scholarly journals Rotavirus disease and health care utilisation among children under 5 years of age in highly developed countries: a systematic review and meta-analysis

Author(s):  
Cristina Ardura-Garcia ◽  
Christian Kreis ◽  
Milenko Rakic ◽  
Manon Jaboyedoff ◽  
Maria Christina Mallet ◽  
...  

AbstractBackgroundRotavirus (RV) infection is the leading cause of diarrhoea-associated morbidity and mortality globally among children under 5 years of age. RV vaccination is available, but has not been implemented in many national immunisation plans, especially in highly developed countries. This systematic review aimed to estimate the prevalence and incidence of health care use for RV gastroenteritis (RVGE) among children aged under 5 years in highly developed countries without routine RV vaccination.MethodsWe searched MEDLINE and Embase databases from January 1st 2000 to December 17th 2018 for publications reporting on incidence or prevalence of RVGE-related health care use in children below 5 years of age: primary care and emergency department (ED) visits, hospitalisations, nosocomial infections and deaths. We included only studies with laboratory-confirmed RV infection, undertaken in highly developed countries with no RV routine vaccination plans. We used random effects meta-analysis to generate summary estimates with 95% confidence intervals (CI) and prediction intervals.ResultsWe screened 4033 abstracts and included 74 studies from 21 countries. Average incidence rates of RVGE per 100 000 person-years were: 2484 (95% CI 697-5366) primary care visits, 1890 (1597-2207) ED visits, 500 (422-584) hospitalisations, 34 (20-51) nosocomial infections and 0.04 (0.02-0.07) deaths. Average proportions of cases of acute gastroenteritis caused by RV were: 21% (95% CI 16-26%) for primary care visits; 32% (25-38%) for ED visits; 41% (36-47%) for hospitalisations, 29% (25-34%) for nosocomial infections and 12% (8-18%) for deaths. Results varied widely between and within countries, and heterogeneity was high (I2>90%) in most models.ConclusionRV in children under 5 years causes many healthcare visits and hospitalisations, with low mortality, in highly developed countries without routine RV vaccination. The health care use estimates for RVGE obtained by this study can be used to model RV vaccine cost-effectiveness in highly developed countries.Take home messageRV-caused illness leads to a high burden of health care usage in highly developed countries who have not introduced RV vaccination.

2020 ◽  
Author(s):  
Cácia Régia de Paula ◽  
Cristiane José Borges ◽  
Flavio Henrique Alves de Lima ◽  
Celmo Celeno Porto ◽  
Marcos André Matos ◽  
...  

Abstract Background: Scientific studies on human health are not remote and show that mortality in this population is increasing. Although male morbidity and mortality rates have a considerable weight in national and international epidemiological profiles, the presence of men in primary health care services is lower than that of women. Many injuries could be avoided if men regularly carried out the first preventive measures. Sensitive Conditions to Primary Care are consolidated as an important marker of access to health services and the resolution capacity of Primary Care. In this systematic review, the objective is to identify what is known about the prevalence and / or incidence of Sensitive Conditions to Primary Care in adult men.Methods: We will identify the studies through systematic research in PUBMED-MEDLINE, SCOPUS, Web of Science, Embase, Cochrane, BDTD and OpenGrey. The quality assessment of retrieved articles will be carried out using the critical assessment tools of the Joanna Briggs Institute (JBI). The quantitative synthesis of the data will be carried out if the studies are homogeneous and provide adequate result data for meta-analysis. Otherwise, the data will be synthesized, using the narrative synthesis approach.Discussion: This review will explore theprevalenceand / orincidenceofSensitiveConditionstoprimarycare (prevalenceofhospitalizations; incidenceofhospitalizationsand deaths from ACSC) in adultmenandwillact as a usefulsource for researchers, policymakersand stakeholders whendevelopingandimplementinginterventions for thatgroup. Systematic review registration: This systematic review protocol was submitted to International Prospective Register of Systematic Reviews (PROSPERO). Submission number: ID 169447. This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols checklist (PRISMA-P).


