Group A streptococcal infection in the United Kingdom: an emerging threat

Within group A Streptococcus (GAS), only Streptococcus pyogenes exhibits clinical significance. GAS is typed serologically based on unique surface proteins and critical virulence factors, such as a hyaluronic acid capsule that shields GAS from phagocytosis. The burden of GAS was estimated in the last five years as 14,000 to 25,000 cases of the invasive group A streptococcal disease in the USA with an estimated death from 1,500 to 2,300 cases per year. Early in the summer of 2022 in England, there was more scarlet fever than was anticipated. Early in the current season, the number of notifications rose to unusual heights. The analysis of invasive GAS (iGAS) isolate typing data shows that this season has seen a wide variety of encoding mature M protein (emm) gene sequence types found. Therefore, public health authorities should think about initiatives to increase clinicians’ and the general public’s awareness of GAS infections and to promote their quick diagnosis, molecular testing and antibiotic susceptibility testing, and standard treatment

Snakebite-Associated Infections: A Systematic Review and Meta-Analysis

Snakebites still constitute a significant public health problem in developing countries and are considered a neglected tropical condition by the WHO. Snake accidents are associated with substantial morbidity and mortality and may produce secondary complications, such as severe infections. The objective of this systematic review was to determine the prevalence of snakebite infections and characterize the bacteria isolated from these infections. A systematic literature review in five databases was carried out to assess the prevalence of snakebite infection. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% CIs. Cochran’s Q test and the I2 statistic were used to assess between-study heterogeneity. The pooled prevalence of infection due to snakebite was 27.0% (95% CI: 22.0–32.0%), with high heterogeneity among studies (I2 5 99.7%). The prevalence was higher in Asia (32%) than in the Americas (21%). Snakebite infections required surgical interventions in 68% (95% CI: 37.0–98.0%). The leading group of pathogens identified corresponded to Gram-negative bacteria (63%), particularly Morganella morganii (32%), but also, Gram-positive cocci (40%), especially Enterococcus spp. (23%) and Staphylococcus aureus (15%). However, multiple other pathogens, including anaerobes, were found. A high prevalence of snakebite-associated infection has been described, primarily due to M. morganii, with the corresponding implications for empirical therapy. Rational use of antimicrobials is recommended, and this should guide initial empirical treatment. Moreover, isolation and identification of the possible bacteria present in snakebite wounds is recommended in all cases to confirm or rule out associated infection.Universidad Científica del SurRevisión por pare

Mpox vaccine acceptance among healthcare workers: a systematic review and meta-analysis

Introduction: Mpox is a zoonotic viral disease that emerged in May 2022 and has since shown a high prevalence in non-mpox-endemic areas, resulting in an outbreak that caused more than 84,000 cases in 110 countries around the globe. Several vaccines are available to prevent the disease, and multiple studies have been conducted to assess the attitudes of different populations toward receiving the mpox vaccine. This study systematically reviews all the studies conducted on mpox vaccine acceptance/hesitancy among healthcare workers. Methods: A systematic literature search was conducted through four electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, up to March 2023. Studies that described mpox vaccine acceptance/hesitancy among healthcare workers were included, and the data were extracted using a uniform extraction sheet. Following the extraction, the meta-analysis included ten studies with 7322 healthcare workers. Three researchers independently assessed the risk of bias in the included study using the Newcastle–Ottawa Scale (NOS). Results: Ten studies were included in the review. This review indicates that the prevalence of mpox vaccine acceptance was 58.5%, and the prevalence of mpox vaccine hesitancy was 41.5%. There was a higher prevalence of acceptance in countries located in Asian and African areas compared to those in North America and Europe, estimated at 68% and 44.3%, respectively. Among the studies conducted solely among physicians, there was a high prevalence of mpox vaccine acceptance, at 77.1%, compared to 49% in studies that included all healthcare workers. Conclusion: There is a significant variation in the prevalence of mpox vaccine acceptance among different populations. Further research is needed to identify the factors that contribute to this variation and to develop interventions to increase vaccine acceptance. In addition, it is important to promote research on mpox vaccine acceptance and hesitancy among healthcare workers in countries where data is limited. This research will help policymakers develop effective policies to increase acceptance and reduce the disease burden

Efficacy and Safety of Colchicine in Pediatric Pericarditis: A Systematic Review and Future Directions.

