Epidemiology of herpes simplex virus type 2 in the Middle East and North Africa: Systematic review, meta-analyses, and meta-regressions

Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with poorly characterized prevalence in the Middle East and North Africa (MENA) region. This study characterized HSV-2 epidemiology in MENA. HSV-2 reports were systematically reviewed as guided by the Cochrane Collaboration Handbook and findings were reported following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were performed to estimate pooled mean outcome measures and to assess predictors of HSV-2 antibody prevalence (seroprevalence), trends in seroprevalence, and between-study heterogeneity. In total, sixty-one overall (133 stratified) HSV-2 seroprevalence measures and two overall (four stratified) proportion measures of HSV-2 detection in laboratory-confirmed genital herpes were extracted from 37 relevant publications. Pooled mean seroprevalence was 5.1% (95% confidence interval [CI]: 3.6%–6.8%) among general populations, 13.3% (95% CI: 8.6%–18.7%) among intermediate-risk populations, 20.6% (95% CI: 5.3%–42.3%) among female sex workers, and 18.3% (95% CI: 3.9%–39.4%) among male sex workers. Compared to Fertile Crescent countries, seroprevalence was 3.39-fold (95% CI: 1.86–6.20) and 3.90-fold (95% CI: 1.78–8.57) higher in Maghreb and Horn of Africa countries, respectively. Compared to studies published before 2010, seroprevalence was 1.73-fold (95% CI: 1.00–2.99) higher in studies published after 2015. Pooled mean proportion of HSV-2 detection in genital herpes was 73.8% (95% CI: 42.2%–95.9%). In conclusion, MENA has a lower HSV-2 seroprevalence than other world regions. Yet, 1 in 20 adults is chronically infected, despite conservative prevailing sexual norms. Seroprevalence may also be increasing, unlike other world regions. Findings support the need for expansion of surveillance and monitoring of HSV-2 infection in MENA.This work was supported by the Qatar National Research Fund [NPRP 9-040-3-008] and by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar

Cytotoxicity and thrombolytic potential of seven different medicinal plant leaves extract

Background: In practice, either the herbs themselves or the crude extracts are used for traditional remedies but not the isolated molecules. Therefore, the importance of toxicity and clot lysis study of the crude extract is beyond description. Objective: The aim of our study was to find out the preliminary cytotoxic and thrombolytic effect of the seven selected medicinal plant leaves extract. Methods: Cold maceration was performed using ethanol for extraction purposes. The cytotoxicity study was done by using brine shrimp nauplii (Artemia salina) and MTT assays by using MCF-7 cell line. Result: In the cytotoxic activity, out of the seven leaves extract three of them exhibited stronger brine shrimp lethality with 4 TH PHARMACEUTICAL RESEARCH CONFERENCE 2018 Challenging The Inquisitive Minds: Frontier Of The Future 24 – 26 August 2018 | Cyberjaya, Malaysia LC50 122.548 (Uncaria acida), 170.861 (Leea indica) and 175.469 (Piper porphyrophyllum) μg /mL respectively, and on MCF-7 cell line, they also exhibited moderate cytotoxic activity with different concentration of the extract of the same plant leaves such as, Uncaria acida (72.31, 56.22, 38.12 and 9.24%), Leea indica (67.31, 58.22, 43.12 and 15.24%), Piper porphyrophyllum (65.88, 48.12, 40.12 and 21.34%). In thrombolytic assessments, all the leaves extract showed moderate (considering > 20% moderate; **p < 0.01; *p < 0.05) clot lysis activity, but among the extracts, Uncaria cordata (27.36 ± 0.10%) showed the highest and Stachytarpheta indica the lowest (6.14 ± 0.20%) percent clot lysis as compared with the standard streptokinase (65.15 ± 0.16%). Conclusion: This study was conducted to support the folkloric use of seven medicinal plant leaves to improve cancer or myocardial infarction. Although, it is a preliminary screening but it will be targeted to the scientific community to put more attention and to do an extensive and molecular level study in future

Characterizing trends and associations for hepatitis C virus antibody prevalence in the Middle East and North Africa: meta-regression analyses

Abstract This study characterized population-level trends and associations with hepatitis C virus (HCV) antibody (Ab) prevalence in the Middle East and North Africa (MENA). Data source was the standardized and systematically gathered MENA HCV Epidemiology Synthesis Project Database. Random-effects univariable and multivariable meta-regressions were conducted. 2,621 HCV Ab prevalence measures on 49,824,108 individuals were analyzed. In the analysis including all populations, 71% of the variation in prevalence was explained, mostly by at-risk population type. Compared to the general population, prevalence was 23-fold higher among people who inject drugs, and 14-fold higher among high-risk clinical populations. In the analysis including only the general population, 67% of the variation in prevalence was explained, mostly by country/subregion. Compared to Afghanistan, prevalence was highest in Egypt and Pakistan. Prevalence in the general population was declining at a rate of 4% per year, but outside the general population, the decline was at only 1% per year. HCV Ab prevalence in MENA is declining rapidly, but this decline is largely occurring in the general population following introduction of blood and injection safety measures. The decline in populations at higher risk of exposure is slow and below the level needed to achieve HCV elimination by 2030