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1.
BMC Infect Dis ; 21(1): 74, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33446122

RESUMO

BACKGROUND: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia. METHODS: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs). RESULTS: The pooled prevalence of MRSA was 3% (95% CI 2-5%) among all bloodstream infections (BSIs) and 44% (95% CI 32-57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1-14%), 1% in Americas (95% CI 1-2%), 2% in Europe (95% CI 1-4%), 4% in Western Pacific (95% CI 2-7%), 8% in South-east Asia (95% CI 4-14%) and 0% in Eastern Mediterranean (95% CI 0-3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P = 0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2 g/mL being the risk factors for mortality. CONCLUSIONS: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.


Assuntos
Bacteriemia/epidemiologia , Infecção Hospitalar/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Neoplasias/epidemiologia , Neoplasias/mortalidade , Infecções Estafilocócicas/epidemiologia , Adulto , África/epidemiologia , América/epidemiologia , Antibacterianos/uso terapêutico , Ásia Sudeste/epidemiologia , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Criança , Comorbidade , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Região do Mediterrâneo/epidemiologia , Neoplasias/microbiologia , Estudos Observacionais como Assunto , Prevalência , Fatores de Risco , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Vancomicina/uso terapêutico
2.
BMC Med ; 19(1): 2, 2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33397366

RESUMO

BACKGROUND: Through a combination of strong routine immunization (RI), strategic supplemental immunization activities (SIA) and robust surveillance, numerous countries have been able to approach or achieve measles elimination. The fragility of these achievements has been shown, however, by the resurgence of measles since 2016. We describe trends in routine measles vaccine coverage at national and district level, SIA performance and demographic changes in the three regions with the highest measles burden. FINDINGS: WHO-UNICEF estimates of immunization coverage show that global coverage of the first dose of measles vaccine has stabilized at 85% from 2015 to 19. In 2000, 17 countries in the WHO African and Eastern Mediterranean regions had measles vaccine coverage below 50%, and although all increased coverage by 2019, at a median of 60%, it remained far below levels needed for elimination. Geospatial estimates show many low coverage districts across Africa and much of the Eastern Mediterranean and southeast Asian regions. A large proportion of children unvaccinated for MCV live in conflict-affected areas with remote rural areas and some urban areas also at risk. Countries with low RI coverage use SIAs frequently, yet the ideal timing and target age range for SIAs vary within countries, and the impact of SIAs has often been mitigated by delays or disruptions. SIAs have not been sufficient to achieve or sustain measles elimination in the countries with weakest routine systems. Demographic changes also affect measles transmission, and their variation between and within countries should be incorporated into strategic planning. CONCLUSIONS: Rebuilding services after the COVID-19 pandemic provides a need and an opportunity to increase community engagement in planning and monitoring services. A broader suite of interventions is needed beyond SIAs. Improved methods for tracking coverage at the individual and community level are needed together with enhanced surveillance. Decision-making needs to be decentralized to develop locally-driven, sustainable strategies for measles control and elimination.


Assuntos
Erradicação de Doenças , Programas de Imunização , Imunização Secundária , Sarampo , Regionalização/organização & administração , Cobertura Vacinal/tendências , África/epidemiologia , Ásia Sudeste/epidemiologia , /prevenção & controle , Criança , Erradicação de Doenças/métodos , Erradicação de Doenças/estatística & dados numéricos , Humanos , Programas de Imunização/métodos , Programas de Imunização/organização & administração , Imunização Secundária/métodos , Imunização Secundária/estatística & dados numéricos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacina contra Sarampo/uso terapêutico , Região do Mediterrâneo/epidemiologia
3.
East Mediterr Health J ; 26(12): 1436-1439, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33355380

RESUMO

The Universal Health Coverage (UHC) Day has been commemorated on 12 December every year since 2017. In 2019, the theme of the day was "Keep the Promise", referring to the Political Declaration on UHC endorsed by Heads of States at the United Nations General Assembly High-Level Meeting on 23 September 2019. In 2020, the theme is "Protect Everyone", emphasizing global and individual health security in the context of the COVID-19 pandemic, attributed to SARS-CoV 2 - a virus that infected more than 4 million people in the Eastern Mediterranean Region (EMR) and left over 100 000 dead in less than 12 months (6.6% and 7.1% of the global toll, respectively). Keeping the promise of UHC, while ensuring health security, is becoming a priority agenda of policy-makers and practitioners in the EMR in order to save lives, advance health and protect livelihoods.


