Anthelmintics

驱虫药
  • 文章类型: Case Reports
    弓形虫病,由犬弓形虫(来自狗)和弓形虫(来自猫)幼虫传播的人畜共患感染,对人类构成罕见但严重的风险。我们介绍了一例由犬弓形虫引起的肝内脏幼虫(VLM)病例,该病例有与宠物狗密切接触的病史。最初的症状和影像学表现模仿化脓性肝脓肿。最初的实验室调查显示嗜中性粒细胞增多和IgE水平升高。尽管有广谱抗生素,持续发烧促使进一步调查。随后对Toxocara抗体进行血清学测试,并对肝组织进行组织病理学分析,证明嗜酸性粒细胞浸润和Charcot-Leyden晶体可明确诊断为犬弓形虫引起的肝脓肿。弓形虫抗体的血清学测试和肝组织的组织病理学分析证实了弓形虫诱发的肝脓肿。阿苯达唑治疗产生了显著的临床改善。该病例强调了在肝脓肿差异中考虑弓形虫病的必要性,特别是在像越南这样的高血清阳性率地区。仅仅依靠血清学检测可能是不够的,强调需要确凿证据,包括肝活检等侵入性手术,用于准确的肝弓形虫病诊断。
    Toxocariasis, a zoonotic infection transmitted by Toxocara canis (from dogs) and Toxocara cati (from cats) larvae, poses rare but severe risks to humans. We present a case of hepatic visceral larva migrans (VLM) caused by Toxocara canis in a 21-year-old male with a history of close contact with a pet dog. Initial symptoms and imaging findings mimicked a pyogenic liver abscess. The initial laboratory investigations revealed neutrophilia and elevated levels of IgE. Despite broad-spectrum antibiotics, persistent fever prompted further investigation. Subsequent serological testing for Toxocara antibodies and histopathological analysis of liver tissue demonstrating eosinophil infiltrates and Charcot-Leyden crystals led to a confirmed diagnosis of a liver abscess caused by Toxocara canis. Serological testing for Toxocara antibodies and histopathological analysis of liver tissue confirmed a Toxocara canis-induced liver abscess. Albendazole treatment yielded significant clinical improvement. This case highlights the necessity of considering toxocariasis in liver abscess differentials, particularly in high-seroprevalence regions like Vietnam. Relying solely on serological tests may be insufficient, emphasizing the need for corroborative evidence, including invasive procedures like liver biopsy, for accurate hepatic toxocariasis diagnosis.
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  • 文章类型: Journal Article
    背景:已经向生活在血吸虫病流行环境中的有和没有血吸虫病的人施用了数以亿计剂量的吡喹酮(PZQ),通过2000年代初开始的大规模药物管理(MDA)策略。最近的一份出版物表明,PZQ相关视觉障碍的风险很高,引发公众健康担忧。我们旨在系统地综合有关PZQ相关视觉障碍程度的证据。
    方法:我们将搜索PubMed,谷歌学者,CINAHL,Scopus,CENTRAL和LILACS从1977年(在PZQ的第一个人体临床试验开始时)到2024年5月31日,没有语言限制。关键搜索词将包括\"Praziquantel\",\"PZQ\",“视觉障碍”,“不良事件”,“副作用”,“视力模糊”和“视力障碍”以及替代术语和同义词。所有血吸虫病流行国家都将作为搜索词包括在内。我们还将搜索HINARI,非洲在线期刊,论文数据库和预打印存储库。如有必要,我们将联系血吸虫病领域的专家研究人员,儿童基金会/开发计划署/世界银行/卫生组织热带病研究和训练特别方案,制药工业,特定国家的食品和药品管理局(FDAs)和欧洲药品管理局数据库。我们将搜索会议记录和相关研究的参考列表,以获得更多研究。至少有两位作者将独立选择研究,提取数据并评估纳入研究的偏倚风险。任何分歧或差异将通过审稿人之间的讨论解决。异质性将以图形方式进行探索,并使用I2统计量进行统计。当异质性明显时,我们将进行随机效应荟萃分析,并表示二分结果(视觉不良事件,包括过度流泪,视力模糊和视力障碍)作为风险比(RR)或赔率比(OR)及其95%置信区间(CI)。我们将进行亚组分析来评估异质性的影响,和敏感性分析,以检验效果估计的稳健性。证据的总体水平将使用等级进行评估。
    目的:本综述期望对PZQ给药后发生的视觉障碍进行鉴定和分类,单独或与其他药物联合使用。通过综合多项研究的数据,本综述旨在对不同人群摄入PZQ后出现视觉障碍的风险或几率进行定量评估.该综述还将深入了解PZQ与其他药物联合使用是否与视觉障碍的几率增加有关,以及视觉障碍的发生是否与剂量或治疗持续时间相关。政策制定者,公共卫生专家和利益相关方可以依靠审查结果,通过调整药物组合或给药方案来实施情境敏感的预防性化疗方案,以降低接受PZQ治疗的人群的视觉不良反应风险.该综述旨在确定在血吸虫病流行环境中使用PZQ后有关视觉障碍的当前证据中的空白,这可以作为未来研究重要但未解决的问题的基础。
    这项研究的结果将通过利益相关者论坛传播,会议,和同行评审出版物。审查方案已在国际前瞻性系统审查登记册(PROSPERO)-CRD42023417963中注册。
    BACKGROUND: Hundreds of millions of doses of Praziquantel (PZQ) have been administered to persons with and without schistosomiasis living in schistosomiasis endemic settings, through the mass drug administration (MDA) strategy which started in the early 2000s. A recent publication suggested high risk of PZQ-related visual disorders, raising public health concerns. We aim to systematically synthesize evidence on the magnitude of PZQ-related visual disorders.
