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Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens.

ABSTRACT: BACKGROUND:Neonatal sepsis is accounted for 30-50% of annual neonatal deaths in developing countries. We performed a systematic review and meta-analysis study to evaluate the national prevalence and identification of the etiological pathogens of neonatal sepsis in Iran. METHODS:A comprehensive literature search was done on the national and international databases for studies published between 2000 and 2019. The DerSimonian and Laird random-effects model was used to calculate pooled prevalence estimates, with 95% confidence intervals (CIs). Subgroup analyses and meta-regressions regarding the gender, type of sepsis and time during were also performed. Data were extracted, analyzed, and presented according to PRISMA guideline. RESULTS:Of 944 publications identified, 22 studies containing 14,683 neonates met the eligibility criteria. The pooled national prevalence of sepsis in Iran was 15.98% (95%CI, 11.96-20.46%; 1,367/14,683). Prevalence rate in boys (20.42%; 95%CI, 9.03-34.8%) was slightly higher than girls (18.5%; 95%CI, 7.4-32.8). A decreasing trend in prevalence of neonatal sepsis was found in recent years, although not statistically significant (c = -0.005; P value = 0.4). The most prevalent causative bacterial pathogens were Enterobacter spp. (23.04%), followed by Klebsiella pneumoniae (17.54%), coagulase-negative Staphylococci (14.06%), Escherichia coli (13.92%), Pseudomonas aeruginosa (12.67%), and Staphylococcus aureus (11.48%). CONCLUSION:Our findings showed a high prevalence of neonatal sepsis in suspected neonates, suggesting the need to implement preventive measures, routine assessment, and close monitoring of neonates. Also, Enterobacter spp. and Klebsiella pneumoniae were identified as the principal bacterial pathogens responsible for neonatal septicemia in Iran.

SUBMITTER: Akbarian-Rad Z

PROVIDER: S-EPMC6980642 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens.

Akbarian-Rad Zahra Z Riahi Seyed Mohammad SM Abdollahi Ali A Sabbagh Parisa P Ebrahimpour Soheil S Javanian Mostafa M Vasigala VeneelaKrishnaRekha V Rostami Ali A

PloS one 20200124 1

<h4>Background</h4>Neonatal sepsis is accounted for 30-50% of annual neonatal deaths in developing countries. We performed a systematic review and meta-analysis study to evaluate the national prevalence and identification of the etiological pathogens of neonatal sepsis in Iran.<h4>Methods</h4>A comprehensive literature search was done on the national and international databases for studies published between 2000 and 2019. The DerSimonian and Laird random-effects model was used to calculate poole ...[more]

PMID: 31978069

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Project description:BackgroundMigraine headaches affect all ages, from childhood to old age. Migraine attacks cause significant changes in the living conditions of the sick person, including a decrease in personal, social, and occupational performance. This study was conducted to determine the prevalence of migraine in Iran through a systematic review and meta-analysis.MethodIn this systematic review and meta-analysis study, the studies associated with the prevalence of migraine using the keywords: migraine, prevalence, and Iran its equivalents in international databases PubMed, Web of Science, Scopus, Science direct, and Iranian internal information databases, including SID and MagIran, was searched without limit until November 2022. Comprehensive Meta-Analysis software (Version 2) was used to analyze the data. Due to the high number of studies reviewed in this systematic review, the Begg and Mazumdar test was used at a significance level of 0.1, and the corresponding Funnel plot was used to check publication bias. Also, the I2 test was used to check the heterogeneity in this study.Results22 records were included in the final analysis. The prevalence of migraine in the general population of Iran was 15.1% (confidence interval 95%: 10.7-20.9), and in this population, the prevalence of migraine was higher in women than in men. The prevalence of migraine based on The International Classification of Headache Disorders (ICHD) 2 criteria was reportedly 16.4% (95% CI: 10.8-24.1), and with ICHD3 criteria, this value was reported as 17.1% (95% CI: 7.7-33.6). Based on a survey of 4571 children, the prevalence of migraine was reported to be 5.2% (95% CI: 1.3-18.7). Also, the prevalence of migraine in adolescents was calculated based on eight studies (n = 8820). Accordingly, 11.2% (95% CI: 5.8-20.4) of adolescents have migraines. Meanwhile, the prevalence of migraine in boys was 8.2% (95% CI: 4.8-13.7), and in girls was 8% (95% CI: 6.2-12.7).ConclusionAs a result, the prevalence of migraine in Iran, based on population-based studies, was reported as 15.1%. The result showed a higher prevalence of migraine in the general population than in children and adolescents. It was also found that the prevalence of migraine in women is higher than in men.

