The epidemiology of postpartum malaria: a systematic review.
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SUBMITTER: Boel ME
PROVIDER: S-EPMC3379929 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundMalaria risk can vary markedly between households in the same village, or between villages, but the determinants of this "micro-epidemiological" variation in malaria risk remain poorly understood. This study aimed to identify factors that explain fine-scale variation in malaria risk across settings and improve definitions and methods for malaria micro-epidemiology.MethodsA systematic review of studies that examined risk factors for variation in malaria infection between individuals, households, clusters, hotspots, or villages in any malaria-endemic setting was conducted. Four databases were searched for studies published up until 6th October 2015. Crude and adjusted effect estimates for risk factors for malaria infection were combined in random effects meta-analyses. Bias was assessed using the Newcastle-Ottawa Quality Assessment Scale.ResultsFrom 743 retrieved records, 51 studies were selected, representing populations comprising over 160,000 individuals in 21 countries, in high- and low-endemicity settings. Sixty-five risk factors were identified and meta-analyses were conducted for 11 risk factors. Most studies focused on environmental factors, especially increasing distance from a breeding site (OR 0.89, 95% CI 0.86-0.92, 10 studies). Individual bed net use was protective (OR 0.63, 95% CI 0.52-0.77, 12 studies), but not household bed net ownership. Increasing household size (OR 1.08, 95% CI 1.01-1.15, 4 studies) and household crowding (OR 1.79, 95% CI 1.48-2.16, 4 studies) were associated with malaria infection. Health seeking behaviour, medical history and genetic traits were less frequently studied. Only six studies examined whether individual-level risk factors explained differences in malaria risk at village or hotspot level, and five studies reported different risk factors at different levels of analysis. The risk of bias varied from low to high in individual studies. Insufficient reporting and comparability of measurements limited the number of meta-analyses conducted.ConclusionsSeveral variables associated with individual-level malaria infection were identified, but there was limited evidence that these factors explain variation in malaria risk at village or hotspot level. Social, population and other factors may confound estimates of environmental risk factors, yet these variables are not included in many studies. A structured framework of malaria risk factors is proposed to improve study design and quality of evidence in future micro-epidemiological studies.
| S-EPMC5399382 | biostudies-literature
Project description:BackgroundHaemoglobinopathies can reduce the risk of malaria syndromes. We aimed to quantify the relation between different haemoglobin mutations and malaria protection to strengthen the foundation for translational studies of malaria pathogenesis and immunity.MethodsWe systematically searched the Medline and Embase databases for studies that estimated the risk of malaria in patients with and without haemoglobinopathies up to Sept 9, 2011, and identified additional studies from reference lists. We included studies that enrolled mainly children or pregnant women and had the following outcomes: Plasmodium falciparum severe malaria, uncomplicated malaria, asymptomatic parasitaemia, or pregnancy-associated malaria, and Plasmodium vivax malaria. Two reviewers identified studies independently, assessed quality of the studies, and extracted data. We produced odds ratios (ORs; 95% CIs) for case-control studies and incidence rate ratios (IRRs; 95% CIs) for prospective studies. We did the meta-analysis with a random-effects model when equivalent outcomes were reported in more than one study.FindingsOf 62 identified studies, 44 reported data for haemoglobin AS, 19 for haemoglobin AC and CC, and 18 for ?-thalassaemia. Meta-analysis of case-control studies showed a decreased risk of severe P. falciparum malaria in individuals with haemoglobin AS (OR 0·09, 95% CI 0·06-0·12), haemoglobin CC (0·27, 0·11-0·63), haemoglobin AC (0·83, 0·67-0·96), homozygous ?-thalassaemia (0·63, 0·48-0·83), and heterozygous ?-thalassaemia (0·83, 0·74-0·92). In meta-analysis of prospective trials only haemoglobin AS was consistently associated with protection from uncomplicated malaria (IRR 0·69, 95% CI 0·61-0·79); no haemoglobinopathies led to consistent protection from asymptomatic parasitaemia. Few clinical studies have investigated ?-thalassaemia, haemoglobin E, P. vivax malaria, or pregnancy-associated malaria.InterpretationHaemoglobin AS, CC, and AC genotypes and homozygous and heterozygous ?-thalassaemia provide significant protection from severe malaria syndromes, but these haemoglobinopathies differ substantially in the degree of protection provided and confer mild or no protection against uncomplicated malaria and asymptomatic parasitaemia. Through attenuation of severity of malaria, haemoglobinopathies could serve as a model for investigation of the mechanisms of malaria pathogenesis and immunity.FundingUS National Institute of Allergy and Infectious Diseases.
