scholarly journals HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019

2021 ◽  
Vol 26 (47) ◽  
Author(s):  
Annemarie Rinder Stengaard ◽  
Lauren Combs ◽  
Virginie Supervie ◽  
Sara Croxford ◽  
Sarika Desai ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Sex Workers ◽  
Hiv Prevalence ◽  
Cochrane Library ◽  
European Economic Area ◽  
Key Populations ◽  
Transgender People ◽  
Population Groups ◽  
Key Population

Background In Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level. Aim We assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom. Methods We conducted a systematic literature review of peer-reviewed studies published during 2009–19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies. Results Eighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4–29.0% (19 countries) and PWID, from 0.0–59.5% (13 countries). Prevalence ranged from 0.0–15.6% in prisoners (nine countries), 1.1–8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence. Conclusion This review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.

scholarly journals HIV and STI positivity rates among transgender people attending two large STI clinics in the Netherlands

2021 ◽  
pp. sextrans-2020-054875
Author(s):  
Susanne Drückler ◽  
Ceranza Daans ◽  
Elske Hoornenborg ◽  
Henry De Vries ◽  
Martin den Heijer ◽  
...  
Keyword(s):  
The Netherlands ◽  
Gender Identity ◽  
Sex Work ◽  
Sexual Behaviour ◽  
Sex Workers ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
Gender Identities ◽  
Transgender People ◽  
Sexually Transmitted

BackgroundGlobal data show that transgender people (TGP) are disproportionally affected by HIV and sexually transmitted infections (STIs); however, data are scarce for Western European countries. We assessed gender identities, sexual behaviour, HIV prevalence and STI positivity rates, and compared these outcomes between TGP who reported sex work and those who did not.MethodsWe retrospectively retrieved data from all TGP who were tested at the STI clinics of Amsterdam and The Hague, the Netherlands in 2017–2018. To identify one’s gender identity, a ‘two-step’ methodology was used assessing, first, the assigned gender at birth (assigned male at birth (AMAB)) or assigned female at birth), and second, clients were asked to select one gender identity that currently applies: (1) transgender man/transgender woman, (2) man and woman, (3) neither man nor woman, (4) other and (5) not known yet. HIV prevalence, bacterial STI (chlamydia, gonorrhoea and/or infectious syphilis) positivity rates and sexual behaviour were studied using descriptive statistics.ResultsTGP reported all five categories of gender identities. In total 273 transgender people assigned male at birth (TGP-AMAB) (83.0%) and 56 transgender people assigned female at birth (TGP-AFAB) (17.0%) attended the STI clinics. Of TGP-AMAB, 14,6% (39/267, 95% CI 10.6% to 19.4%) were HIV-positive, including two new diagnoses and bacterial STI positivity was 15.0% (40/267, 95% CI 10.9% to 19.8%). Among TGP-AFAB, bacterial STI positivity was 5.6% (3/54, 95% CI 1.2% to 15.4%) and none were HIV-positive. Sex work in the past 6 months was reported by 53.3% (137/257, 95% CI 47.0% to 59.5%) of TGP-AMAB and 6.1% (3/49, 95% CI 1.3% to 16.9%) of TGP-AFAB. HIV prevalence did not differ between sex workers and non-sex workers.ConclusionOf all TGP, the majority were TGP-AMAB of whom more than half engaged in sex work. HIV prevalence and STI positivity rates were substantial among TGP-AMAB and much lower among TGP-AFAB. Studies should be performed to provide insight into whether the larger population of TGP-AMAB and TGP-AFAB are at risk of HIV and STI.

scholarly journals 1468. Culture Conversion and Mortality in Patients With Mycobacterium abscessus (MAB) Lung Disease: A Systematic Literature Review

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S736-S736
Author(s):  
Kevin L Winthrop ◽  
Kevin C Mange ◽  
Zhanna Jumadilova ◽  
Kristan B Cline ◽  
Patrick A Flume
Keyword(s):  
Literature Review ◽  
Lung Disease ◽  
Systematic Literature Review ◽  
Panel Member ◽  
Cochrane Library ◽  
Attributable Mortality ◽  
Research Support ◽  
Persistent Symptoms ◽  
Conversion Rates ◽  
Culture Conversion

