to assess the impact and cost-effectiveness of routine rubella immunisation, introduced in 2012 in Bangladesh.

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The seroepidemiology of rubella in western Europe

Epidemiology and Infection ◽

10.1017/s0950268899004574 ◽

2000 ◽

Vol 125 (2) ◽

pp. 347-357 ◽

Cited By ~ 42

Author(s):

R. G. PEBODY ◽

W. J. EDMUNDS ◽

M. CONYN-van SPAENDONCK ◽

P. OLIN ◽

G. BERBERS ◽

...

Keyword(s):

General Population ◽

The Netherlands ◽

Western Europe ◽

Age Groups ◽

Congenital Rubella Syndrome ◽

Childbearing Age ◽

Immunization Programme ◽

Congenital Rubella ◽

The Impact ◽

Selective Vaccination

Most of the countries in western Europe have now implemented mass infant rubella immunization programmes, instead of or in addition to selective vaccination in order to achieve the elimination of congenital rubella syndrome.The European countries Denmark, England and Wales, Finland, France, Germany, Italy and the Netherlands undertook large, national serological surveys collecting several thousand serum specimens during 1994–8. Antibodies against rubella virus were detected by a variety of enzyme immuno-assays. Comparability of the assay results was achieved by a standardized methodology. The age- and sex-stratified serological results were related to the schedules, coverage of rubella vaccination and the incidence in these countries.The results show widely differing levels of immunity to rubella both in the general population and in the specific age groups of males and females. A low rate (< 5%) of susceptibles in childhood and adolescents of both sexes was obtained only in Finland and the Netherlands.Countries such as Italy with only moderate coverage for the infant immunization programme currently have both high susceptibility levels in the general population and in the at-risk population. The likelihood is of continued epidemics of rubella with cases of congenital rubella syndrome. The continued implementation of selective vaccination will help to offset the impact of this ongoing transmission and to protect women on reaching childbearing age.

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Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review

International Journal for Equity in Health ◽

10.1186/s12939-021-01388-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sofia Segura-Pérez ◽

Amber Hromi-Fiedler ◽

Misikir Adnew ◽

Kate Nyhan ◽

Rafael Pérez-Escamilla

Keyword(s):

Public Health ◽

Systematic Review ◽

Women Of Color ◽

Controlled Vocabulary ◽

Minority Women ◽

Community Level ◽

Free Text ◽

Socioecological Model ◽

The Impact ◽

The U.S

Abstract Background In the U.S., strong ethnic/racial, socioeconomic, demographic, and geographic breastfeeding (BF) inequities persist, and African American and Hispanic women are less likely to meet their breastfeeding goals compared to White women. This systematic review (SR) was designed to answer the question: What is the impact of breastfeeding interventions targeting ethnic/racial minority women in the U.S. on improving BF initiation, duration and exclusivity rates? Methods The SR was conducted following the Institute of Medicine Guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The study protocol was developed and registered a priori in PROSPERO (ID#CRD42020177764). The electronical databases searched was MEDLINE All (Ovid). Search strategies were led by the team’s expert public health librarian using both controlled vocabulary and free text queries and were tested against a validated set of relevant papers included in existing reviews. The GRADE methodology was used to assess the quality of the studies. Results We included 60 studies that had randomized (n = 25), observational (n = 24), quasi-experimental (n = 9), or cross-sectional (n = 2) designs. The studies focused on populations that were multi-ethnic/racial (n = 22), only Hispanic (n = 24), only Black (n = 13), and only American Indian (n = 1). The study interventions were classified following the socioecological model: macrosystem/policy level (n = 6); community level (n=51), which included healthcare organizations (n = 34), The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (n = 9), and community organizations/public health institutions (n = 8); and interpersonal level (n = 3). Conclusions Policy and community level interventions delivered through WIC, healthcare facilities, and community agencies) are likely to improve BF outcomes among women of color. The combination of interventions at different levels of the socioecological model has not been studied among minority women in the U.S. Implementation science research is needed to learn how best to scale up and sustain effective BF interventions, taking into account the needs and wants of minority women. Thus, it is strongly recommended to conduct large scale implementation research studies addressesing how to strengthen the different health and social environments surrounding women of color in the U.S. to improving their BF outcomes.

