RESUMO
BACKGROUND: Dengue fever is a zoonotic viral infection that raises a global alarm in the tropics and subtropics, with the potentially escalating into newer geographical regions. Severe dengue may be associated with fatal complications such as myocarditis. There is a paucity of available data on the prevalence of dengue-associated myocarditis. The objective of this systematic review and meta-analysis was to estimate the global prevalence of dengue-associated myocarditis. METHODS: A systematic search was conducted utilizing the Cochrane library, PubMed, Scopus, ProQuest, Web of Science, and Preprint servers such as arXiv, medRxiv, bioRxiv, BioRN, ChiRN, ChiRxiv, and SSRN as of November 25, 2022. All primary studies (case series, cross-sectional, retrospective, and prospective) that reported confirmed cases of dengue myocarditis were included. The I2 statistic test assessed the heterogenic characteristics and publication bias was evaluated using Doi plot and Egger regression tests. RESULTS: A total of 12 studies conducted between 2007 and 2022 with 2795 laboratory-confirmed dengue patients were included. Of the included cases, 502 were positive for myocarditis, with a prevalence of 2.4-78%. The pooled prevalence of dengue-induced myocarditis in the studied population was 21.0% (95% CI, 9 - 38%). The prediction interval was estimated to be 0.00 - 0.81. CONCLUSION: Myocarditis in dengue patients is a significant and understudied complication in many aspects. To prevent dengue-associated myocarditis, appropriate measures such as early detection of cases and signs, symptoms-based diagnosis via electrocardiography and echocardiography, as well as relevant vector control policies must be implemented.
RESUMO
School dropout is a significant concern universally. This paper investigates the incorporation of spatial dependency in estimating the topographical effect of school dropout rates in India. This study utilizes the secondary data on primary, upper primary, and secondary school dropout rates of the different districts of India available at the Unified District Information System for Education plus (UDISE+) for the year 2020 to contemplate the impact of these dropouts from one region to different regions in molding with promotion rate and repetition rate. The Global Moran's I, Univariate and Bivariate Local Indicators of Spatial Association, and spatial models are utilized to investigate the geographical variability and to find the possible relationship between dropout rates and the school-level factors at the district level. The outcomes provide clear spatial clustering and precisely highlight the hot zone dropout regions with high repetition and low promotion rates. Based on this study's results, educational administrators can make evidence-based decisions to reduce dropout rates in hot zones of various regions of India. Furthermore, futuristic studies focusing on linking spatial hot zones with causal factors will add consistent data in assisting policymakers in taking necessary measures to develop a sound education management system.