Evidence of Lactobacillus reuteri to reduce colic in breastfed babies: Systematic review and meta-analysis.

OBJECTIVE: To investigate evidence for the treatment of childhood colic by supplementing Lactobacillus reuteri in infants breastfed with breast milk. METHODS: The study was conducted according to the PRISMA protocol. The databases used for acquiring data were PubMed and Web of Science, applying MeSH terms and free terms. Meta-analysis was conducted using Stata ™ 12.0. The risk of bias was evaluated by the Review Manager (RevMan) 5.3 tool, and the strength of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Ten clinical trials were included in the review. The administration of L. reuteri (DSM 17938 or ATCC55730) was tested in infants (n = 248) versus the control/placebo group (n = 229). Eight articles were included in the meta-analysis. There was a significant response in reducing crying time (minutes/day) and treatment effectiveness (reduction ≥ 50% in average daily crying time) in the first week (p = 0.001 and p = 0.003, respectively). These results were similar in the second, third weeks (p < 0.001 for both outcomes) and fourth weeks (p<0.001 and p = 0.002, respectively). The risk of bias was low for the majority of the studies. Confidence in evidence was considered very low for crying time and low for effectiveness treatment. CONCLUSIONS: The evidence shows that the administration of Lactobacillus reuteri to babies fed with breast milk reduces the crying time in babies diagnosed with colic. But our confidence in the effect estimate is limited.

Systematic review and meta-analysis on Schistosoma mansoni infection prevalence, and associated risk factors in Brazil.

We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.

Detection of Giardia and Cryptosporidium cysts/oocysts in watersheds and drinking water sources in Brazil urban areas.

The protozoan parasites Giardia and Cryptosporidium have been described as important waterborne disease pathogens, and are associated with severe gastrointestinal illnesses. The objective of this paper was to investigate the presence of Giardia cysts and Cryptosporidium oocysts in samples from watershed catchments and treated water sources. A total of 25 water samples were collected and examined according to the US EPA--Method 1623, 2005, consisting of 12 from drinking water and 13 from raw water. Positive samples from raw water for Giardia cysts and Cryptosporidium oocysts were 46.1 and 7.6%, respectively. In finished water, positive samples were 41.7% for Giardia cysts and 25.0% for Cryptosporidium oocysts. Concentrations of Giardia cysts found in raw water samples ranged from "not detected" to 3.4 cysts/L, whereas concentrations of Cryptoporidium oocysts ranged from "not detected" to 0.1 oocysts/L. In finished water, Giardia concentrations ranged from "not detected" to 0.06 cysts/L, and Cryptosporidium, from "not detected" to 0.01 oocysts/L. Concentrations of Giardia cysts and Cryptosporidium oocysts were not high in the samples analyzed. Nevertheless, the results of this study highlight the need to monitor these organisms in both raw and drinking water.