| S-EPMC3404513 | biostudies-literature
Project description:Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1-2 in every 1000 deliveries. These episodes typically present as acute mania or depression with psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. The nosological status of postpartum psychosis remains contentious; however, evidence indicates most episodes to be manifestations of bipolar disorder and a vulnerability to a puerperal trigger. While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of postpartum psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder. Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of postpartum psychosis.
| S-EPMC7824357 | biostudies-literature
Project description:BackgroundIn order to attain the objectives set out in the global technical strategy against malaria 2016-2030, it is important to have accurate epidemiological data on malaria in all age categories, including those which are often neglected because of an apparent low burden of disease. The current systematic review with meta-analysis synthesizes the epidemiology of clinical congenital and neonatal malaria in endemic areas.MethodsPubMed, EMBASE, Global Index Medicus, and Web of Science were searched up to 30th October 2019, to identify observational studies reporting on congenital (0-7 days) and neonatal (0-28 days) malaria. No restriction related to language was applied. Study selection, data extraction, and methodological quality assessment were performed independently by two investigators. A random-effects meta-analysis was used to pool prevalence data. Prevalence were adjusted taking into account the variance due to diagnostic method and regional distribution. Subgroup analyses were performed to identify sources of heterogeneity in case of substantial heterogeneity. This review was registered in PROSPERO with number CRD42020150124.ResultsThe bibliographical search identified 1,961 studies, of which 22 were finally retained with a total population of 28,083 neonates. The overall crude prevalence of clinical congenital malaria was 40.4‰ (95%CI 19.6-67.7; 17 studies). The adjusted prevalence considering the variance due to difference in region/country (hierarchical model) was 33.7‰ (95%CI 6.9-77.2). There was no difference between the prevalence of clinical congenital malaria in Africa 39.5‰ (95%CI 17.2-59.5; 15 studies) and outside Africa 56.3‰ (95%CI 0.0-406.1), p = 0.867. The overall crude prevalence of clinical neonatal malaria was 12.0‰ (95%CI 1.4-30.3; 12 studies), and the adjusted one (considering the variance due to diagnostic method and the region/country) was 12.9‰ (95%CI 0.1-39.7). There was no difference between the prevalence of clinical neonatal malaria in Africa 12.1‰ (95%CI 1.3-31.2; 11 studies) and outside Africa 12.5‰ (95%CI 0.0-52.9), p = 0.802.ConclusionThis study suggests a high prevalence of clinical congenital and neonatal malaria. It calls for an intensification of preventive measures against malaria during pregnancy and in the neonatal period, and to consider neonates as a distinct age category in the elaboration of malaria treatment and prevention guidelines.
| S-EPMC7456021 | biostudies-literature
Project description:PURPOSE:To evaluate the association between postpartum hormonal contraceptive use and postpartum depression. MATERIALS AND METHODS:We searched the literature through March 2018 on the association between postpartum hormonal contraception use and incident postpartum depression. We used the United States Preventive Services Task Force framework to assess study quality. RESULTS:Of 167 articles identified, four met inclusion criteria. Two studies found no differences in rates of postpartum depression between women using postpartum depot medroxyprogesterone and those not using hormonal contraception; however, a study of women receiving injectable norethisterone enanthate immediately postpartum found a 2-3-fold increased risk of depression at 6 weeks, though not at 3 months. One study compared combined hormonal contraception, progestin-only pills (POPs), etonogestrel implants and levonorgestrel intrauterine devices (LNG-IUDs) with no hormonal contraception, and found a 35-44% decreased risk of postpartum depression with POPs and LNG-IUDs, a small increased risk of postpartum antidepressant use among women using the etonogestrel implant and vaginal ring, and a decreased risk of antidepressant use with POPs. CONCLUSIONS:Limited evidence found no consistent associations between hormonal contraceptive use and incidence of postpartum depression. Future research would be strengthened by using validated diagnostic measures, careful consideration of confounders, and ensuring adequate follow-up time.
| S-EPMC6541925 | biostudies-literature
Project description:BackgroundPostpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions.MethodsAn electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD.ResultsOf the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, - 0.09 to 0.34), or source of funding (p = 0.19).ConclusionOverall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.