Pediatric pericarditis presents challenges in its management, necessitating effective therapeutic interventions. Colchicine, known for its efficacy in adults, requires further investigation for its application and safety in pediatric cohorts. A systematic search across renowned databases identified relevant literature on colchicine use in pediatric pericarditis. Twenty-nine articles underwent rigorous screening, with 18 studies meeting inclusion criteria. Data extraction, quality assessment, and synthesis were conducted meticulously. Included studies comprised case reports, case series, and retrospective cohort studies. Colchicine demonstrated efficacy in reducing recurrence rates and symptom burden, with doses ranging from 0.25 mg/day to 2 mg/day. Adverse events were minimal, predominantly gastrointestinal. Notably, nausea was the most common side effect reported. The safety profile of colchicine was favorable, with rare instances of hepatic and hematologic toxicity. Colchicine emerges as a promising therapeutic option for pediatric pericarditis, demonstrating efficacy in reducing recurrence rates and alleviating symptoms. Its favorable safety profile suggests potential as a preferred long-term therapy. However, further research, including randomized controlled trials, is warranted to confirm its efficacy and safety and explore potential combination therapies

Oral manifestations of mpox: A common presentation?

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Parents’ expectation of antibiotic prescriptions for respiratory infections in children: a systematic review and meta-analysis

Objectives: Despite most childhood infections being self-limiting, children are among the leading consumers of antibiotics. Little is known about parental expectations of antibiotics for childhood infections. A comprehensive systematic review and meta-analysis was conducted to explore the nature and extent of parental expectations of antibiotic prescriptions for children with respiratory infections. Design: Systematic review and meta-analysis. Methods: An extensive literature search using six major scientific databases was conducted for all published articles until 7 December 2022. Primary studies reporting parents’ expectations of antibiotics for children with upper respiratory tract infections were included after assessment for quality. Heterogeneity between the studies was assessed using the I 2 statistic and publication bias was analyzed using funnel plots and Egger regression tests. The primary outcome was a summary estimate of the percentage of parents who expect antibiotics from their physicians when their child presents with an upper respiratory tract infection. Results: From a total of 4510 studies found in the initial searches, a final pool of 19 eligible studies with 15,664 individuals was included in this meta-analysis. Nine of the 19 studies were from the United States or Saudi Arabia. The pooled prevalence of parental expectations of antibiotics in the population reviewed was 55.78% (95% CI = 44.60–66.41). There was significant heterogeneity between the studies, but funnel plot and meta-regression did not detect any publication bias. Conclusion: More than half of parents expect antibiotics for their children during consultation for upper respiratory tract infections. Such practices may cause undue side effects among children, contribute to the growing burden of antibiotic resistance, and lead to treatment failure for many common infections in the future. To optimize efforts to tackle antimicrobial resistance, shared decision-making and education emphasizing the proper and judicious use of antibiotics are much needed in pediatric healthcare settings. This can also help to manage parents’ expectations when seeking antibiotics for their children. Despite pressure from parents, pediatric healthcare providers should continue to advocate for antibiotic use only when warranted and help improve knowledge and awareness amongst parents. Registration: The protocol has been registered with PROSPERO (CRD42022364198

Prevalence of computer vision syndrome during the COVID-19 pandemic: a systematic review and meta-analysis

Abstract Background Computer vision syndrome has become a significant public health problem, especially in developing countries. Therefore, this study aims to identify the prevalence of computer vision syndrome during the COVID-19 pandemic. Methods A systematic review and meta-analysis of the literature was conducted using the databases PubMed, Scopus, Web of Science, and Embase up to February 22, 2023, using the search terms "Computer Vision Syndrome" and "COVID-19". Three authors independently performed study selection, quality assessment, and data extraction, and the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to evaluate study quality. Heterogeneity was assessed using the statistical test I 2 , and the R version 4.2.3 program was used for statistical analysis. Results A total of 192 studies were retrieved, of which 18 were included in the final meta-analysis. The total sample included 10,337 participants from 12 countries. The combined prevalence of computer vision syndrome was 74% (95% CI: 66, 81). Subgroup analysis based on country revealed a higher prevalence of computer vision syndrome in Pakistan (99%, 95% CI: 97, 100) and a lower prevalence in Turkey (48%, 95% CI: 44, 52). In addition, subgroup analysis based on study subjects showed a prevalence of 82% (95% CI: 74, 89) for computer vision syndrome in non-students and 70% (95% CI: 60, 80) among students. Conclusion According to the study, 74% of the participants experienced computer vision syndrome during the COVID-19 pandemic. Given this finding, it is essential to implement preventive and therapeutic measures to reduce the risk of developing computer vision syndrome and improve the quality of life of those affected. Trial registration The protocol for this systematic review and meta-analysis was registered in the international registry of systematic reviews, the International Prospective Register of Systematic Reviews (PROSPERO), with registration number CRD42022345965

Cardioprotective Effect of Antiviral Therapy Among Hepatitis C Infected Patients: A Meta-Analysis