Abstract Background Prognosis for patients with MAB lung disease is poor. We sought to examine the potential association between culture conversion and outcomes (progression, mortality) in patients with MAB lung disease. Methods English-language MAB lung disease studies with ≥ 10 patients and reporting mortality and/or microbiological outcomes were identified from Embase, PubMed, relevant congress abstracts, and the Cochrane Library (data cutoff, September 24, 2019) using the National Institute for Health and Clinical Excellence guidance for systematic literature reviews. Two independent reviewers screened 1,551 indexed records; relevant extracted data are expressed as population-weighted means. Results Mean all-cause mortality across 17 studies (N=1,291) was 12.1% (range, 3%–33%); mortality attributable to MAB lung disease was 7.6% (range, 0%–27%; N=526, 9 studies). Culture conversion across 44 studies (N=2,237) was 46.7% (range, 0%–98.6%), with higher rates reported for M. massiliense subspecies (76.9%; N=507,15 studies) than M. abscessus subspecies (35.8%; N=834,18 studies). No direct comparisons were made between mortality and culture conversion; in the 13 studies (N=1,202) that reported both outcomes there was a moderate correlation between increased rate of culture conversion and decreased MAB-attributable mortality (R2=0.60). The most common definition of progression (21 studies) was radiographic worsening supported by persistent symptoms and/or positive cultures. Across 8 studies (N=415) 57.8% patients had improvement while 35.2% progressed with treatment. A broad variance in treatment regimen and duration (range, 32 days to > 3 years) was observed. Limitations include a small number of studies, and inconsistency in methods and outcomes definitions. Conclusion In this systematic literature review, available data suggest that culture conversion was achieved in less than half of patients and was lower in patients with M. abscessus compared with M. massiliense. One third of patients had disease progression despite treatment. Some data suggest lower MAB-attributed mortality outcomes in studies with higher culture conversion rates, more evidence is needed to demonstrate a survival benefit associated with culture conversion. Disclosures Kevin L Winthrop, MD, MPH, Insmed Incorporated (Consultant, Grant/Research Support) Kevin C Mange, MD, MSCE, Insmed Incorporated (Employee) Zhanna Jumadilova, MD, Insmed Incorporated (Employee) Kristan B Cline, PhD, Insmed Incorporated (Employee) Patrick A Flume, MD, Insmed Incorporated (Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member)

Arachnoid web of the spine: a systematic literature review

2019 ◽  
Vol 31 (2) ◽  
pp. 175-184 ◽  
Author(s):  
Peyton L. Nisson ◽  
Ibrahim Hussain ◽  
Roger Härtl ◽  
Samuel Kim ◽  
Ali A. Baaj
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Thoracic Spine ◽  
Case Reports ◽  
Neurological Function ◽  
Sensory Loss ◽  
Cochrane Library ◽  
Radiographic Findings ◽  
Ovid Medline ◽  
The Mean

OBJECTIVEAn arachnoid web of the spine (AWS) is a rare and oftentimes challenging lesion to diagnose, given its subtle radiographic findings. However, when left untreated, this lesion can have devastating effects on a patient’s neurological function. To date, only limited case reports and series have been published on this topic. In this study, the authors sought to better describe this lesion, performing a systematic literature review and including 2 cases from their institution’s experience.METHODSA systematic literature search was performed in September 2018 that queried Ovid MEDLINE (1946–2018), PubMed (1946–2018), Wiley Cochrane Library: Central Register of Controlled Trials (1898–2018), and Thompson Reuters Web of Science: Citation Index (1900–2018), per PRISMA guidelines. Inclusion criteria specified all studies and case reports of patients with an AWS in which any relevant surgery types were considered and applied. Studies on arachnoid cysts and nonhuman populations, and those that did not report patient treatments or outcomes were excluded from the focus review.RESULTSA total of 19 records and 2 patients treated by the senior authors were included in the systematic review, providing a total of 43 patients with AWS. The mean age was 52 years (range 28–77 years), and the majority of patients were male (72%, 31/43). A syrinx was present in 67% (29/43) of the cases. All AWSs were located in the thoracic spine, and all but 2 (95%) were located dorsally (1 ventrally and 1 circumferentially). Weakness was the most frequently reported symptom (67%, 29/43), followed by numbness and/or sensory loss (65%, 28/43). Symptoms predominated in the lower extremities (81%, 35/43). It was found that nearly half (47%, 20/43) of patients had been experiencing symptoms for 1 year or longer before surgical intervention was performed, and 35% (15/43) of reports stated that symptoms were progressive in nature. The most commonly used surgical technique was a laminectomy with intradural excision of the arachnoid web (86%, 36/42). Following surgery, 91% (39/43) of patients had reported improvement in their neurological symptoms. The mean follow-up was 9.2 months (range 0–51 months).CONCLUSIONSAWS of the spine can be a debilitating disease of the spine with no more than an indentation of the spinal cord found on advanced imaging studies. The authors found this lesion to be reported in twice as many males than females, to be associated with a syrinx more than two-thirds of the time, and to only have been reported in the thoracic spine; over 90% of patients experienced improvement in their neurological function following surgery.