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Evaluating Efﬁcacy and Safety of Intradermal Delivery of Vaccines through Microneedle(s) in Animals: Systematic Review Protocol (Preprint)

10.2196/preprints.29400 ◽

2021 ◽

Author(s):

Ishumeet Kaur Bajwa ◽

Navneet Kaur ◽

Joseph L. Mathew

Keyword(s):

Systematic Review ◽

Animal Models ◽

Risk Of Bias ◽

Controlled Vocabulary ◽

Free Text ◽

Efficacy And Safety ◽

Systematic Review Protocol ◽

Intradermal Delivery ◽

Review Protocol ◽

Intradermal Route

BACKGROUND Microneedles are defined as micron-sized projections that create microscopic holes to the skin on application so that drug molecules can penetrate across the outer layers of the skin into the dermis or deeper. Skin is a natural barrier for defense against invading pathogens. Additionally, the dermis possesses dendritic cells that are efficient for antigen presentation and initiating the cascade of immunogenic responses leading to antibody production. Therefore, intradermal delivery of vaccine antigens could be a safe and less invasive alternative for vaccine delivery compared with conventional intramuscular injection. OBJECTIVE We intend to undertake a systematic review of the literature to evaluate the efficacy and safety of intradermal delivery of vaccines using microneedles in animal models. METHODS In this systematic review, we will consider all study designs evaluating the safety and/or efﬁcacy of intradermal delivery of vaccines using microneedles in animal models. Our search strategy will include free text terms and controlled vocabulary for, “microneedle”, “vaccine”, and “intradermal”. We will search literature through PubMed, Embase, Cochrane, and OpenGrey, and we will not have language or date limits. Two review authors will independently select eligible studies and assess the risk of bias using the SYRCLE’s tool particularly for controlled studies and OHAT Risk of Bias Rating Tool for case studies, case-control studies, non-randomized studies, and cohort studies, and CAMARADES checklist to appraise the quality of the included studies. We will report structured summaries of the included studies and, if possible, conduct meta-analyses. The primary outcome to be measured is the efficacy of vaccine delivered through an intradermal route using microneedle(s) such as parameters of immunogenicity (for example antibody levels), sero-efficacy (for example sero-conversion), protective efficacy, etc. Secondary outcomes would include the safety of vaccines delivered through the intradermal route. This could include parameters to identify and/or quantify the timing and nature of local reactions, bleeding, systemic reactions, and death. Pain response during vaccination delivered through the intradermal route will also be evaluated. RESULTS This is a protocol for a systematic review; therefore, results are not available. CONCLUSIONS This is the first systematic review protocol aiming to assess the evidence on the efficacy and safety of intradermal delivery of vaccines using microneedles in various animal models. The findings will inform the safety and efficacy of intradermal delivery of vaccines in animal models, with the overall goal of considering the method for human vaccination as well. The results of this study will be published in a peer-reviewed journal. CLINICALTRIAL PROSPERO CRD42021236625

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Neurological associations of SARS-CoV-2 infection: A Systematic Review

CNS & Neurological Disorders - Drug Targets ◽

10.2174/1871527320666210216121211 ◽

2021 ◽

Vol 20 ◽

Author(s):

Amaan Javed

Keyword(s):

Systematic Review ◽

Case Reports ◽

Case Series ◽

Severe Infection ◽

Cerebrovascular Diseases ◽

Controlled Vocabulary ◽

Cochrane Central Register ◽

Post Traumatic Stress ◽

Medical Subject Headings ◽

Reported Data

Background: The current ongoing COVID-19 pandemic has compelled us to scrutinize major outbreaks in the past two decades, severe acute respiratory syndrome (SARS), in 2002, and Middle East respiratory syndrome (MERS), in 2012. We aimed to assess the associated neurological manifestations with SARS CoV-2 infection. Methods: In this systematic review, a search was carried out by key-electronic databases, controlled vocabulary, and indexing of trials to evaluate the available pertinent studies which included both medical subject headings (MeSH) and advance electronic databases comprising of PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL). Peer-reviewed studies published in English and Spanish were considered which reported data on the neurological associations of individuals with suspected or laboratory-confirmed SARS-CoV-2 infection. Outcomes were nervous signs or symptoms; symptom severity; and diagnoses. Findings: Our search identified 45 relevant studies, with 21 case reports, 3 case series, 9 observational studies, 1 retrospective study, 9 retrospective reviews, and 2 prospective reviews. This systematic review revealed that most commonly reported neuronal presentations involved headache, nausea, vomiting and muscular symptoms like fibromyalgia. Anosmia and ageusia, defects in clarity or sharpness of vision (error in visual acuity), and pain may occur in parallel. Notable afflictions in the form of anxiety, anger, confusion, post-traumatic stress symptoms, and post-intensive care syndrome were observed in individuals who were kept in quarantine and those with long-stay admissions in healthcare settings. SARS CoV-2 infection may result in cognitive impairment. Patients with more severe infection exhibited uncommon manifestations, such as acute cerebrovascular diseases (intracerebral haemorrhage, stroke), rhabdomyolysis, encephalopathy, Guillain-Barré syndrome. Interpretation: SARS-CoV-2 patients experience neuronal presentations varying with the progression of the infection. Healthcare professionals should be acquainted with the divergent neurological symptoms and to curb misdiagnosis and limit long term sequelae. Health-care planners and policymakers must prepare for this eventuality, while the ongoing studies increase our knowledge base on acute and chronic neurological associations of this pathogen.