2018 ◽  
Vol Volume 13 ◽  
pp. 257-273 ◽  
Author(s):  
Alex Jenkins ◽  
Holly Gowler ◽  
Ffion Curtis ◽  
Neil Holden ◽  
Christopher Bridle ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037405
Author(s):  
Daniel Dedman ◽  
Melissa Cabecinha ◽  
Rachael Williams ◽  
Stephen J W Evans ◽  
Krishnan Bhaskaran ◽  
...  

ObjectiveTo identify observational studies which used data from more than one primary care electronic health record (EHR) database, and summarise key characteristics including: objective and rationale for using multiple data sources; methods used to manage, analyse and (where applicable) combine data; and approaches used to assess and report heterogeneity between data sources.DesignA systematic review of published studies.Data sourcesPubmed and Embase databases were searched using list of named primary care EHR databases; supplementary hand searches of reference list of studies were retained after initial screening.Study selectionObservational studies published between January 2000 and May 2018 were selected, which included at least two different primary care EHR databases.Results6054 studies were identified from database and hand searches, and 109 were included in the final review, the majority published between 2014 and 2018. Included studies used 38 different primary care EHR data sources. Forty-seven studies (44%) were descriptive or methodological. Of 62 analytical studies, 22 (36%) presented separate results from each database, with no attempt to combine them; 29 (48%) combined individual patient data in a one-stage meta-analysis and 21 (34%) combined estimates from each database using two-stage meta-analysis. Discussion and exploration of heterogeneity was inconsistent across studies.ConclusionsComparing patterns and trends in different populations, or in different primary care EHR databases from the same populations, is important and a common objective for multi-database studies. When combining results from several databases using meta-analysis, provision of separate results from each database is helpful for interpretation. We found that these were often missing, particularly for studies using one-stage approaches, which also often lacked details of any statistical adjustment for heterogeneity and/or clustering. For two-stage meta-analysis, a clear rationale should be provided for choice of fixed effect and/or random effects or other models.


2021 ◽  
pp. 1-15
Author(s):  
Amanda Roberts ◽  
Jim Rogers ◽  
Stephen Sharman ◽  
G. J. Melendez-Torres ◽  
Sean Cowlishaw

2021 ◽  
Vol 5 (1) ◽  
pp. 23
Author(s):  
Raquel Pacheco ◽  
Maria Alzira Cavacas ◽  
Paulo Mascarenhas ◽  
Pedro Oliveira ◽  
Carlos Zagalo

This systematic review and meta-analysis aimed to assess the literature about the incidence of oral mucositis and its degrees (mild, moderate, and severe), in patients undergoing head and neck cancer treatment (radiotherapy, chemotherapy, and surgery). Addressing this issue is important since oral mucositis has a negative impact on oral health and significantly deteriorates the quality of life. Therefore, a multidisciplinary team, including dentists, should be involved in the treatment. The overall oral mucositis incidence was 89.4%. The global incidence for mild, moderate, and severe degrees were 16.8%, 34.5%, and 26.4%, respectively. The high incidence rates reported in this review point out the need for greater care in terms of the oral health of these patients.


2021 ◽  
pp. 175045892096415
Author(s):  
Tito D Tubog ◽  
Richard S Bramble

The incidence rates of spinal anaesthesia-induced hypotension vary depending on the surgical procedures. This systematic review and meta-analysis evaluates the efficacy of prophylactic ondansetron in reducing the incidence of spinal anaesthesia-induced hypotension in non-caesarean delivery. Thirteen trials consisting of 1166 patients were included for analysis. Compared to placebo, there is a low quality of evidence that ondansetron was effective in reducing the incidence of spinal anaesthesia-induced hypotension (RR 0.62, 95% CI 0.44 to 0.87; p = 0.005) and bradycardia (RR 0.54, 95% CI 0.32 to 0.90; p = 0.02). We also found a moderate quality of evidence that ondansetron lowered the number of rescue ephedrine (RR 0.61, 95% CI 0.43 to 0.87; p = 0.007). Patients treated with ondansetron have higher mean arterial pressure 15 to 20 minutes after spinal anaesthesia induction and higher systolic arterial pressure 5, 10, 15 and 20 minutes after spinal anaesthesia. The evidence suggests that prophylactic administration of ondansetron results in the reduction of the incidence of spinal anaesthesia-induced hypotension, bradycardia and rescue ephedrine in patients undergoing non-caesarean delivery under spinal anaesthesia.


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