Project description:BackgroundNeonatal sepsis is one of the major public health problems globally, particularly, in developing countries. Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli are the common pathogens for neonatal sepsis in developing countries. However, the pooled estimate of common pathogens causing neonatal sepsis in developing countries is still unknown. Therefore, this study is aimed at computing the pooled proportion of the leading cause of pathogens for neonatal sepsis in developing countries.MethodsWe strictly followed the Preferred Reporting Items for Systemic Reviews and Meta-analysis guidelines to report this systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science, CINAHL, Science Direct, and other search engines such as Google Scholar, Africa Journals Online, and Hinari were used to obtain studies related to the leading cause of pathogens for neonatal sepsis in developing countries. The search was done from October 1 to December 30, 2018, by considering both published and gray literature. Studies were evaluated based on the PRISMA guideline checklist by using their titles, abstracts, and full texts. Studies were extracted using Microsoft Excel spreadsheets, and STATA software version 14 was used to analyze data. Heterogeneity between studies was checked based on Cochran's Q-test and the corresponding I 2 statistic test.ResultsThe pooled prevalence of the leading cause of pathogens of neonatal sepsis in developing countries were Klebsiella (26.36%), Staphylococcus aureus (23.22%), Coagulase-negative Staphylococcus (23.22%), and Escherichia coli (15.30%). Common pathogens were varied across regions; for instance, pooled isolated Coagulase-negative Staphylococcus was 25.98% in Africa, 16.62% in Asia, and 36.71% in Latin America, and Klebsiella was 29.80% in Africa, 23.21% in Asia, and 22.00% in Latin America. Also, Staphylococcus aureus was 27.87% in Africa and 18.28% in Asia, and Escherichia coli was 22.97% in Asia and 9.43% in Africa.ConclusionsThis study highlights that the more prevalent common isolated pathogens in developing countries were Klebsiella, Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli, Klebsiella, and Staphylococcus aureus pathogens were predominantly high in Africa as compared to other Asian and Latin American countries. At the same time, Coagulase-negative Staphylococcus was more prevalent in Latin America compared to other regions. Escherichia coli is more dominant in Asia as compared to Africa and Latin America.

Project description:BackgroundThe incidence of neonatal sepsis in India is the highest in the world. Evidence regarding its risk factors can guide clinical practice and prevention strategies.ObjectiveTo review, assess and synthesize the available literature from India on the risk factors of sepsis among neonates.MethodologyA systematic review was conducted. We searched PubMed, CINAHL, Scopus, Web of Science, Popline, IndMed, Indian Science Abstracts and Google Scholar from inception up to March 23, 2018 to identify observational analytical studies reporting on risk factors of laboratory-confirmed neonatal sepsis in India. Two authors independently screened studies (title, abstract and full-text stages), extracted data, and assessed quality. A random-effects meta-analysis was performed as substantial heterogeneity was anticipated. Subgroup and sensitivity analyses were additionally performed. Effect size in our review included odds ratio and standardized mean difference.ResultsFifteen studies were included from 11,009 records, of which nine were prospective in design. Birthweight and gestational age at delivery were the most frequently reported factors. On meta-analyses, it was found that male sex (OR: 1.3, 95% CI: 1.02, 1.68), out born neonates (OR: 5.5, 95% CI: 2.39, 12.49), need for artificial ventilation (OR: 5.61; 95% CI: 8.21, 41.18), gestational age <37 weeks (OR: 2.05; 95% CI:1.40, 2.99) and premature rupture of membranes (OR:11.14, 95% CI: 5.54, 22.38) emerged as risk factors for neonatal sepsis. Included studies scored lowest on exposure assessment and confounding adjustment, which limited comparability. Inadequacy and variation in definitions and methodology affected the quality of included studies and increased heterogeneity.ConclusionsMale neonates, outborn admissions, need for artificial ventilation, gestational age <37 weeks and premature rupture of membranes are risk factors for sepsis among neonates in India. Robustly designed and reported research is urgently needed to confirm the role of other risk factors of neonatal sepsis in India.

Project description:ObjectiveTo estimate the risk of maternal and neonatal sepsis associated with chorioamnionitis.Data sourcesPubMed, BIOSIS, and ClinicalTrials.gov databases were systematically searched for full-text articles in English from inception until May 11, 2020.Methods of study selectionWe screened 1,251 studies. Randomized controlled trials, case-control, or cohort studies quantifying a relationship between chorioamnionitis and sepsis in mothers (postpartum) or neonates born at greater than 22 weeks of gestation were eligible. Studies were grouped for meta-analyses according to exposures of histologic or clinical chorioamnionitis and outcomes of maternal or neonatal sepsis.Tabulation, integration, and resultsOne hundred three studies were included, and 55 met criteria for meta-analysis (39 studies of preterm neonates, 10 studies of general populations of preterm and term neonates, and six studies of late preterm and term neonates). Study details and quantitative data were abstracted. Random-effects models were used to generate pooled odds ratios (ORs); most studies only reported unadjusted results. Histologic chorioamnionitis was associated with confirmed and any early-onset neonatal sepsis (unadjusted pooled ORs 4.42 [95% CI 2.68-7.29] and 5.88 [95% CI 3.68-9.41], respectively). Clinical chorioamnionitis was also associated with confirmed and any early-onset neonatal sepsis (unadjusted pooled ORs 6.82 [95% CI 4.93-9.45] and 3.90 [95% CI 2.74-5.55], respectively). Additionally, histologic and clinical chorioamnionitis were each associated with higher odds of late-onset sepsis in preterm neonates. Confirmed sepsis incidence was 7% (early-onset) and 22% (late-onset) for histologic and 6% (early-onset) and 26% (late-onset) for clinical chorioamnionitis-exposed neonates. Three studies evaluated chorioamnionitis and maternal sepsis and were inconclusive.ConclusionBoth histologic and clinical chorioamnionitis were associated with early- and late-onset sepsis in neonates. Overall, our findings support current guidelines for preventative neonatal care. There was insufficient evidence to determine the association between chorioamnionitis and maternal sepsis.Systematic review registrationPROSPERO, CRD42020156812.

Dataset Information

Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens.

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Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens.

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