scholarly journals Effectiveness of Community Nutrition-Specific Interventions on Improving Malnutrition of Children under 5 Years of Age in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Author(s):  
Delaram Ghodsi ◽  
Nasrin Omidvar ◽  
Bahareh Nikooyeh ◽  
Roshanak Roustaee ◽  
Elham Shakibazadeh ◽  
...  

Childhood malnutrition remains an important public health and development problem in low- and middle-income countries. This study aimed to systematically review the community-based nutrition-specific interventions and their effectiveness and/or cost-effectiveness on the nutritional status of children under 5 years of age in the Eastern Mediterranean Region (EMR). A systematic literature search of the English electronic databases, including PubMed, Scopus, ISI Web of Knowledge, Ovid, EMBASE, as well as Persian databases (SID and Magiran) was performed up to May 2019. Studies regarding the effectiveness/cost-effectiveness of the community-based nutrition-specific programs and interventions targeted at under-five-year children in EMR countries were selected. The primary outcomes were mean of Weight-for-age z-score (WAZ), Height-for-Age z-score (HAZ), and Weight-for-Height z-score (WHZ) of children or prevalence of wasting, stunting, and/or underweight among the children. Meta-analysis was also performed on the selected articles and intervention effects (mean differences) were calculated for each outcome for each study and pooled using a weighted random effects model. Risk of bias (ROB) of each included study was assessed based on the Cochrane Handbook for Systematic Reviews. The study protocol was registered in PROSPERO (CRD42020172643). Of 1036 identified studies, eight met the inclusion criteria. Amongst these, seven were from Pakistan and one from Iran. Only one study conducted in Pakistan reported the cost-effectiveness of nutrition-specific interventions in the region. Nutrition education/consultation and cash-based interventions were the most common nutrition-specific strategies used for management of child malnutrition in the EMR countries. Out of these eight studies, four were included in the meta-analysis. When different interventions were pooled, they had resulted in a significant improvement in WHZ of children (MD: 0.26; 95% CI: 0.07 to 0.46, three studies, I2 82.40%). Considering the high prevalence of child malnutrition in a number of countries in the region, capacity building and investigation regarding the implementation of new approaches to improve nutritional status of children and their effect(s) and cost-effectiveness assessment are highly recommended.

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 503
Author(s):  
Ali Rostami ◽  
Seyed Mohammad Riahi ◽  
Vahid Fallah Omrani ◽  
Tao Wang ◽  
Andreas Hofmann ◽  
...  

Toxascaris leonina is an ascaridoid nematode of dogs and cats; this parasite affects the health of these animals. This study estimated the global prevalence of Ta. leonina infection in dogs and cats using random effects meta-analysis as well as subgroup, meta-regression and heterogeneity analyses. The data were stratified according to geographical region, the type of dogs and cats and environmental variables. A quantitative analysis of 135 published studies, involving 119,317 dogs and 25,364 cats, estimated prevalence rates of Ta. leonina in dogs and cats at 2.9% and 3.4%, respectively. Prevalence was highest in the Eastern Mediterranean region (7.2% for dogs and 10.0% for cats) and was significantly higher in stray dogs (7.0% vs. 1.5%) and stray cats (7.5% vs. 1.8%) than in pets. The findings indicate that, worldwide, ~26 million dogs and ~23 million cats are infected with Ta. leonina; these animals would shed substantial numbers of Ta. leonina eggs into the environment each year and might represent reservoirs of infection to other accidental or paratenic hosts. It is important that populations of dogs and cats as well as other canids and felids be monitored and dewormed for Ta. leonina and (other) zoonotic helminths.


2020 ◽  
Author(s):  
Reza Negarandeh ◽  
Shah Jahan Shayan ◽  
Rajab Nazari ◽  
BSc. Frank Kiwanuka ◽  
MSc. Sanaz Akhavan Rad

Abstract Background Recently, inappropriate use of antibiotics has been correlated with life-threatening side-effects such as adverse effects, increased cost of treatment, and the higher rate of microbial resistance. Besides, it leads to a waste of resources. Therefore, this review sought to determine the pooled prevalence of self-medication with antibiotics, self-medicated illness, reasons for self-medication, antibiotics used for self-medication, source of obtaining antibiotics, the inappropriate practice of antibiotics and suggested recommendations for talking self-medication with antibiotics in the Eastern Mediterranean Region of the World Health Organization (EMRWHO). Methods Review conforms to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Database search was conducted in PubMed, Scopus, Embase, and Web of Science using a combination of keywords which included; antimicrobial, antibacterial, antibiotic, self-medication, self-treatment, self-prescription, non-prescribed, irrational use, inappropriate use, misuse, abuse and Eastern Mediterranean Region of WHO countries. The lists of references of the selected articles were also hand-searched to obtained additional relevant articles. Studies published in English from 2000 to 2018 were included in the review. Results We report on data from 60 articles and 49629 participants in this review. The overall prevalence of self-medication with antibiotics in EMRWHO was 47.2% (95% CI 41.6% – 52.9%). Yemen has the highest pooled rate with a rate of 75.0% (95% CI 63.4% − 83.9%), whilst Lebanon has the lowest pooled rate with a prevalence of 28.7% (95% CI 18.4% − 41.8%). The most common illnesses implicated in antibiotic self-medication were upper-respiratory infections and the most common antibiotic was Amoxicillin-Clavulanic acid. The commonest reasons for antibiotic self-medication include: saving time and money. Pharmacies pointed out as the most common source of obtaining antibiotics for self-medication. Conclusion Self-medication with antibiotics is significantly high in the member states of EMRWHO. Intervention such as an educational program for communities’ members to change their behaviors, policy on the mechanism of distribution of antibiotics is called for in this area.


2020 ◽  
Vol 160 ◽  
pp. 107931 ◽  
Author(s):  
Alireza Mirahmadizadeh ◽  
Mohammad Fathalipour ◽  
Ali Mohammad Mokhtari ◽  
Shahryar Zeighami ◽  
Soheil Hassanipour ◽  
...  

2019 ◽  
Vol 51 (10) ◽  
pp. 719-729
Author(s):  
Abdulbaset Maleknejad ◽  
Neda Dastyar ◽  
Mahin Badakhsh ◽  
Abbas Balouchi ◽  
Hosein Rafiemanesh ◽  
...  

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