Global prevalence of occult hepatitis C virus: A systematic review and meta-analysis

BACKGROUNDOccult hepatitis C infection (OCI) is characterized by the presence of hepatitis C virus (HCV) RNA in the liver, peripheral blood mononuclear cells (PBMC) and/or ultracentrifuged serum in the absence of detectable HCV-RNA in serum. OCI has been described in several categories of populations including hemodialysis patients, patients with a sustained virological response, immunocompromised individuals, patients with abnormal hepatic function, and apparently healthy subjects.AIMTo highlight the global prevalence of OCI.METHODSWe performed a systematic and comprehensive literature search in the following 4 electronic databases PubMed, EMBASE, Global Index Medicus, and Web of Science up to 6th May 2021 to retrieve relevant studies published in the field. Included studies were unrestricted population categories with known RNA status in serum, PBMC, liver tissue and/or ultracentrifuged serum. Data were extracted independently by each author and the Hoy et al tool was used to assess the quality of the included studies. We used the random-effect meta-analysis model to estimate the proportions of OCI and their 95% confidence intervals (95%CI). The Cochran''s Q-test and the I² test statistics were used to assess heterogeneity between studies. Funnel plot and Egger test were used to examine publication bias. R software version 4.1.0 was used for all analyses.RESULTSThe electronic search resulted in 3950 articles. We obtained 102 prevalence data from 85 included studies. The pooled prevalence of seronegative OCI was estimated to be 9.61% (95%CI: 6.84-12.73) with substantial heterogeneity [I² = 94.7% (95%CI: 93.8%-95.4%), P < 0.0001]. Seropositive OCI prevalence was estimated to be 13.39% (95%CI: 7.85-19.99) with substantial heterogeneity [I² = 93.0% (90.8%-94.7%)]. Higher seronegative OCI prevalence was found in Southern Europe and Northern Africa, and in patients with abnormal liver function, hematological disorders, and kidney diseases. Higher seropositive OCI prevalence was found in Southern Europe, Northern America, and Northern Africa.CONCLUSIONIn conclusion, in the present study, it appears that the burden of OCI is high and variable across the different regions and population categories. Further studies on OCI are needed to assess the transmissibility, clinical significance, long-term outcome, and need for treatment.     

2016年12月全国艾滋病性病疫情

  目的  了解中国大陆地区大学生性行为发生情况,为学校开展大学生性教育提供参考依据。  方法  检索中国期刊全文数据库（CNKI）、万方数据资源系统和PubMed数据库,并辅以手工检索和文献追溯法收集2010年1月1日 — 2016年11月29日公开发表的关于中国大陆地区大学生性行为发生情况的相关文献,应用Stata 12.0软件对纳入的文献进行meta分析。  结果  最终纳入66篇文献（中文文献61篇和英文文献5篇）,累计研究对象476 262人。meta分析结果显示,中国大陆地区大学生性行为发生率为15.1 %（9 5 % CI=13.9 % ～16.4 %）。亚组分析结果显示,男大学生性行为发生率为21.1 %,高于女大学生的10.6 %,差异有统计学意义（χ² = 6 167.307,P < 0.001）;东部地区大学生性行为发生率为16.4 %,均高于中部地区大学生的14.8 % 和西部地区大学生的14.8 %,差异均有统计学意义（均P < 0.001）;大一、大二、大三和大四年级大学生性行为发生率分别为9.5 %、12.8 %、 18.2 % 和23.9 %,年级越高的大学生性行为发生率越高（χ_趋势² = 271.355,P < 0.001）;研究时间在2005 — 2009年大学生的性行为发生率为14.6 %,低于研究时间在2010 — 2015年的17.4 %,差异有统计学意义（χ² = 739.486,P < 0.001）。Begg秩相关结果显示本次纳入meta分析的文献不存在发表偏倚（Z = 0.26,P = 0.799）。  结论  中国大陆地区大学生性行为发生率较高,应根据大学生性行为的流行病学特征来制定干预措施,帮助学生形成正确的性观念,正确引导大学生的安全性行为,提高大学生的身心健康水平。     

Prevalence of zoonotic bacteria in wild and farmed aquatic species and seafood: a scoping study, systematic review, and meta-analysis of published research

