ABSTRACT
BACKGROUND: The main aim of this study was to investigate the percentage of individuals who developed long-term disabilities after chikungunya virus (CHIKV) disease on the basis of follow up time interval and its associated risk factors. METHOD: In this meta-analysis, electronic databases PubMed, Science Direct and Google Scholar were searched to identify cohort studies of CHIKV disease from January 2000 to June 2018. Total 28 eligible studies were selected for analysis. The pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures were calculated using a random effects model. RESULT: Among 28 studies, 24 studies were used for PR calculation and the PR for the long-term disabilities of CHIKV disease patients were found 39.70%, [95% CI: (31.77-47.64), p < 0.01] for follow up time between 6 and 12 months, 35.85%, [95% CI: (24.09-47.61), p < 0.01] for follow up time between 12 and 18 months and 28.20%, [95% CI: (19.74-36.66), p < 0.01] for greater than 18 months respectively. Eighteen studies were used for RR calculation and significant association were found between long-term disabilities after CHIKV disease and gender [RR: 1.46, p < 0.01], age [RR: 1.61, p < 0.01], diabetes [RR: 1.40, p < 0.01], hypertension [RR: 1.37, p < 0.01], severity of pain at acute stage [RR: 2.02, p < 0.01]. CONCLUSION: Approximately 40% patients developed long-term disabilities after 6 months of CHIKV disease and 28% patients still suffer from this disease after 18 months of acute infection.
Subject(s)
Arthralgia/complications , Arthralgia/epidemiology , Chikungunya Fever/complications , Disabled Persons/statistics & numerical data , Chikungunya virus , Cohort Studies , Diabetes Mellitus , Female , Humans , Hypertension , Male , Risk Factors , Sex FactorsSubject(s)
Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/pathology , Leishmaniasis, Visceral/complications , Administration, Intravenous , Aged, 80 and over , Amphotericin B/administration & dosage , Antiprotozoal Agents/administration & dosage , Biopsy , Histocytochemistry , Humans , Leishmania donovani/isolation & purification , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Cutaneous/parasitology , Male , Microscopy , Skin/parasitology , Skin/pathology , Treatment OutcomeABSTRACT
Miltefosine (target dose of 2.5 mg/kg/day for 28 days) is the recommended treatment for visceral leishmaniasis (kala-azar) in Bangladesh on the basis of data from India. We evaluated miltefosine in a phase IV trial of 977 patients in Bangladesh. At the six-month final follow up, 701 were cured. 24 showed initial treatment failure, and 95 showed treatment failure at 6 months, although 73 of the 95 showed treatment failure solely by the criterion of low hemoglobin values. One hundred twenty-one patients were not assessable. With the conservative assumption that all low hemoglobin values represented treatment failure, the final per protocol cure rate was 85%. Of 13 severe adverse events, 6 led to treatment discontinuation and 7 resulted in deaths, but only 1 death (associated with diarrhea) could be attributed to drug. Nearly all non-serious adverse events were gastrointestinal: vomiting in 25% of patients and diarrhea in 8% of patients. Oral miltefosine is an attractive alternative to intramuscular antimony and intravenous amphotericin B for treatment of kala-azar in Bangladesh.
Subject(s)
Antiprotozoal Agents/therapeutic use , Leishmaniasis, Visceral/drug therapy , Phosphorylcholine/analogs & derivatives , Adolescent , Adult , Bangladesh , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Phosphorylcholine/therapeutic use , Treatment OutcomeABSTRACT
Strongyloides stercoralis is an intestinal nematode in humans, and estimated about tens of millions of people are infected worldwide. This parasite is endemic in tropical or temperate and subtropical climates like Bangladesh. The authors report a 33-year-old man who presented with recurrent life-threatening upper gastrointestinal bleeding from gastric infection by S stercoralis.