Global and regional geographical prevalence of depression in gastric cancer: a systematic review and meta-analysis.

BACKGROUND: Substantial uncertainty exists about the prevalence of depression in patients with gastric cancer. We aimed to summarise the global and regional pooled prevalence of depression among patients with gastric cancer. METHOD: Up to February 2020, we searched PubMed/MEDLINE, Embase, Scopus, Web of science (ISI) and PsychINFO to identify published studies on the prevalence of depression among patients with gastric cancer. The study selection procedure was in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We estimated the prevalence of depression in gastric cancer patients using a random-effect pooled estimate analysis approach with subgroup analysis based on WHO regions, and methods of depression measurement. RESULTS: Totally, we retrieved 3781 studies from the previously mentioned databases, of which 18 (12 cross-sectional and 6 cohort studies in design) met the eligibility criteria, which were published from 2001 to 2017 in different regions. The total sample size of the included studied contained 4709 patients with gastric cancer, of which 1885 cases were diagnosed with depression. The pooled prevalence of depression among gastric cancer patients was 37%(95% CI: 26% to 48%). Subgroup analysis showed that the highest prevalence of depression was in Eastern Mediterranean (pooled prevalence=42%; 95% CI: 18% to 65%) followed by the Western Pacific region (pooled prevalence=40%;95% CI: 26% to 54%). The results indicated a significant heterogeneity (I 2=98.8%,P<0.05). CONCLUSION: Our findings indicated that depression is high among gastric cancer patients. The findings suggest health authorities to provide specially designed social and psychological supportive care services, including screening for depression, among such patients. PROSPERO REGISTRATION NUMBER: CRD42020139836.

The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: a systematic review and meta-analysis.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common among individuals with human immune deficiency virus (HIV) infection worldwide. In this study, we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV, HBV and HIV coinfections among HIV-positive prisoners. METHODS: We searched PubMed via MEDLINE, Embase, the Cochrane Library, SCOPUS, and Web of science (ISI) to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV. We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies. We used random-effect models and meta-regression for the meta-analysis of the results of the included studies. RESULTS: The number of the included studies were 50 for HCV-HIV, and 23 for HBV-HIV co-infections. The pooled prevalence rates of the coinfections were 12% [95% confidence interval (CI) 9.0-16.0] for HBV-HIV and 62% (95% CI 53.0-71.0) for HCV-HIV. Among HIV-positive prisoners who reported drug injection, the prevalence of HBV increased to 15% (95% CI 5.0-23.0), and the HCV prevalence increased to 78% (95% CI 51.0-100). The prevalence of HBV-HIV coinfection among prisoners ranged from 3% in the East Mediterranean region to 27% in the American region. Also, the prevalence of HCV-HIV coinfections among prisoners ranged from 6% in Europe to 98% in the East Mediterranean regions. CONCLUSIONS: Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners, particularly among those with a history of drug injection, varies significantly across the globe. The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades, rising a call for better screening and treatment programs targeting this high-risk population. To prevent the above coinfections among prisoners, aimed public health services (e.g. harm reduction via access to clean needles), human rights, equity, and ethics are to be seriously delivered or practiced in prisons. Protocol registration number: CRD42018115707 (in the PROSPERO international).