BACKGROUND: Hepatitis C (HCV) infections have been shown to be associated a with higher risk of atherosclerotic cardiovascular disease (CVD). However, the use of antiviral therapy (AVT) and the risk of CVD has not been well established with limited literature. OBJECTIVE: We sought to evaluate the association between AVT use post-HCV infection and cardiovascular outcomes. METHODS: We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until 10th March 2023. Primary clinical outcomes were the incidence of any CVD. Secondary endpoints were all-cause of mortality, stroke, myocardial infarction, and peripheral artery disease. RESULTS: A total of 394,452 patients were included in the analysis (111,076 in the AVT group and 283,376 patients in the NAVT group). The mean age of patients among AVT and NAVT groups was comparable (58.7 vs 58.18). The pooled analysis of primary outcomes showed that AVT was associated with a significantly reduced risk of any CVD (HR, 0.55(95%CI: 0.41-0.75), P \u3c 0.001) compared with the NAVT group of patients. Secondary outcomes including ACM (HR, 0.38(95%CI: 0.32-0.46), P \u3c 0.001), MI (HR, 0.62(95%CI: 0.41-0.94), P = 0.02), and PAD (HR, 0.62(95%CI: 0.41-0.93), P = 0.02) were significantly lower among AVT groups compared with NAVT groups of patients with HCV infection. However, the risk of stroke was comparable between both groups of patients (HR, 0.79(95%CI: 0.58-1.07), P = 0.13). CONCLUSION: Our analysis shows HCV-infected patients post-AVT have a significantly lower risk of any CVD, MI, ACM, and PAD compared with NAVT groups of patients

The global prevalence of Trichuris trichiura infection in humans (2010-2023): A systematic review and meta-analysis

This systematic review and meta-analysis study aimed to evaluate global Trichuris infection prevalence, assessing progress towards the WHO's 2030 target. We searched international databases from 2010–2023, categorizing data by regions and socio-economic variables using a random-effects model. Analyzing 757 articles covering 7154,842 individuals from 78 countries, the study found a pooled global prevalence of (6.64–7.57%), with the highest rates in the Caribbean (21.72%; 8.90–38.18%) and South-East Asia (20.95; 15.71–26.71%) regions. Southern Africa (9.58; 2.11–21.46%), Latin America (9.58; 2.11–21.46%), and Middle Africa Middle Africa (8.94; 6.31–11.98%) also exhibited high prevalence. Eastern Europe had the lowest prevalence at 0.16% (0.09–0.24). Approximately 513 (480−547) million people worldwide were estimated to harbor Trichuris. Moreover ∼1.5% of people tested worldwide (2010–2023) had a moderate to heavy intensity of infection. The study emphasizes the persistent global health threat of Trichuris infection, urging tailored strategies for effective control and prevention on a global scale

Antiviral Treatment against Monkeypox: A Scoping Review

During the COVID-19 pandemic, the increase in reports of human monkeypox virus infection cases spreading in many countries outside Africa is a major cause for concern. Therefore, this study aimed to explore the evidence of antiviral pharmacotherapy available for the treatment of adult patients with monkeypox. A scoping review of the literature was conducted using PubMed, Scopus, Web of Science, Embase, and CENTRAL databases until 12 September 2022. The key search terms used were “monkeypox” and “treatment”. A total of 1927 articles were retrieved using the search strategy. After removing duplicates (n = 1007) and examining by title, abstract, and full text, 11 studies reporting case reports of monkeypox with antiviral treatment were included, detailing the number of monkeypox cases, clinical manifestations, number of participants with antiviral treatment, history of sexually transmitted diseases, method of diagnosis, location of skin lesions, drugs used in antiviral treatment, route of administration, and outcome. A total of 1281 confirmed cases of monkeypox have been reported, of which 65 monkeypox cases had antiviral treatment distributed most frequently in the United States (n = 30), the United Kingdom (n = 6), and Spain (n = 6). Of the total cases, 1269 (99.1%) were male with an age range of 18 to 76 years, and 1226 (95.7%) had a sexual behavior of being men who have sex with men. All confirmed cases of monkeypox were diagnosed by reverse transcriptase polymerase chain reaction (RT-PCR). The most frequent clinical manifestations were skin lesions, fever, lymphadenopathy, headache, fatigue, and myalgia. The most frequent locations of the lesions were perianal, genital, facial, and upper and lower extremities. The most commonly used drugs for antiviral treatment of monkeypox were: tecovirimat, cidofovir, and brincidofovir. All patients had a complete recovery. According to current evidence, the efficacy and safety of antiviral drugs against monkeypox is of low quality and scarce