Assuntos
/epidemiologia , Pandemias , Cobertura Universal do Seguro de Saúde , Saúde Global , Política de Saúde , Prioridades em Saúde , Programas Gente Saudável , Humanos , Região do Mediterrâneo/epidemiologia , Nações Unidas
4.
East Mediterr Health J ; 26(12): 1570-1575, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33355398

RESUMO

Background: During the 2019 Hajj, the Ministry of Health in Saudi Arabia implemented for the first time a health early warning system for rapid detection and response to health threats. Aims: This study aimed to describe the early warning findings at the Hajj to highlight the pattern of health risks and the potential benefits of the disease surveillance system. Methods: Using syndromic surveillance and event-based surveillance data, the health early warning system generated automated alarms for public health events, triggered alerts for rapid epidemiological investigations and facilitated the monitoring of health events. Results: During the deployment period (4 July-31 August 2019), a total of 121 automated alarms were generated, of which 2 events (heat-related illnesses and injuries/trauma) were confirmed by the response teams. Conclusion: The surveillance system potentially improved the timeliness and situational awareness for health events, including non-infectious threats. In the context of the current COVID-19 pandemic, a health early warning system could enhance case detection and facilitate monitoring of the disease geographical spread and the effectiveness of control measures.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Surtos de Doenças/prevenção & controle , Islamismo , Administração em Saúde Pública/métodos , Vigilância em Saúde Pública/métodos , Aglomeração , Planejamento em Saúde/organização & administração , Humanos , Comportamento de Massa , Região do Mediterrâneo/epidemiologia , Pandemias , Arábia Saudita/epidemiologia , Vigilância de Evento Sentinela , Viagem
5.
East Mediterr Health J ; 26(6): 626-629, 2020 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-32621492

RESUMO

The COVID-19 pandemic began as a cluster of reported cases of acute respiratory illness in China on 31 December 2019 and went on to spread with exponential growth across the globe. By the time it was characterized as a global pandemic on 11 March 2020, 17 of 22 countries in the Eastern Mediterranean Region (EMR) had reports of infected persons. EMR countries are particularly susceptible to such outbreaks due to the presence of globally interconnected markets; complex emergencies in more than half of the countries; religious mass gatherings that draw tens of millions of pilgrims annually; and variation in emergency care systems capacity and health systems performance within and between countries.


Assuntos
Infecções por Coronavirus/terapia , Serviços Médicos de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Epidemiologia/educação , Cooperação Internacional , Pneumonia Viral/terapia , Saúde Pública/educação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Política de Saúde , Acesso aos Serviços de Saúde , Humanos , Região do Mediterrâneo/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Prática de Saúde Pública , Organização Mundial da Saúde
8.
J Infect Public Health ; 13(10): 1367-1372, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32586684

RESUMO

In December 2019, a cluster of atypical Pneumonia cases in Wuhan, China were reported to the World Health Organization (WHO). Later, those cases were attributed to a novel respiratory virus currently known as COVID-19. The infection is affecting every continent. It was characterized by WHO as a global pandemic on 11 March 2020. Countries worldwide are implementing various preventive measures to contain the spread of the infection such as travel and trade restrictions, closure of educational institutions and shops, and some took more strict measures such as imposing curfew. WHO is emphasizing the importance of early detection of cases, contact tracing, risk communications, implementing multisectoral approach in order to combat COVID-19 infection. Countries should provide the public with accurate, transparent information about the local and global situation of this escalating infection. Much uncertainty still surrounds this viral infection, its modes of transmission and dynamics. Epidemiological investigations particularly for the first few cases of COVID-19 infection are critical to expand our knowledge about this evolving pandemic. In this review we summarized the data available about the first few cases and fatalities of COVID-19 infection up to 18 March 2020 across Eastern Mediterranean Region of the World Health Organization. such data were only available in websites of ministries of health of the targeted countries, WHO situational reports, online newspapers, and other media channels and this gave us an idea about the amount and type of data available for the public regarding this evolving infection.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , África Oriental/epidemiologia , África do Norte/epidemiologia , Betacoronavirus , Humanos , Região do Mediterrâneo/epidemiologia , Oriente Médio/epidemiologia , Paquistão/epidemiologia , Organização Mundial da Saúde
9.
East Mediterr Health J ; 26(5): 492-494, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32538438