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The effects of hip- and ankle-focused exercise intervention on dynamic knee valgus: a systematic review

PeerJ ◽

10.7717/peerj.11731 ◽

2021 ◽

Vol 9 ◽

pp. e11731

Author(s):

Farhah Nadhirah Aiman Sahabuddin ◽

Nazatul Izzati Jamaludin ◽

Nurul Hidayah Amir ◽

Shazlin Shaharudin

Keyword(s):

Systematic Review ◽

Knee Joint ◽

Intervention Program ◽

Exercise Intervention ◽

Free Text ◽

Knee Valgus ◽

Top Down ◽

Bottom Up ◽

Limb Injuries ◽

The Impact

Background A range of non-contact injuries such as anterior cruciate ligament tear, and patellofemoral pain syndrome are caused by disordered knee joint loading from excessive dynamic knee valgus (DKV). Previous systematic reviews showed that DKV could be modified through the influence of hip strength and ankle range of motion. Therefore, the purpose of this systematic review was to examine the effects of exercise intervention which involved either top-down or bottom-up kinetic chains on minimizing DKV in male and female adults and adolescents, with and without existing knee pain. Methodology Electronic searches were conducted in SAGE, Science Direct, SCOPUS, and Pubmed. The search strategy consisted of medical subject headings and free-text search keywords, synonyms and variations of ‘exercise intervention,’ ‘knee alignment,’ ‘dynamic knee valgus’, ‘knee abduction’ that were merged via the Boolean operator ‘AND’ and ‘OR’. The search was conducted on full-text journals that documented the impact of the exercise intervention program involving either the bottom-up or top-down DKV mechanism on the knee kinematics. Furthermore, exercise intervention in this review should last at least one week which included two or three sessions per week. This review also considered both men and women of all ages with a healthy or symptomatic knee problem. The risk of bias of the included studies was assessed by Cochrane risk assessment tool. The protocol of this review was registered at PROSPERO (registration number: CRD42021219121). Results Ten studies with a total of 423 participants (male = 22.7%, female = 77.3%; adults = 249, adolescents = 123; pre-adolescent = 51) met the inclusion criteria of this review. Seven studies showed the significant effects of the exercise intervention program (range from two weeks to ten weeks) on reducing DKV. The exercise training in these seven studies focused on muscle groups directly attached to the knee joint such as hamstrings and gastrocnemius. The remaining three studies did not show significant improvement in DKV after the exercise intervention (range between eight weeks to twelve weeks) probably because they focused on trunk and back muscles instead of muscles crossing the knee joint. Conclusion Exercises targeting specific knee-joint muscles, either from top-down or bottom-up kinetic chain, are likely to reduce DKV formation. These results may assist athletes and coaches to develop effective exercise program that could minimize DKV and ultimately prevent lower limb injuries.

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Association of TB treatment with pregnancy complications: A Systematic Review and Meta-analysis Protocol

10.21203/rs.3.rs-274069/v1 ◽

2021 ◽

Author(s):

Stefanie Johanna Maria Kruger ◽

WENDY PHOSWA

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Pregnancy Complications ◽

Drug Exposure ◽

Research Question ◽

Flow Diagram ◽

Cochrane Library ◽

Free Text ◽

Tb Treatment ◽

The Impact

Abstract Introduction: Tuberculosis is a worldwide health risk factor, especially among immunocompromised groups such as in pregnant women. Diagnosis for TB is complex and appropriate initiation of treatment must be timely and cannot be postponed. This systematic review aims to assess the impact of TB drug exposure linked with pregnancy complications.Methods: Electronic databases (PubMed, Google Scholar, Elsevier and the Cochrane Library) will be screened that covers original articles published from 2010 to 2020, using medical subject headings (MeSH) and free text searches. Population study of TB-infected pregnant women with control being non-infected pregnant women, defined by maternal age between 15 ≤ 44 years, which reported pregnancy outcomes after exposure to TB treatment during pregnancy will be included. PICOS for research question eligibility, PRISMA-P guidelines and flow diagram will be adhered to and assessed by two independent reviewers. Software manager Zotero v5.0.81 will be used to eliminate duplicates and assess eligibility criteria.Ethics and dissemination: We anticipate finding a large number of studies reporting on the impact of TB drugs on the incidence of pregnancy complications which, once summarised, will be useful to establishing the link between TB drugs and pregnancy complications induced by these drugs. The protocol for the systematic review will be registered in PROSPERO. The study will be disseminated electronically and in print. It will also be presented to conferences related to TB and pregnancy.Trial registration: PROSPERO CRD42021226233; Registered on 14 January 2021