Increased reliance on seafood has brought to light concerns regarding food safety, but the information to inform risk assessment or surveillance needs is lacking. A scoping study (ScS) was conducted to characterize published research investigating selected zoonotic bacteria and public health topics in various wild and farmed aquatic species and seafood. This was followed by a systematic review (SR) on selected bacteria (Aeromonas spp., generic Escherichia coli, Salmonella spp., and Vibrio spp.) and aquatic species (clams, mussels, oysters, salmon, and shrimp [including prawn]); a meta-analysis (MA) was conducted only at the retail level due to considerable variability among various pathogen/seafood combinations. The ScS revealed the most frequently investigated themes were farm-level prevalence and intervention research for Vibrio spp. and Aeromonas spp. Antimicrobial use (AMU) and the association between AMU and antimicrobial resistance were rarely investigated. The SR indicated a consistent lack of reporting regarding study methodology and results, precluding the use of many studies in and full benefits of MA. MA of Aeromonas, E. coli, and Salmonella prevalence in retail salmon resulted in pooled estimates of 13% (6-27%), 2% (0.1-11%), and 1% (0-5%), respectively. When MA of pathogen/seafood combination resulted in statistically significant heterogeneity (p<0.1), median/range were reported at the region level. The results from our ScS, SR, and MA could be used for better design of future bacteriological surveys of seafood and as inputs for risk assessments or surveillance initiatives in this field.     

Immunogenicity of pneumococcal conjugate vaccines in infants after two or three primary vaccinations: a systematic review and meta-analysis

Pneumococcal conjugate vaccines have been successfully used in infant vaccination programs. While most countries have used vaccination schedules with three primary immunisations and one booster dose, some countries have implemented schedules with only two primary immunisations and a booster dose. This systematic review aims to summarize evidence on immunogenicity of pneumococcal conjugate vaccines in infants comparing two and three primary immunisations before a booster dose is given. We systematically reviewed papers published between 1999 and 2011. Results from individual studies were pooled in a meta-analysis with the difference in proportion of children achieving serotype-specific ELISA antibody levels of ≥0.35 μg/ml. We estimated that about 10% less children achieve ELISA antibody levels of ≥0.35 μg/ml after two primary immunisations compared to three primary immunisations for most of serotypes included in one of the licensed pneumococcal conjugate vaccines. This difference in proportion was higher for serotypes 6B and 23F, where −49.4% (−66.0; −32.9%) and −26.9% (−37.2%; −16.6%) less children achieved protective antibody levels. These results support the notion that the majority of children are protected by two primary immunisations with pneumococcal conjugate vaccines in the first year of life. However, for serotypes 6B and 23F protection may be reduced.     

Healthcare equipment as a source of nosocomial infection: a systematic review

Nosocomial infections (NIs) result in significant financial and individual costs, with large numbers of patients acquiring infections annually. Healthcare equipment has been identified as a likely source of these infections, and research indicates that up to one-third of all NIs may be prevented by adequate cleaning of equipment. Thus, this systematic review aimed to determine levels of contamination on healthcare equipment, to identify viable cleaning protocols and to establish the methodological quality of current evidence. Published and unpublished studies from January 1972 to December 2004 were identified in eight major databases. Methodological quality was evaluated using the hierarchy of evidence and a quantitative critical appraisal tool. Data were extracted and analysed using five major outcome measures. Fifty studies were identified investigating a range of healthcare equipment, of which 23 were included in the review. Methodological quality ranged from 6.5 to 9.5 out of 14 for observational studies and from 6.5 to 9.5 out of 15 for repeated measures studies. The included studies reported that 86.8% of all sampled equipment was contaminated, with 70% alcohol reducing the levels of contamination on equipment by 82.1%. Healthcare equipment is a significant source of NI. High levels of contamination are present on a wide range of healthcare equipment. However, the majority of contamination and hence any risk of acquiring a NI can be reduced substantially by regular cleaning of equipment with 70% alcohol. Further research is required into the role of community healthcare equipment in NI.     

