scholarly journals Daily associations between sleep and physical activity: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Sarah Atoui ◽  
Guillaume Chevance ◽  
Ahmed Jerome Romain ◽  
Celia Kingsbury ◽  
Jean-Philippe Lachance ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Sleep Time ◽  
Care Providers ◽  
Individual Level ◽  
Bidirectional Association ◽  
Small Effect Size ◽  
Meta Analyses

The day-to-day variations of sleep and physical activity are associated with various health outcomes in adults, and previous studies suggested a bidirectional association between these behaviors. The daily associations between sleep and physical activity have been examined in observational or interventional contexts. The primary goal of the current systematic review and meta-analysis was to summarize existing evidence about daily associations between sleep and physical activity outcomes at inter- and intra-individual level in adults. A systematic search of records in eight databases from inception to July 2019 identified 33 peer-reviewed empirical publications that examined daily sleep – physical activity association in adults. The qualitative and quantitative analyses of included studies did not support a bidirectional daily association between sleep outcomes and physical activity. Multilevel meta-analyses showed that three sleep parameters were associated with physical activity the following day: sleep quality, sleep efficiency, and wake after sleep onset. However, the associations were small, and varied in terms of direction and level of variability (e.g. inter- or intra-individual). Daytime physical activity was associated with lower total sleep time the following night at an inter-person level with a small effect size. From a clinical perspective, care providers should monitor the effects of better sleep promotion on physical activity behaviours in their patients. Future studies should examine sleep and physical activity during a longer period and perform additional sophisticated statistical analyses.

scholarly journals Evaluation of the effectiveness of behavioural economic incentive programmes for the promotion of a healthy diet and physical activity: a protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e046035
Author(s):  
Suparee Boonmanunt ◽  
Oraluck Pattanaprateep ◽  
Boonsong Ongphiphadhanakul ◽  
Gareth McKay ◽  
John Attia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Financial Incentives ◽  
Meta Analysis ◽  
Economic Incentive ◽  
Healthy Diet ◽  
Current Evidence ◽  
Diet And Physical Activity ◽  
Behavioural Economic ◽  
Meta Analyses

IntroductionObesity and being overweight are major risk factors for metabolic syndrome and non-communicable diseases. Despite the recommendation that a healthy diet and physical activity can reduce the severity of these diseases, many fail to adhere to these measures. From a behavioural economic perspective, adherence to such measures can be encouraged through financial incentives. However, additional related behavioural economic approaches may improve the effectiveness of an incentive programme. As such, we have developed a protocol for a systematic review and network meta-analysis to summarise the current evidence from financial incentive programmes with and without behavioural economic insights for promoting healthy diet and physical activity.Methods and analysisPrevious systematic reviews, meta-analyses and individual studies were identified from Medline and Scopus in June 2020 and will be updated until December 2020. Individual studies will be selected and data extracted by two reviewers. Disagreement will be resolved by consensus or adjudicated by a third reviewer. A descriptive analysis will summarise the effectiveness of behavioural economic incentive programmes for promoting healthy diet and physical activity. Moreover, individual studies will be pooled using network meta-analyses where possible. I2 statistics and Cochran’s Q test will be used to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as the overall strength of the evidence.Ethics and disseminationEthics approval for a systematic review and meta-analysis is not required. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020198024.

scholarly journals Physically Active Lessons Meta-Analysis - Norris et al. POST-PRINT

2019 ◽  
Author(s):  
Emma Norris ◽  
Tommy van Steen ◽  
Artur Direito ◽  
Emmanuel Stamatakis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Health Outcomes ◽  
Educational Outcomes ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Control Group ◽  
Physically Active ◽  
Meta Analyses

Objective: This review provides the first meta-analysis of the effects of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design: Systematic review and meta-analysis. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources: PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria: Physically active lessons compared to a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results: 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible for inclusion in the systematic review and 37 of them were included across the six meta-analyses (n=12,663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95%CI 1.42, 3.25: k=16) and small, significant effects on overall PA (d= 0.32, 95%CI 0.18, 0.46: k=8). A large, significant effect was shown on lesson-time educational outcomes (d=0.81; 95%CI 0.47, 1.14: k=7) and a small, significant effect on overall educational outcomes (d=0.36, 95%CI [0.09, 0.63], k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least 2 domains. Conclusion: In elementary and preschool settings, when physically active lessons were added into the curriculum they had a positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool settings.

scholarly journals Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Alexandra Rhodes ◽  
Andrea D. Smith ◽  
Paul Chadwick ◽  
Helen Croker ◽  
Clare H. Llewellyn
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Gain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Dietary Behaviors ◽  
User Engagement ◽  
Digital Interventions ◽  
Effective Interventions ◽  
Meta Analyses