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Hepatitis C and pregnancy outcomes: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-024288 ◽

2018 ◽

Vol 8 (12) ◽

pp. e024288 ◽

Cited By ~ 1

Author(s):

Stephanie Parent ◽

Kate Salters ◽

Lindila Awendila ◽

Lianping Ti

Keyword(s):

Systematic Review ◽

Hepatitis C ◽

Gestational Diabetes ◽

Pregnancy Outcomes ◽

Cochrane Library ◽

Childbearing Age ◽

Hcv Treatment ◽

Conference Abstract ◽

Hcv Transmission ◽

The Impact

IntroductionMany women living with hepatitis C (HCV) are of childbearing age. While the risk of vertical HCV transmission has been well established, the impact of HCV on pregnancy outcomes are equivocal, with some studies reporting risks of preterm birth, low gestational weight, gestational diabetes and hypertension, while other studies report no such risks. With the shift of the HCV treatment landscape to more effective, tolerable and shorter medications, understanding pregnancy outcomes of women living with HCV are an important consideration in order to provide a baseline from which to consider the usefulness and safety of HCV treatment for this population. The objective of this systematic review will be to investigate pregnancy outcomes associated with maternal HCV infection.Methods and analysisThis systematic review will incorporate articles relevant to pregnancy outcomes among women living with HCV (eg, gestational diabetes and caesarean delivery). Articles will be retrieved from academic databases including MEDLINE, EMBASE, CINAHL, clinicaltrial.gov and the Cochrane Library and hand searching of conference proceedings and reference lists. A database search will not be restricted by date, and conference abstract will be restricted to the past 2 years. The Newcastle-Ottawa Quality Assessment Scale will be used to assess the quality of the retrieved studies. Data will be extracted and scored independently by two authors. A narrative account will synthesise the findings to answer the objectives of this review.Ethics and disseminationThis systematic review will synthesise the literature on the pregnancy outcomes of women living with HCV. Results from this review will be disseminated to clinical audiences, community groups and policy-makers, and may support clinicians and decision-makers in developing guidelines to promote best outcomes for this population.

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The impact of decision aids in patients with colorectal cancer: a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-028379 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028379 ◽

Cited By ~ 4

Author(s):

Jenaya Goldwag ◽

Priscilla Marsicovetere ◽

Peter Scalia ◽

Heather A Johnson ◽

Marie-Anne Durand ◽

...

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Cancer Treatment ◽

Data Extraction ◽

Decision Aids ◽

Case Series ◽

Cochrane Library ◽

Eligibility Criteria ◽

The Impact ◽

Colorectal Cancer Treatment

ObjectivesOur aim was to conduct a systematic review of the literature to determine the impact of patient decision aids (PDA) on patients facing treatment decisions for colorectal cancer.DesignSystematic review.Data sourcesSources included Embase, Medline, Web of Science, CINAHL and the Cochrane Library from inception to June, 20, 2019.Eligibility criteriaWe included randomised controlled trials (RCTs), cohort studies, mixed methods and case series in which a PDA for colorectal cancer treatment was used. Qualitative studies were excluded from our review.Data extraction and synthesisFollowing execution of the search strategy by a medical librarian, two blinded independent reviewers identified articles for inclusion. Two blinded reviewers were also responsible for data extraction, risk of bias and study quality assessments. Any conflict in article inclusion or extraction was resolved by discussion.ResultsOut of 3773 articles identified, three met our inclusion criteria: one RCT, one before-and-after study and one mixed-method study. In these studies, the use of a PDA for colorectal cancer treatment was associated with increased patient knowledge, satisfaction and preparation for making a decision. On quality assessment, two of three studies were judged to be of low quality.ConclusionA paucity of evidence exists on the effect of PDA for colorectal cancer treatment with existing evidence being largely of low quality. Further investigation is required to determine the effect of decision aids for colorectal cancer treatment as well as reasons for the lack of PDA development and implementation in this area.Prospero registration numberCRD42018095153.

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