scholarly journals BEST DRUG INTERACTION FOR COVID-19 THERAPEUTIC MANAGEMENT: A METANALYSIS

2020 ◽  
Author(s):  
Maria Gabriela Farias ◽  
Wesley Conceição ◽  
María Gutiérrez ◽  
Mariana Pereira ◽  
Carla Daltro ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Experimental Approach ◽  
Meta Analysis ◽  
Mortality Rates ◽  
World Health ◽  
Robust Methods ◽  
Rt Pcr ◽  
Large Hospital ◽  
Randomized Controlled ◽  
Health Organization

Background and Purpose: The Covid-19 is a viral infection classified as a pandemic by the World Health Organization. There is not currently therapy against the Sars-cov-2. We aimed to assess the best drug therapy approach for the management of Covid-19. Experimental Approach: We did a systematic review and meta-analysis of randomized controlled trials of drugs used in patients with Covid-19. We performed research in the PubMed and the Medrxiv. The trials were included if the patients were over 12 years old, diagnosed through the rt-PCR test and who assessed as primary outcomes or decreased mortality, or time to clinical improvement, or hospitalization time. Random-effects meta-analysis was used to pool individual studies. Heterogeneity was assessed using I². The review has been registered on PROSPERO, number 179879. Key Results: Nine trials were included for analysis. Remdesivir, mainly early after the onset of symptoms, led to a reduction in mortality (OR, 0·85; 95% CI, 0·05 to 0·98; P=0·045). Although this meta-analysis did not observe a reduction using dexamethasone, the Recovery Trial indicates that it can be an option for a patient that needs oxygen support. Our study did not demonstrate the efficacy of any treatment to minimize the effects of Covid-19 related to large hospital stay or time to clinical improvement. Conclusion and Implications: Remdesivir is the only drug that can change the course of Covid-19, reducing mortality rates. Despite this result, other studies must evaluate the effectiveness of this and other drugs in the management of Covid-19 mainly studies with robust methods.

A CYCLE THRESHOLD VALUE-BASED EPIDEMIC PROGNOSTICATION TO MONITOR LONG-TERM EPIDEMIOLOGIC TRENDS OF SARS-COV-2 VIRUS

2021 ◽  
pp. 24-30
Author(s):  
Aditi Munmun Sengupta ◽  
Diptendu Chatterjee ◽  
Bibhuti Saha
Keyword(s):  
Meta Analysis ◽  
Threshold Value ◽  
High Viral Load ◽  
World Health ◽  
Rt Pcr ◽  
Cycle Threshold ◽  
Ct Value ◽  
Health Organization ◽  
The Impact

The real-time reverse transcription-polymerase chain reaction (RT-PCR) is considered as the sensitive proof for detecting the viral infection of the SARS-CoV-2 virus obtained from respiratory samples. The quantitative values for the analysis are benecial for estimating the transmissibility of people who test positive for SARS-CoV-2. This can be further achieved by analyzing the samples by semiquantitative means through the interpretation of the cycle threshold (Ct) values of RT-PCR that represent the rst cycle of PCR at which a detectable signal appears during the assays. The Ct value shows a correlation between high viral load and disease infectiousness, which is observed with other respiratory viruses, including the inuenza B infection and rhinovirus infection. Hence, the present study aims to analyze the surveillance of COVID-19 to monitor longer-term epidemiologic trends and trends in deaths due to COVID-19. In order to achieve this aim, the present review was reported to the preferred reporting items for systematic reviews and meta-analysis statements (PRISMA) for analyzing the Ct value-based epidemic predictions and to monitor long-term epidemiologic trends of SARS-CoV-2 virus. Total 33 studies have been nalized for nding out the results of the study. The epidemiologic parameter and a representative of the surveillance data for reporting to the World Health Organization were fullled by analyzing the systematic review and metaanalysis of the selected study. Moreover, the evaluation of the impact of the pandemic on the health care system and society was achieved by analyzing the studies mentioned here.