HIV decline associated with changes in risk behaviours among young key populations in Nepal: analysis of population-based HIV prevalence surveys between 2001 and 2012

2016 ◽  
Vol 28 (9) ◽  
pp. 864-875 ◽  
Author(s):  
Keshab Deuba ◽  
Anna Mia Ekström ◽  
Göran Tomson ◽  
Rachana Shrestha ◽  
Gaetano Marrone
Keyword(s):  
Condom Use ◽  
Migrant Workers ◽  
Sex Workers ◽  
Hiv Prevalence ◽  
Capital City ◽  
Key Populations ◽  
Risk Behaviours ◽  
The Past ◽  
Increased Risk ◽  
Male Labour

We assessed changes in HIV prevalence and risk behaviours among young key populations in Nepal. A total of 7505 participants (aged 16–24 years) from key populations who were at increased risk of HIV infection (2767 people who inject drugs (PWID); 852 men who have sex with men/transgender (MSM/TG); 2851 female sex workers (FSW) and 1035 male labour migrants) were recruited randomly over a 12-year period, 2001–2012. Local epidemic zones of Nepal (Kathmandu valley, Pokhara valley, Terai Highway and West to Far West hills) were analysed separately. We found a very strong and consistent decline in HIV prevalence over the past decade in different epidemic zones among PWID and MSM/TG in Kathmandu, the capital city, most likely due to a parallel increase in safe needle and syringe use and increased condom use. A decrease in HIV prevalence in 22 Terai highway districts, sharing an open border with India, was also consistent with increased condom use among FSW. Among male labour migrants, HIV prevalence was low throughout the period in the West to Far West hilly regions. Condom use by migrant workers involved with FSW abroad increased while their condom use with Nepalese FSW declined. Other risk determinants such as mean age at starting first injection, injection frequency, place of commercial sex solicitation, their mean age when leaving to work abroad did not change consistently across epidemic zones among the young key populations under study. In Nepal, the decline in HIV prevalence over the past decade was remarkably significant and consistent with an increase in condom use and safer use of clean needles and syringes. However, diverging trends in risk behaviours across local epidemic zones of Nepal suggest a varying degree of implementation of national HIV prevention policies. This calls for continued preventive efforts as well as surveillance to sustain the observed downward trend.

scholarly journals Who Should Discuss Advance Directives With Patients With Cancer and When? A Systematic Literature Review

2020 ◽  
Author(s):  
Pierre Boyer ◽  
Laëtitia Gimenez ◽  
Vladimir Druel ◽  
Alicia Marcaud ◽  
Marie-Eve Rougé-Bugat
Keyword(s):  
Literature Review ◽  
Advance Directives ◽  
Systematic Literature Review ◽  
Data Bank ◽  
Cochrane Library ◽  
Patients With Cancer ◽  
Public Health Data ◽  
Opportune Time ◽  
The Subject ◽  
Methodological Aspects

Abstract Background Among patients with cancer, discussion about the desired care is important, because progression of the disease, particularly signs of impaired consciousness, can lead to unwanted care in situations where no advance directives (ADs) have been provided. The aim of this study was to identify the most appropriate individual and time for addressing the subject of ADs with patients with cancer.Methods A systematic literature review was carried out between September 2014 and August 2015, using the following databases or sets of databases: PubMed, Web of Science, Cochrane Library, EM Premium, and the French database Public Health Data Bank. The methodological aspects of the articles were selected and evaluated with the help of PRISMA international guidelines.Results Of the 1170 articles identified, 7 were included (6 descriptive studies, 1 interventional study). A doctor was cited as the preferred individual for discussing the subject of advance directives with the patient. In 3 studies, this was listed as a general practitioner, whereas in the other 3 studies, it was an oncologist. The most opportune time was during the absence of a serious pathology (3 studies) and at the time the disease was diagnosed (2 studies).Conclusions Our results support the goals of Claeys-Leonetti, a 2016 French law concerned with the rights of patients receiving end-of-life care, and they suggest the implementation of a consultation for discussing and drafting ADs.

scholarly journals Efficiency measures of emergency departments: an Italian systematic literature review