| S-EPMC7789727 | biostudies-literature
Project description:BackgroundMental health is a significant contributor to global burden of disease and the consequences of perinatal psychiatric morbidity can be substantial. We aimed to obtain global estimates of puerperal psychosis prevalence based on population-based samples and to understand how postpartum psychosis is assessed and captured among included studies.MethodsIn June 2014, we searched PubMed, CiNAHL, EMBASE, PsycINFO, Sociological Collections, and Global Index Medicus for publications since the year 1990. Criteria for inclusion in the systematic review were: use of primary data relevant to pre-defined mental health conditions, specified dates of data collection, limited to data from 1990 onwards, sample size >200 and a clear description of methodology. Data were extracted from published peer reviewed articles.ResultsThe search yielded 24,273 publications, of which six studies met the criteria. Five studies reported incidence of puerperal psychosis (ranging from 0.89 to 2.6 in 1000 women) and one reported prevalence of psychosis (5 in 1000). Due to the heterogeneity of methodologies used across studies in definitions and assessments used to identify cases, data was not pooled to calculate a global estimate of risk.ConclusionsThis review confirms the relatively low rate of puerperal psychosis; yet given the potential for serious consequences, this morbidity is significant from a global public health perspective. Further attention to consistent detection of puerperal psychosis can help provide appropriate treatment to prevent harmful consequences for both mother and baby.
| S-EPMC5534064 | biostudies-literature
Project description:Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.
| S-EPMC4369539 | biostudies-literature
Project description:BackgroundPodoconiosis is one of the few diseases that could potentially be eliminated within one generation. Nonetheless, the global distribution of the disease remains largely unknown. The global atlas of podoconiosis was conceived to define the epidemiology and distribution of podoconiosis through dedicated surveys and assembling the available epidemiological data.MethodsWe have synthesized the published literature on the epidemiology of podoconiosis. Through systematic searches in SCOPUS and MEDLINE from inception to February 14, 2018, we identified observational and population-based studies reporting podoconiosis. To establish existence of podoconiosis, we used case reports and presence data. For a study to be included in the prevalence synthesis, it needed to be a population-based survey that involved all residents within a specific area. Studies that did not report original data were excluded. We undertook descriptive analyses of the extracted data. This study is registered with PROSPERO, number CRD42018084959.ResultsWe identified 3,260 records, of which 27 studies met the inclusion criteria. Podoconiosis was described to exist or be endemic in 32 countries, 18 from the African Region, 3 from Asia and 11 from Latin America. Overall, podoconiosis prevalence ranged from 0·10% to 8.08%, was highest in the African region, and was substantially higher in adults than in children and adolescents. The highest reported prevalence values were in Africa (8.08% in Cameroon, 7.45% in Ethiopia, 4.52% in Uganda, 3.87% in Kenya and 2.51% in Tanzania). In India, a single prevalence of 0.21% was recorded from Manipur, Mizoram and Rajasthan states. None of the Latin American countries reported prevalence data.ConclusionOur data suggest that podoconiosis is more widespread in the African Region than in the rest of the regions, although this could be related to the fact that most podoconiosis epidemiological research has been focused in the African continent. The assembled dataset confirms that comprehensive podoconiosis control strategies such as promotion of footwear and personal hygiene are urgently needed in endemic parts of Africa. Mapping, active surveillance and a systematic approach to the monitoring of disease burden must accompany the implementation of podoconiosis control activities.
| S-EPMC5849362 | biostudies-literature
Project description:BACKGROUND: China has already achieved remarkable accomplishments in shrinking the malaria burden since the mid-20th Century. The country now plans to eliminate malaria by the year 2020. Looking at the dynamics of malaria outbreaks during the last decades might provide important information regarding the potential challenges of such an elimination strategy and might help to avoid mistakes of the past. METHODS: A systematic review of the published literature (English and Chinese) was conducted to identify malaria outbreaks during the period 1990 until 2013 in China. The main causes of outbreaks as described in these papers were categorized according to whether they were related to population migration, environmental factors, vector and host related factors, and operational problems of the health services. RESULTS: The review identified 36 malaria outbreaks over the 23-year study period, on which sufficient information was available. They mainly occurred in southern and central China involving 12 provinces/autonomous regions. More than half of all outbreaks (21/36, 58%) were attributed at least in part to population migration, with malaria importation to non- or low-endemic areas from high-endemic Chinese areas (13/15) or endemic countries (2/15) having been the most frequent reason (15/21, 71%). Other main causes were problems of the health services (15/36, 42%), in particular poor malaria case management (10/15, 67%), environmental factors (7/36, 19%), and vector and host related factors (5/36, 14%). CONCLUSIONS: Beside a number of other challenges, addressing population movement causing malaria appears to be of particular importance to the national malaria programme. Strengthening of surveillance for malaria and early radical treatment of cases should thus be considered among the most important tools for preventing malaria outbreaks and for the final goal of malaria elimination in China.
| S-EPMC4105761 | biostudies-other