Isolation, detection and characterization of swine hepatitis E virus from herds in Costa Rica

Although swine HEV isolates from North America, Europe, and Asia have been genetically characterized, little is known about the strains presumed to be circulating in Latin America. In this study, seven commercial swine production sites in Costa Rica were surveyed for HEV. Using RT-PCR, with primers located in ORF2, 19/52 fecal samples produced a product of the expected size following two rounds of amplification. Most positive samples were from swine between the ages of 1.5 and 4 months. This study provides documented evidence for the endemicity of HE infections in swine residing in Central America. Through nucleic acid sequencing, isolates were found to be genetically similar, if not identical, with no amino acid substitutions. By comparison of swine and human HEV strains representing all four genotypes and phylogenetic analysis, our isolates closely resembled the US swine and human and other Genotype III strains, with 85-93% nucleic acid identity.     

中国原发性开角型青光眼患病率meta分析

目的 综合定量评价中国原发性开角型青光眼（POAG）的患病率,为我国POAG的防治工作提供参考依据。方法 检索中国知网数据库、万方数据服务平台、维普中文科技期刊全文数据库、PubMed数据库、EMbase数据库和Web of Science数据库,全面收集国内外1990年1月1日-2015年7月1日公开发表的关于POAG患病的相关文献;采用Note Express 2软件对纳入的文献进行剔重,应用Comprehensive Meta Analysis Version 2.2.064软件进行meta分析。结果 最终纳入20篇文献（中文文献12篇,英文文献8篇）,涉及15个省市共201 111人,其中POAG患者1 254例,中国POAG总体患病率为0.8%（95%CI=0.6%~1.2%）;亚组分析结果显示,男性POAG患病率为0.9%（95%CI=0.5%~1.6%）,高于女性患病率的0.8%（95%CI=0.5%~1.4%）,差异有统计学意义（Z=2.229,P=0.038）;南方地区POAG患病率为0.9%（95%CI=0.4%~1.8%）,高于北方地区POAG患病率的0.8%（95%CI=0.5%~1.2%）,差异有统计学意义（Z=2.332,P=0.034）;漏斗图和Egger检验结果（t=0.864,P=0.199）均未显示纳入的文献存在明显的发表偏倚。结论 中国POAG患病率相对较低,POAG患病率男性高于女性、南方地区高于北方地区。     

复方制剂缬沙坦—氨氯地平治疗原发性高血压meta分析

目的系统评价复方制剂缬沙坦–氨氯地平治疗原发性高血压的疗效和不良反应,为该复方制剂的合理使用提供参考依据。方法以高血压、复方制剂、缬沙坦、氨氯地平等为检索词,检索Web of Science、Embase、Pub Med、Cochrane图书馆、维普、万方、中国知网等数据库,文献发表时间为1997年~2017年,获得复方制剂缬沙坦–氨氯地平治疗原发性高血压的文献资料,提取数据信息,以软件Rev Man 5.3进行meta分析。结果共纳入符合条件的研究25篇,合计患者数为23 761例;复方制剂缬沙坦–氨氯地平与其他抗高血压药物比较,治疗高血压的效果优于其他药物(90.62%vs 75.58%,合并OR=2.98,95%CI=2.02~4.40,P<0.001),不良反应发生率高于其他药物(17.58%vs 16.50%,合并OR=0.66,95%CI=0.50~0.87,P=0.003)。结论复方制剂缬沙坦–氨氯地平的降压效果较好,但临床应用时需加强对不良反应的用药教育,这为合理用药和药物政策制定提供了循证依据。     

广西地区猪、鼠、狗戊型肝炎病毒感染血清学分析

目的了解广西地区猪、鼠和狗血清中抗．戊型肝炎病毒（HEV）IgG抗体流行情况。方法应用HEV基因1型开放读码框（ORF）2和ORF3多肽包被酶标板，辣根过氧化物酶（HRP）标记的羊抗猪、羊抗鼠和羊抗狗建立的酶联免疫吸附试验（ELISA）法检测猪、鼠和狗血清中抗．HEV IgG。结果总抗．HEV IgG阳性率为31．84％（170／534），其中猪血清抗．HEV IgG阳性率为26．40％（66／250），鼠血清抗．HEV IgG阳性率为43．02％（77／179），狗血清抗．HEV IgG阳性率为25．71％（27／105）。结论猪、鼠和狗血清中存在HEV感染，鼠抗．HEV IgG阳性率最高。     

A 24-step guide on how to design,conduct, and successfully publish a systematic review and meta-analysis in medical research

European Journal of Epidemiology - To inform evidence-based practice in health care, guidelines and policies require accurate identification, collation, and integration of all available evidence in...     