2021 ◽  
Vol 10 (3) ◽  
pp. e001058
Author(s):  
Danilo Di Laura ◽  
Lucia D'Angiolella ◽  
Lorenzo Mantovani ◽  
Ginevra Squassabia ◽  
Francesco Clemente ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Emergency Departments ◽  
Critical Role ◽  
Evidence Base ◽  
Healthcare Systems ◽  
Cochrane Library ◽  
Number Of Patients ◽  
The World

Life expectancy globally increased in the last decades: the number of people aged 65 or older is consequently projected to grow, and healthcare demand will increase as well. In the recent years, the number of patients visiting the hospital emergency departments (EDs) rocked in almost all countries of the world. These departments are crucial in all healthcare systems and play a critical role in providing an efficient assistance to all patients. A systematic literature review covering PubMed, Scopus and the Cochrane Library was performed from 2009 to 2019. Of the 718 references found in the literature research, more than 25 studies were included in the current review. Different predictors were associated with the quality of EDs care, which may help to define and implement preventive strategies in the near future. There is no harmonisation in efficiency measurements reflecting the performance in the ED setting. The identification of consistent measures of efficiency is crucial to build an evidence base for future initiatives. The aim of this study is to review the literature on the problems encountered in the efficiency of EDs around the world in order to identify an organisational model or guidelines that can be implemented in EDs to fill inefficiencies and ensure access optimal treatment both in terms of resources and timing. This review will support policy makers to improve the quality of health facilities, and, consequently of the entire healthcare systems.

scholarly journals Monitoring of Systemic Lupus Erythematosus Pregnancies: A Systematic Literature Review

2018 ◽  
Vol 45 (10) ◽  
pp. 1477-1490 ◽  
Author(s):  
Emily G. McDonald ◽  
Lyne Bissonette ◽  
Stephanie Ensworth ◽  
Natalie Dayan ◽  
Ann E. Clarke ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Lupus Erythematosus ◽  
Umbilical Artery ◽  
Grey Literature ◽  
Cochrane Library ◽  
Doppler Studies ◽  
Systemic Lupus ◽  
Umbilical Artery Doppler

Objective.Few data exist to guide the frequency and type of monitoring in systemic lupus erythematosus (SLE) pregnancies. A systematic literature review was performed to address this gap in the literature.Methods.A systematic review of original articles (1975–2015) was performed using Medline, Embase, and Cochrane Library. We included search terms for SLE, pregnancy, and monitoring. We also hand-searched reference lists, review articles, and grey literature for additional relevant articles.Results.The search yielded a total of 1106 articles. After removing 117 duplicates, 929 articles that were evidently unrelated to our topic based on title and/or abstract, and 7 that were in a language other than English or French, 53 articles were included for full-text review. Following a more in-depth review, 15 were excluded: 6 did not use any measure of SLE activity and 6 did not specifically address SLE monitoring in pregnancy; 1 case series, 1 review, and 1 metaanalysis were removed. Among the 38 included studies, presence of active disease, antiphospholipid (aPL) antibodies positivity, and abnormal uterine and umbilical artery Doppler studies predicted poor pregnancy outcomes. No studies evaluated an evidence-based approach to the frequency of monitoring.Conclusion.Few existing studies address monitoring for optimal care during SLE pregnancies. The available data imply roles for aPL antibodies measurement (prior to pregnancy and/or during the first trimester), uterine and umbilical artery Doppler studies in the second trimester, and following disease activity. Optimal frequency of monitoring is not addressed in the existing literature.

scholarly journals A systematic literature review of attitudes towards secondary use and sharing of health administrative and clinical trial data: a focus on consent

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Elizabeth Hutchings ◽  
Max Loomes ◽  
Phyllis Butow ◽  
Frances M. Boyle
Keyword(s):  
Clinical Trial ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Clinical Trial Data ◽  
Secondary Data ◽  
Health Data ◽  
Trial Data ◽  
Cochrane Library ◽  
Original Research ◽  
Secondary Use

