Global knowledge and attitudes towards mpox (monkeypox) among healthcare workers: a systematic review and meta-analysis

BACKGROUND

The recent increase in human mpox (monkeypox) cases emphasizes the importance of early detection, prompt response and preventive management to control the spread of the disease. Healthcare workers (HCWs) play a crucial role in this process. This study aimed to determine the global knowledge and attitudes towards mpox among HCWs.

METHODS

This study searched multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, Embase, Springer and ProQuest, to locate various publications. The search was limited to English-language articles published between May 2022 (when the increase in mpox incidence was reported) and August 2023. The Joanna Briggs Institute (JBI) quality checklist was utilized to evaluate the quality of the included studies. Data were obtained using a Microsoft Excel spreadsheet and subsequently scrutinized through STATA software, version 14. The heterogeneity of the studies was assessed using the inverse variance and Cochran Q statistics based on the I2 test statistics. The Dersimonian and Liard random effects models were used where heterogeneity existed. Subgroup analysis and univariate and multivariable metaregression techniques were used to examine the causes of heterogeneity.

RESULTS

A total of 22 studies, including 22 studies for knowledge (27 731 HCWs) and 6 studies for attitudes (14 388 HCWs), were included in the meta-analysis. The pooled estimates for good knowledge and positive attitudes among HCWs were 26.0% (95% confidence interval [CI] 17.8 to 34.2) and 34.6% (95% CI 19.0 to 50.2), respectively. Moreover, the knowledge was 34.8% (95% CI 24.1 to 45.6) among HCWs with <5 y of work experience and 41.6% (95% CI 33.1 to 50) among individuals possessing >5 y of professional background.

CONCLUSIONS

Good knowledge of HCWs is at a low level. It is suggested that training sessions should be tailored towards younger HCWs with less healthcare experience. Additionally, it is essential to identify strategies on how to improve the knowledge and attitudes for better practice about the disease in HCWs worldwide.

The incidence of oral cavity cancer in Iran: A systematic review and meta-analysis

BACKGROUND AND AIMS

Oral cancer is now a top priority for non-communicable illnesses and universal health care plans, according to the WHO. There is no general estimate of the incidence of oral cavity cancer in Iran, despite multiple investigations. The purpose of this study is to evaluate the age-standardized incidence rate (ASR) of oral cavity cancers in Iran.

METHOD

In accordance with the MOOSE (Meta-analyses of Observational Studies in Epidemiology) Checklist recommendations, this systematic review was conducted. PubMed/MEDLINE, Web of Science, ScienceDirect, Embase, Scopus, ProQuest, and Google Scholar were used as the international databases for the systematic literature search, while SID (Scientific Information Database), Magiran and element were used as the Iranian databases. The heterogeneity of the research will be evaluated by means of the inverse variance and Cochran Q tests, along with random-effect models. It was determined what caused the heterogeneity using a meta-regression model. By eliminating experiments one at a time, sensitivity analysis was used. The meta-analysis was corrected utilizing the Trim-and-fill method due to the identification of noteworthy publication bias via the Egger's test and asymmetry of the funnel plot.

RESULTS

This research incorporated a total of 22 journal articles. The pooled ASR of oral cavity cancer for males and females was estimated at 1.96 (95% CI: 1.65-2.26) (Q statistic = 1118.09, df = 25, p < .0001, I²  = 97.8%), and 1.46 (95% CI: 1.14-1.77) (Q statistic = 2576.99, df = 26, p < .0001, I²  = 99.0%), respectively. According to the funnel plots and Egger's test, there is no evidence of publication bias in studies reporting on males (bias = 1.3220, 95% CI: -3.9571, 6.6012, p = .610), but for ASR in females, Egger's test was significant (bias = -7.6366, 95% CI: 2.2141, 13.05904, p = .008). Based on Trim-and-fill methods, overall ASR corrected in females was estimated to be 1.36 (95% CI: 1.05%-1.66%).

CONCLUSION

Iran's oral cavity cancer incidence was lower than the global average, but owing to variables including an aging population, a rise in life expectancy, and exposure to risk factors like smoking, we anticipate an increasing trend.

Global knowledge, attitude, and practice towards COVID-19 among pregnant women: a systematic review and meta-analysis

BACKGROUND

Pregnant women form a specially vulnerable group due to unique changes in pregnancy, leading to a higher risk of getting a severe infection. As severe COVID-19 increases the risk of preeclampsia, preterm delivery, gestational diabetes, and low birth weight in pregnancy, there is a need to enhance pregnant women's knowledge, attitudes, and practices to prevent these complications. This systematic review and meta-analysis aimed to determine their levels of knowledge, attitudes, and practice (KAP) regarding COVID-19 at the global level.

METHODS

The systematic literature search was conducted in the English language, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest, from the occurrence of the pandemic until September 2022. We used The Newcastle Ottawa scale for cross-sectional studies checklist to evaluate the risk of bias in the studies. Data were extracted by a Microsoft Excel spreadsheet and analyzed by STATA software version 14. We also employed Cochran Q statistics to assess the heterogeneity of studies and utilized Inverse variance random-effects models to estimate the pooled level of pregnant women's KAP towards COVID-19 infection prevention.

