scholarly journals Residual Risk of HIV in African Transfusional Setting: Systematic Review and Meta-Analysis

Author(s):  
Christian Mangala ◽  
Joseph Fokam ◽  
Denis Maulot Bangola ◽  
Mireille Moundanga ◽  
Thérèse Nkoa

Context: The residual risk of HIV transmission is still a real problem into the transfusional settings of limited resources countries. Blood banks of African countries confront the risk of transmitting HIV to recipients. The objective of this study is to estimate the residual risk of HIV in African transfusion settings and to compare this residual risk with that of other countries in the South (developping countries). Methods: This study resulted of a systematic review with meta-analysis of data from several comprehensive studies carried out between 2011 and 2017 whose purpose was focused on the residual risk of HIV transmission through blood transfusion. The studies on the residual risk were systematically searched in the different databases (PubMed, Medline and Google Scholar). The eligibility criteria were based on published studies which had blood donors as participants, looking at the residual risk of HIV in developing countries and the technique was based on the search for antibodies-P24 Antigen of the HIV or on nucleic acid (RNA) testing. Studies carried out before 2011 and after 2017 were excluded. Studies in rich countries were also excluded. The Cochrane tool was used to assess the risk of bias. Results: A total of 327,278 seronegative donors (for 12 eligible studies) were admitted for this study, i.e. 75.5% of men and 24.5% of women. The median age of all donors was 30.4 years. For studies carried out in the Africa zone (Burkina Faso, Ivory Coast, Nigeria, Democratic Republic of Congo, Tanzania and Zimbabwe), 327,278 donors were initially seronegative, of which 626 were found to be positive. Indeed, out of 742 incident cases in this study from African countries and other countries of the South, 84.4% of positive donors came from African studies and 15.6% of positive donors came from other countries of the South in this study. The residual risk (RR) of HIV in Africa has been estimated at 13 per 1,000,000 donations, with an incidence rate (IR) of 21.5 per 100,000 person-years. And in the other countries of the South (Brazil, Croatia, India, Iran, Malaysia and Pakistan), the RR of HIV has been estimated at 0.6 per 1,000,000 donations, or an incidence rate of 1.1 per 100,000 person-years. Conclusion: The residual risk of HIV in the transfusion environment is still high and still persists in blood banks in southern countries in general and in Africa in particular.

Author(s):  
Christian Mangala ◽  
Joseph Fokam ◽  
Denis Maulot Bangola ◽  
Thérèse Nkoa

Background: The genetic diversity of human immunodeficiency virus type 1 (HIV-1) is a real problem facing blood banks. This genetic diversity has a negative impact on diagnostic strategies within the transfusion chain by weakening the security of the donation. The objective of this study is to clarify the concepts emanating from the research project entitled : «Genetic diversity of HIV-1 and its effect on the residual risk in blood transfusion in Gabon». Methods: This study was the result of a systematic review and a conceptual analysis of several studies that were systematically searched for in databases (PubMed, Google Scholar, and Medline), and whose object was focused on the genetic diversity of HIV -1 and its impact on transfusion safety. Indeed, the information relating to the concepts coming from the full articles was used. These were obtained by reading the most relevant articles. All relevant studies reporting data on HIV-1 genetic diversity and blood safety published in English between January 2012 and December 2020 have been identified for context. The method of conceptual analysis of « Walker and Avant (2005) » was used to clarify the different concepts of our study. The correlation test was used to show the relationship between the concepts. Results: This systematic review and conceptual analysis study made it possible to determine the variables and to clarify the different concepts (HIV-1, Genetic diversity, Blood transfusion, Residual risk) essential for carrying out our research project entitled: "Genetic diversity of HIV-1 and its effect on the residual risk in blood transfusion". This model made it possible to show the effect of the genetic diversity of HIV-1 on the residual risk in blood transfusion using as model variables : viral load and serological markers (Antibodies and P24 Antigen). Knowledge of molecular strains (URF, CRF, subtypes) during this study made it possible to better identify the molecular strains most involved in the residual risk. Despite its complexity, this conceptual analysis contributed enormously to the understanding of the activities and the quantifiable and non-quantifiable components that participated in our study. Statistical analysis showed that the HIV-1 concept was significantly related to the other three concepts with P = 0.001. Likewise for the concept of genetic diversity was also significantly linked to the two other concepts with P = 0.003. Conclusion: The genetic diversity of HIV-1 in the blood transfusion environment contributes significantly to the transmission of HIV from donor to recipient. The mastery of these molecular strains is essential for the various blood banks to ensure a safe blood supply.