Abstract Background We aimed to synthesise data on issues related to stakeholder perceptions of consent for the use of secondary data. To better understand the current literature available, we conducted a systematic literature review of healthcare consumer attitudes towards the secondary use and sharing of health administrative and clinical trial data. Methods EMBASE/MEDLINE, Cochrane Library, PubMed, CINAHL, Informit Health Collection, PROSPERO Database of Systematic Reviews, PsycINFO and ProQuest databases were searched. Eligible articles included those reporting qualitative or quantitative original research and published in English. No restrictions were placed on publication dates, study design or disease setting. One author screened articles for eligibility and two authors were involved in the full-text review process. Conflicts were resolved by consensus. Quality and bias were assessed using the QualSyst criteria for qualitative studies. Results This paper focuses on a subset of 47 articles identified from the wider search and focuses on the issue of consent. Issues related to privacy, trust and transparency, and attitudes of healthcare professionals and researchers to secondary use and sharing of data have been dealt with in previous publications. Studies included a total of 216,149 respondents. Results indicate that respondents are generally supportive of using health data for research, particularly if the data is de-identified or anonymised. The requirement by participants to obtain consent prior to the use of health data for research was not universal, nor is the requirement for this always supported by legislation. Many respondents believed that either no consent or being informed of the research, but not providing additional consent, were sufficient. Conclusions These results indicate that individuals should be provided with information and choice about how their health data is used and, where feasible, a mechanism to opt-out should be provided. To increase the acceptability of using health data for research, health organisations and data custodians must provide individuals with concise information about data protection mechanisms and under what circumstances their data may be used and by whom. Systematic review registration PROSPERO CRD42018110559 (update June 2020).

scholarly journals 070 Burden of migraine is australia: a systematic literature review

2019 ◽  
Vol 90 (e7) ◽  
pp. A22.2-A22
Author(s):  
Hicham Benhaddi ◽  
Sophie McCabe ◽  
Diana T Lau
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Economic Burden ◽  
Data Extraction ◽  
Time Frame ◽  
Episodic Migraine ◽  
Cochrane Library ◽  
Positive Effects ◽  
Electronic Database Search ◽  
The Impact

IntroductionMigraine is a disabling neurological disease characterised by recurrent attacks of moderate to severe headaches. This systematic literature review (SLR) aimed to investigate the clinical, humanistic, and economic burden of chronic migraine (CM), episodic migraine (EM), and of current preventive migraine treatments in Australia.MethodsThe methodology of this SLR was aligned with the National Institute for Health and Care Excellence (NICE) guidelines. An electronic database search was conducted in Embase, MEDLINE and the Cochrane Library, with a time frame of 2008 to 2018.ResultsIn total, 1,122 records were identified and 168 of these were included for data extraction. The prevalence of migraine in Australia is estimated at 18.9%. Of those, 44% of people with EM and 86% of people with CM reported moderate-to-severe disability. Over one-third (36%) of people with EM and nearly two-thirds (64%) of people with CM reported visiting a healthcare provider in the previous three months. No data relating to the economic burden of migraine were returned by the searches. In people with EM and CM, anti-calcitonin gene-related peptide (anti-CGRP) preventive treatments for migraine safely, effectively and significantly reduced the mean number of monthly migraine and/or headache days from baseline compared with placebo.ConclusionsMigraine is associated with a substantial burden, and people living with migraine feel the impact in their day-to-day lives. Anti-CGRPs are a promising class of preventive treatments for all people with migraine. Longer-term studies are needed to determine if the positive effects of anti-CGRPs are sustained over greater time periods.

scholarly journals Therapeutic Plasma Exchange in Myasthenia Gravis: A Systematic Literature Review and Meta-Analysis of Comparative Evidence

2021 ◽  
Vol 12 ◽  
Author(s):  
Tina S. Ipe ◽  
Adeola R. Davis ◽  
Jay S. Raval
Keyword(s):  
Literature Review ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Systematic Literature Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Therapeutic Plasma Exchange ◽  
Cochrane Library ◽  
Pubmed Database

Background: Patients with Myasthenia Gravis (MG) can be treated acutely with therapeutic plasma exchange (TPE) or intravenous immune globulin (IVIG). To date, there is no definitive understanding of which of the two treatments is more effective and safer. The purpose of this study was to systematically review the literature on the comparative efficacy and safety of TPE to other available treatments for MG.Methods: A systematic literature search for studies published between 1997 and 2017 was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using two database sources, MEDLINE (through the PubMed database) and Cochrane Library.Results: The search strategy resulted in 535 articles whose abstracts were reviewed. Among these, 165 full texts articles were reviewed for eligibility and 101 articles were excluded. Of the 165 articles, 64 articles were included for a systematic literature and 11 articles for a meta-analysis.Conclusions: This systematic literature review and meta-analysis of treatment options showed that there was a higher response rate with TPE than IVIG in acute MG patients and patients undergoing thymectomy. There was no difference in mortality between the two treatment options. Our findings highlight the need for additional randomized clinical trials in these patients with MG.

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