BACKGROUND Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. OBJECTIVE This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. METHODS A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. RESULTS In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (−0.28 kg; 95% CI −1.43 to 0.87) or per-protocol data (−0.65 kg; 95% CI −1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the <i>goals and planning</i>, and <i>feedback and monitoring</i> domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. CONCLUSIONS In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.

scholarly journals The Assessment of Functional Movement in Children and Adolescents: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Wesley O’Brien ◽  
Zeinab Khodaverdi ◽  
Lisa Bolger ◽  
Giampiero Tarantino ◽  
Conor Philpott ◽  
...  
Keyword(s):  
Systematic Review ◽  
Secondary School ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Developmental Trajectory ◽  
School Level ◽  
Functional Movement ◽  
School Aged Children ◽  
Small Effect Size ◽  
Meta Analyses

Abstract Background The Functional Movement Screen™ (FMS™) is an assessment of human movement that may signal potential deficits that could predispose an otherwise healthy person to injury risk. FMS™ scores are well reported in both athletic and adult samples. However, to date, there has been no comprehensive systematic review and meta-analysis of FMS™ data among school-aged children and adolescents. Objective We aimed to systematically review and analyse functional movement proficiency of children and adolescents, specifically when assessed using the FMS™, and to establish initial normative values for the FMS™ in this population group and to further estimate differences in functional movement proficiency between the sexes, by school level (i.e., between primary and secondary school-level children and adolescents), and based on differences in child and adolescent body mass index (BMI). Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, prospective studies were identified from searches across eight databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, EMBASE, ERIC, PsychINFO and PubMed), without any date restrictions, up to December 2020. The primary meta-analysis estimated the overall FMS™ score for school-aged children and adolescents across published studies. An additional three subgroup meta-analyses estimated comparisons for FMS™ data with school level, sex, and BMI across published studies. FMS™ data were meta-analysed using a number of different meta packages (Schwarzer et al. in Meta-Analysis with R, 1st ed, Springer International Publishing, Berlin, 2015), available in R Studio. Results A total of 19 articles were included in the systematic review. Meta-analysis revealed a weighted FMS™ mean score of 14.06, with a standardised Tau value of 0.56, signalling a moderate-to-large degree of variability in FMS™ means between studies. The difference in FMS™ means between samples of males (weighted FMS™ mean 13.91) and females (weighted FMS™ mean 14.56) was compatible with a possible small effect size (standardised mean difference − 0.27). The variability in FMS™ means between studies was approximately five times greater in samples of secondary school children (factor difference in Tau values 5.16). The final meta-regression identified a negative association between BMI and FMS™ scores (r =  − 0.42), which signalled a moderate-to-large difference in FMS™ scores between healthy weight and overweight children/adolescents. Conclusion This systematic review and meta-analysis represents a novel and important synthesis of published FMS™ data from groups of children and adolescents. The study signals possible sex- and age-related differences in FMS™ scores, as well as a clear negative relationship between BMI and functional movement proficiency. More longitudinal research is needed to better understand the developmental trajectory and the effects of maturation milestones on FMS™ proficiency. Additional research is also needed to identify the types of interventions that could improve functional movement proficiency among ‘at risk’ groups, who are susceptible to functional movement deficiency, and whether changes in body composition mediate the relationship between these interventions and the improvement of FMS™ scores.

scholarly journals The relationship between pregnancy intentions and diet or physical activity behaviours in the preconception and antenatal periods: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Isaac Nkrumah ◽  
Madelon North ◽  
Emily Jane Kothe ◽  
Tze Lin Chai ◽  
Stephanie Pirotta ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Pregnancy Intention ◽  
Risk Of Bias ◽  
Folate Intake ◽  
Caffeine Intake ◽  
Pregnancy Intentions ◽  
Diet And Physical Activity ◽  
Meta Analyses