Impact of pharmacists as immunizers on vaccination rates: A systematic review and meta-analysis

BackgroundUnderutilization of vaccination programs remains a significant public health concern. Pharmacists serve as educators, facilitators, and in some jurisdictions, as administrators of vaccines. Though pharmacists have been involved with immunizations in various ways for many years, there has yet to be a systematic review assessing the impact of pharmacists as immunizers in these three roles.ObjectiveTo complete a systematic review of the literature on the impact of pharmacists as educators, facilitators, and administrators of vaccines on immunization rates.MethodsWe identified 2825 articles searching the following databases from inception until October 2015: PubMed, EMBASE, Cochrane Libraries, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts, Google Scholar. Grey literature was identified through use of the Canadian Agency for Drugs and Technology in Health “Grey Matters” search tool. Content from relevant journals and references of included studies were also searched. Inclusion criteria were clinical or epidemiologic studies in which pharmacists were involved in the immunization process. Studies were excluded if no comparator was reported. Two reviewers independently completed data extraction and bias assessments using standardized forms.ResultsThirty-six studies were included in the review, 22 assessed the role of pharmacists as educators and/or facilitators and 14 assessed their role as administrators of vaccines. All studies reviewed found an increase in vaccine coverage when pharmacists were involved in the immunization process, regardless of role (educator, facilitator, administrator) or vaccine administered (e.g., influenza, pneumococcal), when compared to vaccine provision by traditional providers without pharmacist involvement. Limitations of the results include the large number of non-randomized trials and the heterogeneity between study designs.ConclusionsPharmacist involvement in immunization, whether as educators, facilitators, or administrators of vaccines, resulted in increased uptake of immunizations.PROSPERO Registration: CRD42013005067.     

A systematic review and meta-analysis of management options for adults who respond poorly to hepatitis B vaccination

An estimated 5–10% of adults do not seroconvert after a three-dose primary course of hepatitis B vaccines, and are considered non-responders. Many approaches have been used to induce immunity in healthy adult non-responders, but few studies have compared their relative effectiveness. We conducted a systematic review and meta-analysis of seroconversion rates after additional doses of four approaches: 20 mcg or 40 mcg intramuscular (IM), and 5 mcg or 20 mcg intradermal (ID). The search identified 13 articles encompassing 16 studies (N = 1067) that met the eligibility criteria. Seroconversion rates after additional doses of each approach were pooled and estimated. After one additional dose, the four approaches produced very similar seroconversion rates and we did not find any evidence to support the use of 40 mcg IM in healthy adults.     

Close similarity between sequences of hepatitis E virus recovered from humans and swine, France, 2008-2009

Frequent zoonotic transmission of hepatitis E virus (HEV) has been suspected, but data supporting the animal origin of autochthonous cases are still sparse. We assessed the genetic identity of HEV strains found in humans and swine during an 18-month period in France. HEV sequences identified in patients with autochthonous hepatitis E infection (n = 106) were compared with sequences amplified from swine livers collected in slaughterhouses (n = 43). Phylogenetic analysis showed the same proportions of subtypes 3f (73.8%), 3c (13.4%), and 3e (4.7%) in human and swine populations. Furthermore, similarity of >99% was found between HEV sequences of human and swine origins. These results indicate that consumption of some pork products, such as raw liver, is a major source of exposure for autochthonous HEV infection.     

Recovery of hepatitis A virus from a water supply responsible for a common source outbreak of hepatitis A.

An outbreak of hepatitis A occurred in a north Georgia trailer park served by a private well. Of 18 residents who were serosusceptible to hepatitis A virus (HAV), 16 (89%) developed hepatitis A. Well water samples were collected 3 months after illness onset in the index case and 28 days after illness onset in the last trailer park resident. Hepatitis A virus antigen (HAVAg) was detected in the samples by enzyme immunoassay from three of the five cell lines following two 30-day passages and from a fourth cell line following a third passage of 21 days.