Dataset Information

Different Clinical Manifestations of Human Brucellosis in Pregnant Women: A Systematic Scoping Review of 521 Cases from 10 Countries.

ABSTRACT: Introduction:This systematic scoping review aims to assess the frequency and severity of clinical manifestations of pregnant women with brucellosis. Methods:Three literature databases, PubMed, Web of Science and China National Knowledge Infrastructure (CNKI), and two search engines (Google and Yahoo) were adopted to identify the relevant articles that published until 31 December 2019. Two investigators independently screened the publications and extracted the data; the case reports and case series which described at least two symptoms or clinical manifestations of pregnant women with brucellosis were included. Results:A total of 27 articles describing the information of 521 pregnant women with brucellosis were included. Serum agglutination test was the most common laboratory test in the diagnosis of brucellosis. A total of 36 clinical manifestations were extracted from the included articles, and the most common clinical manifestations were fever (400, 76.8%), joint pain/swelling/arthralgia (389, 74.7%), sweats (382, 73.3%), fatigue/asthenia/weakness (262, 50.3%) and back pain (189, 36.3%). Among the 32 included individual cases that with available obstetric outcome information, 10 (31.3%) suffered preterm delivery, 12 (37.5%) had an abortion and 3 (9.8%) had intrauterine fetal death. Conclusion:Brucellosis is popular and threatening for pregnant women. Regarding the localized body system complications, osteoarticular system was mostly involved, the obstetrics outcomes were severe among pregnant women with brucellosis. The detailed clinical and epidemiological characteristics in this scoping review may add a better and more complete understanding of the disease for both physicians and policy-makers, and provide evidence for timely diagnosis, adequate therapy and better prevention.

SUBMITTER: Liu Z

PROVIDER: S-EPMC7166055 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Different Clinical Manifestations of Human Brucellosis in Pregnant Women: A Systematic Scoping Review of 521 Cases from 10 Countries.

Liu Zhe Z Wei Dawei D Li Yanjun Y Zhou Hao H Huang Desheng D Guan Peng P

Infection and drug resistance 20200414

<h4>Introduction</h4>This systematic scoping review aims to assess the frequency and severity of clinical manifestations of pregnant women with brucellosis.<h4>Methods</h4>Three literature databases, PubMed, Web of Science and China National Knowledge Infrastructure (CNKI), and two search engines (Google and Yahoo) were adopted to identify the relevant articles that published until 31 December 2019. Two investigators independently screened the publications and extracted the data; the case report ...[more]

PMID: 32341659

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Project description:BackgroundThe coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. Data on the effect of coronavirus disease 2019 in pregnancy are limited to small case series.ObjectiveTo evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of severe acute respiratory syndrome coronavirus 2 infection.Study designClinical records were retrospectively reviewed for 116 pregnant women with coronavirus disease 2019 pneumonia from 25 hospitals in China between January 20, 2020, and March 24, 2020. Evidence of vertical transmission was assessed by testing for severe acute respiratory syndrome coronavirus 2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples.ResultsThe median gestational age on admission was 38+0 (interquartile range, 36+0-39+1) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. Of the 116 cases, there were 8 cases (6.9%) of severe pneumonia but no maternal deaths. One of 8 patients who presented in the first trimester and early second trimester had a missed spontaneous abortion. Of 99 patients, 21 (21.2%) who delivered had preterm birth, including 6 with preterm premature rupture of membranes. The rate of spontaneous preterm birth before 37 weeks' gestation was 6.1% (6/99). One case of severe neonatal asphyxia resulted in neonatal death. Furthermore, 86 of the 100 neonates tested for severe acute respiratory syndrome coronavirus 2 had negative results; of these, paired amniotic fluid and cord blood samples from 10 neonates used to test for severe acute respiratory syndrome coronavirus 2 had negative results.ConclusionSevere acute respiratory syndrome coronavirus 2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of severe acute respiratory syndrome coronavirus 2 infection when the infection manifests during the third trimester of pregnancy.

Project description:BackgroundThe objectives of this systematic review, commissioned by WHO, were to assess the frequency and severity of clinical manifestations of human brucellosis, in view of specifying a disability weight for a DALY calculation.Methods/principal findingsThirty three databases were searched, with 2,385 articles published between January 1990-June 2010 identified as relating to human brucellosis. Fifty-seven studies were of sufficient quality for data extraction. Pooled proportions of cases with specific clinical manifestations were stratified by age category and sex and analysed using generalized linear mixed models. Data relating to duration of illness and risk factors were also extracted. Severe complications of brucellosis infection were not rare, with 1 case of endocarditis and 4 neurological cases per 100 patients. One in 10 men suffered from epididymo-orchitis. Debilitating conditions such as arthralgia, myalgia and back pain affected around half of the patients (65%, 47% and 45%, respectively). Given that 78% patients had fever, brucellosis poses a diagnostic challenge in malaria-endemic areas. Significant delays in appropriate diagnosis and treatment were the result of health service inadequacies and socioeconomic factors. Based on disability weights from the 2004 Global Burden of Disease Study, a disability weight of 0.150 is proposed as the first informed estimate for chronic, localised brucellosis and 0.190 for acute brucellosis.ConclusionsThis systematic review adds to the understanding of the global burden of brucellosis, one of the most common zoonoses worldwide. The severe, debilitating, and chronic impact of brucellosis is highlighted. Well designed epidemiological studies from regions lacking in data would allow a more complete understanding of the clinical manifestations of disease and exposure risks, and provide further evidence for policy-makers. As this is the first informed estimate of a disability weight for brucellosis, there is a need for further debate amongst brucellosis experts and a consensus to be reached.

Project description:BACKGROUND:This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. RESULTS:A retrospective case-control longitudinal study was designed and included non-pregnant women (n?=?32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n?=?22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. CONCLUSION:We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the predominant members of the microbial community in normal pregnancy. These results can serve as the basis to study the relationship between the vaginal microbiome and adverse pregnancy outcomes.

Dataset Information

Different Clinical Manifestations of Human Brucellosis in Pregnant Women: A Systematic Scoping Review of 521 Cases from 10 Countries.

Publications

Different Clinical Manifestations of Human Brucellosis in Pregnant Women: A Systematic Scoping Review of 521 Cases from 10 Countries.

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