Author(s):  
D. Maulot-Bangola ◽  
C. Mangala ◽  
J. Fokam ◽  
T. Nkoa

Background: Blood transfusions carry the risk of transmitting blood-borne infections. A precise estimate of the transfusion risk of viral infection will help to determine the effect of new and current safety measures in sub-Saharan Africa. This study proposes to estimate the residual risk of HBV in blood banks in African countries and to compare them to other countries in the South. Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Medline, Google Scholar and Zotero were accessed. The eligibility criteria were based on published studies that had blood donors as participants, looking at the residual risk of HBV in developing countries and the technique was based on the search for HBsAg or Hepatitis B Core Antibodies or Nucleic Acid (DNA) testing. The Cochrane tool was used to assess the risk of bias. Results: Twelve articles comprising 71,207 allogeneic and hepatitis B surface antigen (HBsAg)-negative blood donations were included in the meta-analysis. A total of 4912 HBsAg negative African donation including (51.0%) new donors and (49.0%) from regular donors. 80.8% of them were male and the median age was 28 years. Of 1225 HBV strains (47% and 53.4% incident cases) were frequencies in sub-Saharan Africa and in other Southern countries respectively. Considering the twelve participating blood centres as a whole, the incidence rate of new infections was high (4905.1) in sub-Saharan Africa than (869.7) in other Southern countries per 100,000 person-years. In contrast, the estimated residual risk in sub-Saharan Africa (5913 in 1 million donations) was five times higher than estimated in other Southern countries (1048.4 in 1 million donations). Conclusion: Blood donations with HBsAg undetectable by routine testing and low levels of HBV DNA are extremely common in sub-Saharan Africa, at a rate of 5913 per 1 million donations. Given that at least several of these samples could reflect contamination or a false negative result, elimination of infection by a test limited to HBsAg does not prevent transmission.


Author(s):  
Chris C Y Pang ◽  
Kevin Phan ◽  
Md Nazmul Karim ◽  
Afsana Afroz ◽  
Matthew Winter ◽  
...  

Abstract Objectives An estimated 125 million workers are exposed to asbestos worldwide. Asbestos is classified by the International Agency for Research on Cancer as a Group 1 carcinogen. The association between occupational asbestos exposure and kidney cancer is not well established however. This study aimed to determine the mortality and incidence of kidney cancer in workers who have been exposed to asbestos. We performed a systematic review and meta-analysis to evaluate the association between occupational asbestos exposure and kidney cancer. Methods Medline, EMBASE, and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles on occupational asbestos exposure and kidney cancer. The studies reported the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of kidney cancer in workers exposed to asbestos. SMRs or SIRs with its 95% confidence interval (CI) were pooled using a fixed-effect model. Results Forty-nine cohort studies involving 335 492 workers were selected for analysis. These studies included 468 kidney cancer deaths and 160 incident cases. The overall pooled-SMR of kidney cancer was 0.95 (95% CI: 0.86–1.05), with no significant heterogeneity (PQ = 0.09, I2 = 24.87%). The overall pooled-SIR of kidney cancer was 0.95 (95% CI: 0.79–1.11), with no significant heterogeneity (PQ = 0.68, I2 = 0.00%). Subgroup analysis did not find any increased association with occupational asbestos exposure. There was no evidence of publication bias with Egger’s test P values of 0.08 for mortality studies and 0.99 for incidence studies. Conclusions This systematic review and meta-analysis did not show evidence of association between occupational asbestos exposure and kidney cancer mortality or incidence.