RESUMO

The coronavirus disease 2019 (COVID-19) outbreak that began in Wuhan, Hubei Province, China in late 2019 has spread globally within a few months. The Director General of the World Health Organization (WHO) declared the COVID-19 outbreak to be a public health emergency of international concern (PHEIC) after the second meeting of the IHR (2005) Emergency Committee on 30 January 2020. On 12 March 2020, the outbreak of COVID-19 was characterized as a pandemic.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Betacoronavirus , Ensaios Clínicos como Assunto , Controle de Doenças Transmissíveis/economia , Congressos como Assunto , Surtos de Doenças , Financiamento Governamental , Humanos , Região do Mediterrâneo/epidemiologia , Pandemias , Pneumonia Viral , Organização Mundial da Saúde
10.
PLoS One ; 15(4): e0231256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32352988

RESUMO

The Justinianic Plague, the first part of the earliest of the three plague pandemics, has minimal historical documentation. Based on the limited primary sources, historians have argued both for and against the "maximalist narrative" of plague, i.e. that the Justinianic Plague had universally devastating effects throughout the Mediterranean region during the sixth century CE. Using primary sources of one of the pandemic's best documented outbreaks that took place in Constantinople during 542 CE, as well as modern findings on plague etiology and epidemiology, we developed a series of dynamic, compartmental models of disease to explore which, if any, transmission routes of plague are feasible. Using expected parameter values, we find that the bubonic and bubonic-pneumonic transmission routes exceed maximalist mortality estimates and are of shorter detectable duration than described by the primary sources. When accounting for parameter uncertainty, several of the bubonic plague model configurations yielded interquartile estimates consistent with the upper end of maximalist estimates of mortality; however, these models had shorter detectable outbreaks than suggested by the primary sources. The pneumonic transmission routes suggest that by itself, pneumonic plague would not cause significant mortality in the city. However, our global sensitivity analysis shows that predicted disease dynamics vary widely for all hypothesized transmission routes, suggesting that regardless of its effects in Constantinople, the Justinianic Plague would have likely had differential effects across urban areas around the Mediterranean. Our work highlights the uncertainty surrounding the details in the primary sources on the Justinianic Plague and calls into question the likelihood that the Justinianic Plague affected all localities in the same way.


Assuntos
Pandemias/história , Peste/história , Animais , História Medieval , Humanos , Região do Mediterrâneo/epidemiologia , Modelos Teóricos , Peste/transmissão
11.
BMC Public Health ; 20(1): 433, 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245425