scholarly journals Digital Education of Health Professionals on the Management of Domestic Violence: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2019 ◽  
Author(s):  
Ushashree Divakar ◽  
Nuraini Nazeha ◽  
Pawel Posadzki ◽  
Krister Jarbrink ◽  
Ram Bajpai ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Health Professionals ◽  
Digital Health ◽  
Meta Analysis ◽  
World Health ◽  
Health Concern ◽  
Digital Education ◽  
Randomized Controlled ◽  
Education Interventions ◽  
Health Organization

BACKGROUND The World Health Organization states that 35% of women experience domestic violence at least once during their lifetimes. However, approximately 80% of health professionals have never received any training on management of this major public health concern. OBJECTIVE The objective of this study was to evaluate the effectiveness of health professions digital education on domestic violence compared to that of traditional ways or no intervention. METHODS Seven electronic databases were searched for randomized controlled trials from January 1990 to August 2017. The Cochrane Handbook guideline was followed, and studies reporting the use of digital education interventions to educate health professionals on domestic violence management were included. RESULTS Six studies with 631 participants met our inclusion criteria. Meta-analysis of 5 studies showed that as compared to control conditions, digital education may improve knowledge (510 participants and 5 studies; standardized mean difference [SMD] 0.67, 95% CI 0.38-0.95; I2=59%; low certainty evidence), attitudes (339 participants and 3 studies; SMD 0.67, 95% CI 0.25-1.09; I2=68%; low certainty evidence), and self-efficacy (174 participants and 3 studies; SMD 0.47, 95% CI 0.16-0.77; I2=0%; moderate certainty evidence). CONCLUSIONS Evidence of the effectiveness of digital education on health professionals’ understanding of domestic violence is promising. However, the certainty of the evidence is predominantly low and merits further research. Given the opportunity of scaled transformative digital education, both further research and implementation within an evaluative context should be prioritized.

scholarly journals Effect of Kangaroo Mother Care on the Likelihood of Breastfeeding from Birth up to 6 Months of Age: A Meta-analysis

2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Angelica Joyce A. Gacutno-Evardone ◽  
Fay S. De Ocampo ◽  
Maria Esterlita T. Villanueva-Uy
Keyword(s):  
Exclusive Breastfeeding ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Kangaroo Mother Care ◽  
World Health ◽  
Randomized Controlled ◽  
Trial Quality ◽  
Breastfeeding Rate ◽  
Health Organization ◽  
Review Manager

Background. One of the World Health Organization (WHO) nutrition target by 2025 is 50% exclusive breastfeeding rate among infants until age 6 months. Kangaroo mother care (KMC) known to increase breastfeeding rates, especially in preterm and low birth weight (LBW) infants. Objectives. This study determined the effect of KMC to the rate of exclusive breastfeeding among preterm and LBW infants at 6 months of age. Methods. Conducted searches in MEDLINE and CENTRAL databases, likewise hand searched local publications December 1996 until June 2018. Included several randomized controlled trials and prospective observational studies comparing KMC and conventional care among preterm and LBW infants. The primary outcome was exclusive breastfeeding of infants at six months of age. Two authors independently assessed trial quality and extracted data the statistical analysis applied using Review Manager version 5.3. Results. Identified nine eligible trials involving 1,202 neonates. All studies had low-to-moderate risk of bias. KMC significantly noted to increase the likelihood of exclusive breastfeeding by 1.9 times at birth up to 6 months (OR 1.93 [1.18,3.17], p=0.009). Conclusion. KMC can increase exclusive breastfeeding among preterm and LBW infants from birth up to 6 months of age.

Interventions to Reduce Alcohol Harms in Low and Middle Income Countries: a Systematic Review and Meta Analysis

2018 ◽  
Author(s):  
Joao Ricardo Nickenig Vissoci
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Randomized Controlled Trials ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Middle Income ◽  
Brief Motivational Intervention ◽  
Randomized Controlled