2013 ◽  
Vol 43 (1) ◽  
pp. 235-248 ◽  
Author(s):  
Esther J Aspinall ◽  
Dhanya Nambiar ◽  
David J Goldberg ◽  
Matthew Hickman ◽  
Amanda Weir ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Baoli Wang ◽  
Wei Chenru ◽  
Yong Jiang ◽  
Lunyang Hu ◽  
He Fang ◽  
...  

Objective: We conducted a systematic review and meta-analysis to comprehensively estimate the incidence and mortality of acute respiratory distress syndrome (ARDS) in overall and subgroups of patients with burns.Data sources: Pubmed, Embase, the Cochrane Library, CINAHL databases, and China National Knowledge Infrastructure database were searched until September 1, 2021.Study selection: Articles that report study data on incidence or mortality of ARDS in patients with burns were selected.Data extraction: Two researchers independently screened the literature, extracted data, and assessed the quality. We performed a meta-analysis of the incidence and mortality of ARDS in patients with burns using a random effects model, which made subgroup analysis according to the study type, inclusion (mechanical ventilation, minimal burn surface), definitions of ARDS, geographic location, mean age, burn severity, and inhalation injury. Primary outcomes were the incidence and mortality of burns patients with ARDS, and secondary outcomes were incidence for different subgroups.Data synthesis: Pooled weighted estimate of the incidence and mortality of ARDS in patients with burns was 0.24 [95% confidence interval (CI)0.2–0.28] and 0.31 [95% CI 0.18−0.44]. Incidences of ARDS were obviously higher in patients on mechanical ventilation (incidence = 0.37), diagnosed by Berlin definition (incidence = 0.35), and with over 50% inhalation injury proportion (incidence = 0.41) than in overall patients with burns. Patients with burns who came from western countries and with inhalation injury have a significantly higher incidence of ARDS compared with those who came from Asian/African countries (0.28 vs. 0.25) and without inhalation injury (0.41 vs. 0.24).Conclusion: This systematic review and meta-analysis revealed that the incidence of ARDS in patients with burns is 24% and that mortality is as high as 31%. The incidence rates are related to mechanical ventilation, location, and inhalation injury. The patients with burns from western countries and with inhalation injury have a significantly higher incidence than patients from Asian/African countries and without inhalation injury.Systematic Review Registration: identifier: CRD42021144888.


2019 ◽  
Vol 54 (12) ◽  
pp. 711-718 ◽  
Author(s):  
Alejandro López-Valenciano ◽  
Iñaki Ruiz-Pérez ◽  
Alberto Garcia-Gómez ◽  
Francisco J Vera-Garcia ◽  
Mark De Ste Croix ◽  
...  

ObjectiveWe performed a systematic review and meta-analysis of epidemiological data of injuries in professional male football.MethodForty-four studies have reported the incidence of injuries in football. Two reviewers independently extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement and Newcastle Ottawa Scale. Studies were combined in a pooled analysis using a Poisson random effects regression model.ResultsThe overall incidence of injuries in professional male football players was 8.1 injuries/1000 hours of exposure. Match injury incidence (36 injuries/1000 hours of exposure) was almost 10 times higher than training injury incidence rate (3.7 injuries/1000 hours of exposure). Lower extremity injuries had the highest incidence rates (6.8 injuries/1000 hours of exposure). The most common types of injuries were muscle/tendon (4.6 injuries/1000 hours of exposure), which were frequently associated with traumatic incidents. Minor injuries (1–3 days of time loss) were the most common. The incidence rate of injuries in the top 5 European professional leagues was not different to that of the professional leagues in other countries (6.8 vs 7.6 injuries/1000 hours of exposure, respectively).ConclusionsProfessional male football players have a substantial risk of sustaining injuries, especially during matches.


Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Shu-Chen Liao ◽  
Shih-Chieh Shao ◽  
Chi-Wen Cheng ◽  
Yung-Chang Chen ◽  
Ming-Jui Hung

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