RESUMO

BACKGROUND: Child and adolescent injury is one of the leading causes of child death globally with a large proportion occurring in Low- and Middle-Income Countries (LMICs). Similarly, the Eastern Mediterranean Region (EMR) countries borne a heavy burden that largely impact child and adolescent safety and health in the region. We aim to assess child and adolescent injury morbidity and mortality and estimate its burden in the Eastern Mediterranean Region based on findings from the Global Burden of Disease (GBD), Injuries and Risk Factors study 2017. METHODS: Data from the Global Burden of Disease GBD 2017 were used to estimate injury mortality for children aged 0-19, Years of Life Lost (YLLs), Years lived with Disability (YLDs) and Disability Adjusted Life Years (DALYs) by age and sex from 1990 to 2017. RESULTS: In 2017, an estimated 133,117 (95% UI 122,587-143,361) children died in EMR compared to 707,755 (95% UI 674401.6-738,166.6) globally. The highest rate of injury deaths was reported in Syria at 183.7 (95% UI 181.8-185.7) per 100,000 population. The leading cause of injury deaths was self-harm and interpersonal violence followed by transport injury. The primary cause of injury DALYs in EMR in 2017 was self-harm and interpersonal violence with a rate of 1272.95 (95% UI 1228.9 - 1319.2) almost 3-times the global rate. CONCLUSION: Almost 19% of global child injury related deaths occur in the EMR. Concerted efforts should be integrated to inform policies and adopt injury preventive strategies to reduce injury burden and promote child and adolescent health and well-being in EMR countries.


Assuntos
Carga Global da Doença/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Região do Mediterrâneo/epidemiologia , Morbidade , Pobreza , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Comportamento Autodestrutivo/mortalidade , Síria/epidemiologia , Violência/estatística & dados numéricos , Adulto Jovem
13.
J Prev Med Public Health ; 53(2): 98-105, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32268464

RESUMO

OBJECTIVES: Obesity is regarded as one of the most prominent health threats worldwide and a serious risk factor for non-communicable diseases, such as diabetes mellitus type 2, high blood pressure, cardiovascular diseases, and some types of cancer. Given the role that societal development-as reflected by the Human Development Index (HDI)-may play in the prevalence of obesity and overweight, this study aimed to investigate the degree to which the prevalence of obesity and overweight is affected by HDI and its components. METHODS: In this ecological study, the required data on HDI and its components were gathered from the latest report of the United Nations Development Program, and data on obesity and overweight were acquired from the latest reports published on the World Health Organization website. Statistical analyses were conducted using SPSS version 24.0. RESULTS: The prevalence of obesity was determined to be significantly higher among females than males, and the gross national index per capita was found to be significantly higher for males than females (p<0.05). Significant positive correlations were found between HDI and its components and sex, as well as indices of obesity and overweight. CONCLUSIONS: A significant positive correlation exists between HDI and obesity. As policy-makers attempt to improve the general welfare of the people, they should be aware of potential unwanted effects of development on the risk of obesity and overweight among the population.


Assuntos
Índice de Massa Corporal , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Desenvolvimento Industrial , Entrevistas como Assunto , Masculino , Região do Mediterrâneo/epidemiologia , Pessoa de Meia-Idade , Obesidade/etiologia , Prevalência , Saúde Pública , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Urbanização , Organização Mundial da Saúde , Adulto Jovem
14.
J Infect Public Health ; 13(3): 377-384, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32146138

RESUMO

Vaccination is the main control measure for influenza and its severe complications. To better understand the influenza vaccination situation in the Eastern Mediterranean Region, we conducted an extensive review of literature published between 2006 and 2016 in the region on influenza vaccine policies, use, recommendations and coverage. Forty-eight articles met the inclusion criteria. These originated from 11 of the 22 countries of the region, with most being from Saudi Arabia and Iran. The review revealed knowledge gaps and misconceptions about influenza and its vaccines even among healthcare workers. Most of the papers reviewed reported low coverage in the target populations. Limited literature on the number of countries with concrete national influenza vaccination policies was available, which may not accurately represent the situation in the Region. In conclusion, lack of awareness and knowledge are the main barriers to influenza vaccination, which remains very low in the Eastern Mediterranean Region. Countries of the region need to promote and invest in research on influenza vaccination, which is critical to inform evidence-based programmes and policies to improve vaccination rates and control influenza.