RESULTS

Based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and inclusion criteria, 53 qualified studies were acquired from several countries. In total, 51 articles (17,319 participants) for knowledge, 15 articles (6,509 participants) for attitudes, and 24 articles (11,032 participants) for practice were included in this meta-analysis. The pooled good knowledge, positive attitude, and appropriate practice in pregnant women were estimated at 59%(95%CI: 52-66%), 57%(95%CI: 42-72%), and 53%(95%CI: 41-65%), respectively. According to subgroup analysis, the level of knowledge, attitude, and practice were 61%(95%CI: 49-72), 52%(95%CI: 30-74), and 50%(95%CI: 39-60), respectively, in Africa, and 58.8%(95%CI: 49.2-68.4), 60%(95%CI: 41-80) and 60% (95%CI: 41-78), respectively, in Asia.

CONCLUSION

The Knowledge, attitude, and practice towards COVID-19 infection prevention in pregnant women were low. It is suggested that health education programs and empowerment of communities, especially pregnant women, about COVID-19 continue with better planning. For future studies, we propose to investigate the KAP of COVID-19 in pregnant women in countries of other continents and geographical regions.

The Global Seroprevalence of Equine Brucellosis: A Systematic Review and Meta-analysis Based on Publications From 1990 to 2022

Brucellosis, a bacterial infection caused by Brucella spp., is a widespread zoonosis concerning human and animal health. In equines, brucellosis may occur asymptomatically or with clinical signs such as arthritis, bursitis, and tenosynovitis. This study aims to ascertain the overall seroprevalence of equine brucellosis and its related factors, including geographic region, serological detection method, equine's species, gender, age, and body condition. This is because equine brucellosis is a zoonotic infection with significant epidemiological implications. The systematic literature search was conducted from January 1, 1990, to April 1, 2022, in the following electronic databases: Google Scholar, Scopus, Pub Med, Science Direct, Web of Science, Embase, Springer, and ProQuest. Based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and inclusion criteria, 49 qualified studies were acquired from several countries. Because Egger's test result and the asymmetry in the funnel plot indicated significant publication bias, the meta-analysis model was corrected using the trim-and-fill method. After correction, the pooled seroprevalence of equine brucellosis was 1.92% (95% CI, 0.67-3.79; estimated by the random effect model). Based on meta-regression analysis, the probable heterogeneity factors may be geographic areas (continents and countries). The brucellosis seroprevalence in equines was the lowest in Europe (0%, 95% CI, 0-0.1) and the highest in Asia (10.03%, 95% CI, 8-12.9). The highest overall estimate of seroprevalence of Brucella infection in equines based on a subset of serological tests was made using the serum agglutination test (10.2%, 95% CI, 7.7-13.4). The combined seroprevalence of brucellosis in donkeys (7.3%, 95% CI, 4.9-9.7) was higher than in other equine species. The overall seroprevalence of brucellosis in female equines was significantly higher than in males (OR = 1.437; 95% CI, 1.025-2.014); despite this, the overall seroprevalence had no significant difference based on other risk factors such as age and body condition. Understanding the epidemiology of this zoonotic infection in equines is critical for one-health integration. In addition, this study's results may be appropriate for controlling and managing equine brucellosis.

Global prevalence and subtype distribution of Blastocystis sp. in rodents, birds, and water supplies: A systematic review and meta-analysis

Animals such as rodents and birds may play a key role in the distribution of Blastocystis sp., either as introducers of the parasite into the water or as receptors of an infection already established in the water. Hence, we aimed to evaluate the prevalence and subtype distributions of Blastocystis sp. in rodents, birds, and water supplies at a global scale through a systematic review and meta-analysis approach. The standard protocol of preferred reporting items for systematic reviews and meta-analyses (PRISMA) statements were applied. Eligible prevalence studies on Blastocystis sp. in rodents, birds, and water supplies, published between 1 January 2000 and 20 January 2022 were collected using a systematic literature search in online databases (Scopus and Web of Science) and search engines (PubMed and Google Scholar). Inclusion and exclusion criteria were followed. The point estimates and 95% confidence intervals (CI) were calculated using a random-effects model. The variances between studies (heterogeneity) were computed by I2 index. In total, 20 articles (24 datasets) for birds, 18 articles (18 datasets) for rodents, and 10 articles (12 datasets) for water supply were included for the final meta-analysis. The pooled prevalence of Blastocystis sp. in birds, rodents, and water was estimated to be 29% (95% CI 12-47%), 18% (95% CI 12-23%), and 10% (95% CI 6%-15%), respectively. Considering the subtypes, Blastocystis sp. with subtypes ST7 in birds, ST4 in rodents, and ST1 in water supplies were the highest reported subtypes. The present results highlight the role of birds, rodents, and water as a reservoir for human-infected Blastocystis sp. Therefore, this global estimate could be beneficial for preventive and control measures.

Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis

BACKGROUND

There are three main forms of leishmaniasis in humans: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), and mucocutaneous leishmaniasis. The prevalence of human leishmaniasis varies widely in different countries and different regions of the same country. To date, there is no overall estimation of the prevalence of human leishmaniasis in Sudan.

AIM

To determine the pooled prevalence of human leishmaniasis and the disease risk factors among Sudanese citizens.

METHODS

From all articles written in English or Arabic languages conducted before the 4th of August 2021 from [Scopus, Web of Science, PubMed, and MEDLINE, African Journals Online (AJOL), ResearchGate, direct Google search, Google Scholar, and universities websites], just 20 articles with a total of 230960 participants were eligible for this study. Data synthesis and analysis were done using STATA software, version 16. EndNote citation manager version X9.3.3 and Reference Citation Analysis (RCA) were used to remove the duplicated studies and manage the citation respectively.

RESULTS

The overall pooled prevalence of human leishmaniasis in Sudan was 21% (with confidence interval 12%-30%). CL was the most common type of leishmaniasis in Sudan, with a pooled prevalence of 26% followed by VL (18%). Nevertheless, the pooled prevalence of human leishmaniasis in Sudan was higher in males compared with females (60% vs 40%). The current results revealed that the people in the age group between 15 and 44 were the most affected group (60%), and central Sudan has the highest pooled prevalence of human leishmaniasis (27%) compared with other regions of Sudan. Finally, the prevalence of human leishmaniasis seems to decrease with time.

CONCLUSION

This study showed that human leishmaniasis infection is still endemic in many regions in Sudan and highly prevalent in central and eastern Sudan, and CL is the most prevalent in the country. Males and adults were more susceptible to infection compared with females and children. However, the human leishmaniasis prevalence decreased relatively over time.

Seroprevalence of bovine viral diarrhea virus (BVDV) infection in cattle population in Iran: a systematic review and meta-analysis

Bovine viral diarrhea virus (BVDV) is an important pathogen correlated with reproductive, respiratory, and gastrointestinal disorders in cattle. Furthermore, it causes endemic infections and significant economic losses in cattle herds worldwide. This review was performed to determine the pooled seroprevalence of BVDV infection and related risk factors among cattle in Iran. Data were systematically gathered without time limitation until 1 December 2020 in the Islamic Republic of Iran from the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Elmnet, Magiran, Irandoc, Scientific Information Database (SID), and Civilica. According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and inclusion criteria, 28 eligible studies were obtained from various Iran areas. In total, the pooled seroprevalence of BVDV infection, using random-effect model, was estimated 52% (95% CI, 40.1-63.9) in cattle. According to serological detection methods, pooled seroprevalence was as follows: based on ELISA 53.9% and SVN 25.1%. The highest pooled seroprevalence of BVDV infection was in the southeast provinces of Iran (78.4%) and lowest pooled seroprevalence was in Southwest provinces of the country (28.5%). The pooled seroprevalence of BVDV infection in cattle ≤ 2 years was significantly lower than cattle > 2 years (OR = 0.606; 95% CI, 0.397-0.925), whereas the pooled seroprevalence had no significant difference according to other factors such as gender, herd size, and herd types. In conclusion, the pooled seroprevalence of BVDV infection among cattle in Iran is relatively high. The seroprevalence was different among geographical regions of the country. These results are desirable for managing the control programs of this infection in Iran.

Temporal analysis of visceral leishmaniasis between 2000 and 2019 in Ardabil Province, Iran: A time-series study using ARIMA model

Background:

Visceral leishmaniasis in human (VLH) also known as kala-azar is a neglected disease of humans that mainly occurs in more than 50 countries mostly located in the Eastern Mediterranean and the Northern America.

Objective:

The purpose of this study was to determine the temporal patterns and predict of occurrence of VL in Ardabil Province, in northwestern Iran using autoregressive integrated moving average (ARIMA) models.

Methods:

This descriptive study employed yearly and monthly data of 602 cases of VLH in the province between January 2000 to December 2019, which was provided by the leishmaniasis national surveillance system. The monthly occurrences case constructed the ARIMA model of time-series model. The insignificance of the correlation in the lags of 12, 24 and 36 months, and Chi-square test showed the occurrence of VLH does not have a seasonal pattern. Eleven potential ARIMA models were examined for VLH cases. Finally, the best model was selected with the lower Akaike Information Criteria (AIC) and Bayesian information criterion (BIC) value. Then, the selected model was used to forecast frequency of monthly occurrences case. The forecasting precision was estimated by mean absolute percentage error (MAPE). Data analysis was performed using Stata14 and its package time series analysis.

Results:

ARIMA (5, 0, 1) model with AIC (25.7) and BIC (43.35) was selected. The MAPE value was 26.89% and the portmanteau test for white noise was (Q = 23.02, P = 0.98) for the residuals of the selected model showed that the data were fully modelled. The total cumulative VLH cases in the next 24 months’ in Ardabil province predicted 14 cases (95% CI: 4-54 case).

Conclusion:

The ARIMA (5, 0, 1) model can be a useful tool to predict VLH cases as early warning system and the results are helpful for policy makers and primary care physicians in the readiness of public health problems before the outbreak of the disease.