Introduction: Healthy preconception and antenatal diet and physical activity behaviours are crucial to prevent adverse maternal and offspring outcomes. These behaviours are thought to be linked to pregnancy intentions. The aim of this study was to conduct a systematic review and meta-analysis to determine the association between women’s pregnancy intentions and diet or physical activity behaviours in the preconception and antenatal periods. Methods: Medline Complete, PsycINFO, CINAHL Complete, Global Health, Embase, and INFORMIT: Health Subset were searched in September 2018 for studies that evaluated relationships between pregnancy intentions and dietary and physical activity behaviours. Risk of bias was assessed and random effects meta-analyses were conducted for dietary (food groups; energy and macronutrients; diet quality; and caffeine, iodine and folate intake) and physical activity outcomes.Results: Of 2623 screened records, 19 eligible studies were identified. Overall risk of bias was moderate to high. Twelve studies measured diet/physical activity behaviours during preconception, 5 during pregnancy, and 2 across both periods. Eleven studies measured pregnancy intention retrospectively, and 8 prospectively measured pregnancy intention. The number of studies available for meta-analyses of individual dietary and physical activity outcomes ranged from 2 to 5. Pregnancy intentions were not associated with preconception fruit, vegetable, or caffeine intake or physical activity. Antenatally, women with intended pregnancies were more likely to report healthier diets, lower caffeine intake and higher physical activity. Insufficient studies were available to conduct subgroup comparisons for prospective/retrospective assessment.Discussion: Pregnancy intentions were not associated with preconception diet or physical activity behaviours. In contrast, antenatally, women with intended pregnancies demonstrated better diet and physical activity behaviours. Given the small number of studies available for meta-analyses, further research is needed to consolidate our findings. Meanwhile, health professionals can assess women’s pregnancy intentions during preconception and pregnancy and encourage a healthy lifestyle.PROSPERO registration number CRD42018107854.

scholarly journals Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis

10.2196/18255 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e18255
Author(s):  
Alexandra Rhodes ◽  
Andrea D Smith ◽  
Paul Chadwick ◽  
Helen Croker ◽  
Clare H Llewellyn
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Gain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Dietary Behaviors ◽  
User Engagement ◽  
Digital Interventions ◽  
Effective Interventions ◽  
Meta Analyses

Background Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. Objective This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. Methods A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. Results In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (−0.28 kg; 95% CI −1.43 to 0.87) or per-protocol data (−0.65 kg; 95% CI −1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the goals and planning, and feedback and monitoring domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. Conclusions In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.

Effectiveness of Outdoor Exercise Parks on Health Outcomes in Older Adults—A Mixed-Methods Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-13
Author(s):  
Yoke Leng Ng ◽  
Keith D. Hill ◽  
Pazit Levinger ◽  
Elissa Burton
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Meta Analysis ◽  
Small Sample ◽  
Activity Levels ◽  
Single Leg Stance ◽  
Small Sample Sizes ◽  
Meta Analyses

The objective of this systematic review was to examine the effectiveness of outdoor exercise park equipment on physical activity levels, physical function, psychosocial outcomes, and quality of life of older adults living in the community and to evaluate the evidence of older adults’ use of outdoor exercise park equipment. A search strategy was conducted from seven databases. Nine articles met the inclusion criteria. The study quality results were varied. Meta-analyses were undertaken for two physical performance tests: 30-s chair stand test and single-leg stance. The meta-analysis results were not statistically significant. It was not possible to conclude whether exercise parks were effective at improving levels of physical activity. The review shows that older adults value the benefits of health and social interaction from the use of exercise parks. Findings should be interpreted with caution due to the small sample sizes and the limited number of studies.

Efficacy of Micronized Progesterone for Sleep: A Systematic Review and Meta-analysis of Randomized Controlled Trial Data

2020 ◽  
Author(s):  
Brendan J Nolan ◽  
Bonnie Liang ◽  
Ada S Cheung
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Effect Size ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Sleep Time ◽  
Controlled Trials ◽  
Sleep Onset Latency ◽  
Randomized Controlled ◽  
Micronized Progesterone

Abstract Context Preclinical data has shown progesterone metabolites improve sleep parameters through positive allosteric modulation of the γ-aminobutyric acid type A receptor. We undertook a systematic review and meta-analysis of randomized controlled trials to assess micronized progesterone treatment on sleep outcomes. Evidence Acquisition Using preferred reporting items for systematic review and meta-analysis guidelines, we searched MEDLINE, Embase, PsycInfo, and the Cochrane Central Register of Controlled Trials for randomized controlled trials of micronized progesterone treatment on sleep outcomes up to March 31, 2020. This study is registered with the International Prospective Register of Systematic Reviews, number CRD42020165981. A random effects model was used for quantitative analysis. Evidence Synthesis Our search strategy retrieved 9 randomized controlled trials comprising 388 participants. One additional unpublished trial was found. Eight trials enrolled postmenopausal women. Compared with placebo, micronized progesterone improved various sleep parameters as measured by polysomnography, including total sleep time and sleep onset latency, though studies were inconsistent. Meta-analysis of 4 trials favored micronized progesterone for sleep onset latency (effect size, 7.10; confidence interval [CI] 1.30, 12.91) but not total sleep time (effect size, 20.72; CI -0.16, 41.59) or sleep efficiency (effect size, 1.31; CI -2.09, 4.70). Self-reported sleep outcomes improved in most trials. Concomitant estradiol administration and improvement in vasomotor symptoms limit conclusions in some studies. Conclusions Micronized progesterone improves various sleep outcomes in randomized controlled trials, predominantly in studies enrolling postmenopausal women. Further research could evaluate the efficacy of micronized progesterone monotherapy using polysomnography or validated questionnaires in larger cohorts.