Assuntos
Política de Saúde , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Humanos , Programas de Imunização , Influenza Humana/epidemiologia , Irã (Geográfico)/epidemiologia , Masculino , Região do Mediterrâneo/epidemiologia , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Arábia Saudita/epidemiologia , Estações do Ano , Adulto Jovem
15.
J Infect Public Health ; 13(3): 451-456, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32144017

RESUMO

Influenza causes significant morbidity and mortality worldwide. Owing to its ability to rapidly evolve and spread, the influenza virus is of global public health importance. Information on the burden, seasonality and risk factors of influenza in countries of the World Health Organization Eastern Mediterranean Region is emerging because of collaborative efforts between countries, WHO and its partners over the past 10 years. The fourth meeting of the Eastern Mediterranean Acute Respiratory Infection Surveillance network was held in Amman, Jordan on 11-14 December 2017. The meeting reviewed the progress and achievements reported by the countries in the areas of surveillance of and response to seasonal, zoonotic and pandemic influenza. The first scientific conference on acute respiratory infection in the Eastern Mediterranean Region was held at the same time and 38 abstracts from young researchers across the Region were presented on epidemiological and virological surveillance, outbreak detection and response, influenza at the animal-human interface, use and efficacy of new vaccines to control respiratory diseases and pandemic influenza threats. The meeting identified a number of challenges and ways to improve the quality of the surveillance system for influenza, sustain the system so as to address pandemic threats and use the data generated from the surveillance system to inform decision-making, policies and practices to reduce the burden of influenza-associated illnesses in the Region.


Assuntos
Influenza Humana/epidemiologia , Pandemias/prevenção & controle , Infecções Respiratórias/epidemiologia , Congressos como Assunto , Surtos de Doenças/prevenção & controle , Monitoramento Epidemiológico , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Jordânia/epidemiologia , Região do Mediterrâneo/epidemiologia , Oriente Médio/epidemiologia , Saúde Pública , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , Estações do Ano , Vigilância de Evento Sentinela , Organização Mundial da Saúde
16.
East Mediterr Health J ; 26(2): 136-137, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141588

RESUMO

On 31 December 2019, a cluster of acute respiratory illness was reported from China and later confirmed as novel coronavirus on 7 January 2020. This virus is the same member of the coronavirus family that caused the severe acute respiratory syndrome (SARS-CoV) reported in China 2003, and Middle East respiratory syndrome (MERS-CoV) reported in Saudi Arabia in 2012. The initial cases have been linked to a live seafood market in Wuhan, China, and the specific animal source is yet to be determined. The detection of this new virus in humans without knowing the source of the infection has raised greatly heightened concerns not only in China, but also internationally. To date, the outbreak has spread to most provinces in China and 25 other countries within a relatively short period. Consequent to its spread, Dr Tedros Ghebreyesus, Director General of the World Health Organization (WHO), declared the outbreak a Public Health Emergency of International Concern (PHEIC) on 30 January 2020.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Controle de Infecções/métodos , Pneumonia Viral/epidemiologia , Prática de Saúde Pública , Animais , Surtos de Doenças , Humanos , Região do Mediterrâneo/epidemiologia , Pandemias , Organização Mundial da Saúde
17.
East Mediterr Health J ; 26(2): 219-232, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141601

RESUMO

Background: Breast cancer is the fourth leading cause of death and disability in the Eastern Mediterranean Region (EMR); although the incidence is lower than in the developed regions, there has been an increasing trend in recent decades. Aims: Our aim was to calculate the pooled survival rate of patients with breast cancer in the EMR. Methods: We searched electronic databases from 1946 to 19 January 2018, without language restrictions. We used a random effect model to estimate pooled 1-, 3-, 5- and 10-year survival rates for patients with breast cancer. Chi-squared and I² index were used to assess between-study heterogeneity. Subgroup analysis and meta-regression were used to investigate the potential source of heterogeneity. Results: We found 80 articles eligible for inclusion in our review. The pooled 1-, 3-, 5- and 10-year survival rates in women with breast cancer in the EMR were 0.95, 0.80, 0.71, and 0.56, respectively. The I² index indicated considerable between-study heterogeneity (all I² > 50%). The 5-year survival rate in the male subgroup was 0.63. The 5-year survival rate of women with breast cancer in age groups ≤ 39, 40-64, and 65+ years were 0.74, 0.76 and 0.58, respectively. There was a statistically significant association between the Human Development Index (ß = 9, P = 0.01) and decade of study (ß = 8.2, P = 0.04) and 5-year survival rate. Conclusions: The survival rate of women with breast cancer in those countries in the EMR which have better health care systems improved in the past decade; women aged 40-64 years had the best survival rate.