BackgroundHarmful alcohol use leads to a large burden of disease and disability which disportionately impacts LMICs. The World Health Organization and the Lancet have issued calls for this burden to be addressed, but issues remain, primarily due to gaps in information. While a variety of interventions have been shown to be effective at reducing alcohol use in HICs, their efficacy in LMICs have yet to be assessed. This systematic review describes the current published literature on alcohol interventions in LMICs and conducts a meta analysis of clinical trials evaluating interventions to reduce alcohol use and harms in LMICs.MethodsIn accordance with PRISMA guidelines we searched the electronic databases Pubmed, EMBASE, Scopus,Web of Science, Cochrane, and Psych Info. Articles were eligible if they evaluated an intervention targeting alcohol-related harm in LMICs. After a reference and citation analysis, we conducted a quality assessment per PRISMA protocol. A meta-analysis was performed on the 39 randomized controlled trials that evaluated an alcohol-related outcome.ResultsOf the 3,801 articles from the literature search, 87 articles from 25 LMICs fit the eligibility and inclusion criteria. Of these studies, 39 randomized controlled trials were included in the meta-analysis. Nine of these studies focused specifically on medication, while the others focused on brief motivational intervention, brain stimulation, AUDIT-based brief interventions, WHO ASSIST-based interventions, group based education, basic screening and interventions, brief psychological or counseling, dyadic relapse prevention, group counseling, CBT, motivational + PTSD based interview, and health promotion/awareness. Conclusion Issues in determining feasible options specific to LMICs arise from unstandardized interventions, unequal geographic distribution of intervention implementation, and uncertain effectiveness over time. Current research shows that brain stimulation, psychotherapy, and brief motivational interviews have the potential to be effective in LMIC settings, but further feasibility testing and efforts to standardize results are necessary to accurately assess their effectiveness.

The study of Iranian children and adolescents’ physical activity: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Adel Alizadeh ◽  
Reza Negarandeh ◽  
Fahimehe Bagheri Amiri ◽  
Zahra Yazdani
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
World Health ◽  
Chi Square ◽  
The Status ◽  
Newcastle Ottawa Scale ◽  
Health Organization ◽  
Iranian Children

Abstract Objectives This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents’ physical activity. Content All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I 2 index and chi-square were used to assess the heterogeneity between the results. Summary 490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1–42.8: 95% CI) and also 20.5% of the boys (7.3–33.7: 95% CI). Outlook Overall, this study’s findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.

scholarly journals A living WHO guideline on drugs to prevent covid-19

BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Meta Analysis ◽  
World Health ◽  
Policy And Practice ◽  
Assessment Development ◽  
Research Priority ◽  
Health Organization ◽  
Almost All ◽  
Drug Interventions

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.

scholarly journals Azithromycin Reduction to Reach Elimination of Trachoma (ARRET): study protocol for a cluster randomized trial of stopping mass azithromycin distribution for trachoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdou Amza ◽  
Boubacar Kadri ◽  
Beido Nassirou ◽  
Ahmed M. Arzika ◽  
Ariana Austin ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Clinical Signs ◽  
Cluster Randomized Trial ◽  
World Health ◽  
Baseline Assessment ◽  
Randomized Controlled ◽  
Registration Number ◽  
Cluster Randomized ◽  
Health Organization

Abstract Background The World Health Organization (WHO) recommends annual mass azithromycin distribution until districts drop below 5% prevalence of trachomatous inflammation—follicular (TF). Districts with very low TF prevalence may have little or no transmission of the ocular strains of Chlamydia trachomatis that cause trachoma, and additional rounds of mass azithromycin distribution may not be useful. Here, we describe the protocol for a randomized controlled trial designed to evaluate whether mass azithromycin distribution can be stopped prior to the current WHO guidelines. Methods The Azithromycin Reduction to Reach Elimination of Trachoma (ARRET) study is a 1:1 community randomized non-inferiority trial designed to evaluate whether mass azithromycin distribution can be stopped in districts with baseline prevalence of TF under 20%. Communities in Maradi, Niger are randomized after baseline assessment either to continued annual mass azithromycin distribution or stopping annual azithromycin distribution over a 3-year period. We will compare the prevalence of ocular C. trachomatis (primary outcome), TF and other clinical signs of trachoma, and serologic markers of trachoma after 3 years. We hypothesize that stopping annual azithromycin distribution will be non-inferior to continued annual azithromycin distributions for all markers of trachoma prevalence and transmission. Discussion The results of this trial are anticipated to provide potentially guideline-changing evidence for when mass azithromycin distributions can be stopped in low TF prevalence areas. Trial registration number This study is registered at clinicaltrials.gov (NCT04185402). Registered December 4, 2019; prospectively registered pre-results.

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