scholarly journals Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up: a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034541
Author(s):  
Charlotte Wahlich ◽  
Umar A R Chaudhry ◽  
Rebecca Fortescue ◽  
Derek G Cook ◽  
Shashivadan Hirani ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Community Based ◽  
Intervention Effects ◽  
Meta Analyses

ObjectiveTo identify randomised controlled trials (RCTs) of physical activity (PA) interventions with objective PA outcomes in adults and to evaluate whether intervention effects were sustained beyond 12 months.DesignSystematic review and meta-analysis.Data sourcesSeven databases (Medline, Embase, PsycINFO, Web of Science, Cochrane library, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and ASSIA (Applied Social Sciences Index and Abstracts)) were searched from January 2000 until December 2019.Eligibility criteriaRCTs reporting objective PA outcomes beyond 12 months with community-based participants aged ≥18 years were included; those where controls received active interventions, including advice to increase PA levels, were excluded.Data extraction and synthesisTwo independent reviewers completed extraction of aggregate data and assessed risk of bias. Meta-analyses used random-effects models at different follow-up points. Primary outcomes were daily steps and weekly minutes of moderate-to-vigorous PA (MVPA).ResultsOf 33 282 records identified, nine studies (at generally low risk of bias) were included, five in meta-analyses with 12 months to 4 year follow-up. We observed 12 month increases for intervention vs control participants in steps/day (mean difference (MD)=554 (95% CIs: 384 to 724) p<0.0001, I2=0%; 2446 participants; four studies) and weekly MVPA minutes (MD=35 (95% CI: 27 to 43) p<0.0001, I2=0%; 2647 participants; four studies). Effects were sustained up to 4 years for steps/day (MD=494 (95% CI: 251 to 738) p<0.0001, I2=0%; 1944 participants; four studies) and weekly MVPA minutes (MD=25 (95% CI: 13 to 37) p<0.0001, I2=0%; 1458 participants; three studies).ConclusionsThere are few PA interventions with objective follow-up beyond 12 months, more studies are needed. However, this review provided evidence of PA intervention effects beyond 12 months and sustained up to 4 years for both steps/day and MVPA. These findings have important implications for potential long-term health benefits.PROSPERO registration numberCRD42017075753.

scholarly journals Bovine Ehrlichiosis Prevalence: A Systematic Review and Meta-Analysis of Molecular Studies

2021 ◽  
Vol 11 (1) ◽  
pp. 1-15
Author(s):  
D. Katterine Bonilla-Aldana ◽  
Keidenis Quintero-Rada ◽  
Juan Pablo Montoya-Posada ◽  
Diego Soler-Tovar ◽  
Paola Barato ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Animal Health ◽  
Notifiable Disease ◽  
Individual Level ◽  
Lack Of Information ◽  
Pooled Prevalence ◽  
The Individual ◽  
World Organization ◽  
Meta Analyses

While some Ehrlichia species, such as E. ruminantium and E. minasensis, are not popular even among veterinarians, they can infect cattle. The current study aimed to review studies on Ehrlichia spp. to evaluate its worldwide molecular prevalence, given the lack of information about bovine ehrlichiosis and the lack of previous systematic reviews and meta-analyses on this subject. In order to determine the molecular prevalence of Ehrlichia spp. in cattle, a systematic review of the literature was conducted in three databases. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence with 95% confidence intervals (95% CI) and measures of heterogeneity were reported. Subgroup analyses were performed in terms of Ehrlichia species, country, and regions. The literature search yielded 1051 papers until August 1, 2019, with 71 studies entirely eligible for review. The pooled molecular prevalence for Ehrlichia at the individual level (N = 6232) was 2.3% (95% CI: 1.7-2.9%) with the highest value of 82.4%. Studies identified the highest pooled molecular prevalence of 6.6% (95% CI: 0.6-12.7%) for E. canis, followed by E. ruminantium (n = 4695, 75.33%) 52 studies, with 1.7% (95% CI: 1.1-2.3%) and E. chaffeensis with 1.5% (95% CI: 0.0-0.3%). Moreover, the obtained result was indicative of only one study addressing E. minasensis. As the findings suggested, heartwater (E. ruminantium infection) is a notifiable disease of domestic and wild ruminants, recorded by the World Organization for Animal Health. There is a possible risk of endemic heartwater in the Americas due to the climatic features. Furthermore, E. minasensis, E. chaffeensis, and E. canis were observed in cattle although the two last species could be a molecular misidentification with regard to their phylogenetic relationships with E. minasensis.

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