Assuntos
Neoplasias da Mama/mortalidade , Taxa de Sobrevida , Adulto , Neoplasias da Mama/epidemiologia , Bases de Dados Factuais , Feminino , Humanos , Incidência , Região do Mediterrâneo/epidemiologia , Pessoa de Meia-Idade
18.
BMC Womens Health ; 20(1): 53, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32183824

RESUMO

BACKGROUND: This study was conducted to provide evidence on the current status of breast cancer and its incidence trend in Eastern Mediterranean Region during 1998-2019. Also, this study aimed to investigate the association between the incidence of breast cancer and Human Development Index and some factors related to this index, including total fertility rate, and obesity, using a meta-analysis. METHOD: Data on incidence of breast cancer were collected from various sources, including PubMed, Embase, Web of Science, and WHO, from 1998 to 2019 using systematic review and meta-analysis. Pooled age standardized rate was calculated based on study duration and quality of data using a subgroup analysis and random effect meta-analysis. RESULTS: A total of 80 studies (545 data points) were analyzed. Pooled age standardized rate of breast cancer for Eastern Mediterranean Region was 37.1 per 100,000 person-year (95% confidence interval [CI], 34.5, 39.8) during 2011-2019. age standardized rate of breast cancer had an upward trend in Eastern Mediterranean Region from 2005 to 2019. However, the increasing trend was found to be slightly different in various regions based on quality of data. Moreover, pooled age standardized rate had a significant association with Human Development Index [- 89.2 (95% CI, - 119.8, - 58.7)] and obesity [1.2 (95% CI, 0.9, 1.5)]. CONCLUSION: Pooled age standardized rate of breast cancer in Eastern Mediterranean Region was lower than the global average. Also, the age standardized rate value and its incremental trend have been higher in countries with high-quality data than in other countries of this region in recent years. Data quality or physiological factors, such as increase in obesity rates, could be the reasons for this incremental trend.


Assuntos
Neoplasias da Mama/epidemiologia , Feminino , Humanos , Incidência , Região do Mediterrâneo/epidemiologia
20.
PLoS One ; 15(1): e0226606, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929543

RESUMO

BACKGROUND: The objective of this study was to assess regional and ethnic differences in an unselected patient population treated with polymer-free sirolimus-eluting stents (PF-SES) in Asia and Europe. METHODS: Two all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined for data analysis to assure sufficient statistical power. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 9-12 months. RESULTS: Of the total population of 7243 patients, 44.0% (3186) were recruited in the Mediterranean region and 32.0% (2317) in central Europe. The most prominent Asian region was South Korea (17.6%, 1274) followed by Malaysia (5.7%, 413). Major cardiovascular risk factors varied significantly across regions. The overall rates for accumulated TLR and MACE were low with 2.2% (140/6374) and 4.4% (279/6374), respectively. In ACS patients, there were no differences in terms of MACE, TLR, MI and accumulated mortality between the investigated regions. Moreover, dual antiplatelet therapy (DAPT) regimens were substantially longer in Asian countries even in patients with stable coronary artery disease as compared to those in Europe. CONCLUSIONS: PF-SES angioplasty is associated with low clinical event rates in all regions. Further reductions in clinical event rates seem to be associated with longer DAPT regimens.


Assuntos
Doença da Artéria Coronariana/terapia , Stents Farmacológicos , Grupos Étnicos/estatística & dados numéricos , Imunossupressores/uso terapêutico , Infarto do Miocárdio/prevenção & controle , Intervenção Coronária Percutânea/métodos , Sirolimo/uso terapêutico , Idoso , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Malásia/epidemiologia , Masculino , Região do Mediterrâneo/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Polímeros , Prognóstico , Estudos Prospectivos , República da Coreia/epidemiologia
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