    METHODS: We will search PubMed, Google Scholar, CINAHL, SCOPUS, CENTRAL and LILACS from 1977 (when the first human clinical trials on PZQ started) to 31st May 2024, with no language restrictions. The key search terms will include \"Praziquantel\", \"PZQ\", \"visual disorder\", \"adverse events\", \"side effects\", \"blurry vision\" and \"visual impairment\" together with alternative terms and synonyms. All the countries endemic for schistosomiasis will be included as search terms. We will also search HINARI, Africa Journals Online, Thesis Databases and Preprint Repositories. Where necessary, we will contact expert researchers working in the field of schistosomiasis, UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), pharmaceutical industries, country-specific Food and Drug Authorities (FDAs) and the European Medicines Agency databases. We will search Conference Proceedings and reference lists of relevant studies for additional studies. At least two authors will independently select studies, extract data and assess risk of bias in the included studies. Any disagreements or discrepancies will be resolved through discussion between the reviewers. Heterogeneity will be explored graphically, and statistically using the I2-statistic. We will conduct random-effects meta-analysis when heterogeneity is appreciable, and express dichotomous outcomes (visual adverse events including excessive lacrimation, blurry vision and visual impairments) as risk ratio (RR) or Odds Ratio (OR) with their 95% confidence interval (CI). We will perform subgroup analysis to assess the impact of heterogeneity, and sensitivity analyses to test the robustness of the effect estimates. The overall level of evidence will be assessed using GRADE.
    OBJECTIVE: The present review expects to identify and categorize visual disorders occurring after administration of PZQ, alone or in combination with other drugs. By synthesizing the data from multiple studies, the review aims to present a quantitative assessment of the risk or odds of experiencing a visual disorder in different populations after ingesting PZQ. The review will also generate insights into whether PZQ in combination with other drugs are associated with increased odds of visual disorders and whether the occurrence of visual disorders correlates with dosage or treatment duration. Policymakers, public health experts and stakeholders could rely on the review findings to deliver context-sensitive preventive chemotherapy programs by adjusting drug combinations or dosing schedules to reduce risk of visual adverse effects in populations treated with PZQ. The review aims to identify gaps in the current evidence regarding visual disorders following PZQ administration in schistosomiasis endemic settings which can serve as the basis for future research on important but unanswered questions.
    UNASSIGNED: The findings of this study will be disseminated through stakeholder forums, conferences, and peer-review publications. The review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO)- CRD42023417963.
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  • 文章类型: Journal Article
    通过大规模药物管理的预防性化疗被全球推荐作为达到消除血吸虫病的主要方法,特别是在高危儿科人群中。本系统综述总结了儿童血吸虫病控制计划对消除撒哈拉以南非洲血吸虫病的影响。在PubMed进行了系统的搜索,EBSCOhost,和其他数据库,以获得有关撒哈拉以南非洲儿童血吸虫病控制计划影响的研究。对3455项研究进行了资格筛选,包括关于儿科控制计划和血吸虫病的报道,当文章没有专门报告儿科血吸虫病控制计划时,文章被排除在外。使用JBI关键评估工具对40项选定的研究进行了相关性评估,并将30项研究纳入了研究。进行了深入的定量描述性分析,全面的叙述性总结解释了审查问题范围内的结果。结果表明,尽管预防性化疗降低了血吸虫病的患病率,在流行地区,再次感染的机会很高。预防性化疗,没有补充干预措施,包括安全供水和适当的卫生设施,血吸虫病病因学的钉螺防治及健康教育,传播模式和控制措施可能无法消除血吸虫病。
    Preventive chemotherapy by mass drug administration is globally recommended as the primary method of reaching the elimination of schistosomiasis, especially in the high risk-paediatric population. This systematic review provides a summary of the effects of paediatric schistosomiasis control programs on eliminating schistosomiasis in sub-Saharan Africa. A systematic search was conducted in PubMed, EBSCOhost, and other databases to obtain studies regarding the effects of paediatric schistosomiasis control programmes in sub-Saharan Africa. 3455 studies were screened for eligibility, included articles reported on both paediatrics control programmes and schistosomiasis, and articles were excluded when they did not report on schistosomiasis control programmes in paediatrics exclusively. 40 selected studies were critically appraised using the JBI critical appraisal tools for relevance and 30 studies were included in the study. An in-depth quantitative descriptive analysis was conducted, and a comprehensive narrative summary explained the results within the scope of the review questions. The results show that despite preventive chemotherapy lowering schistosomiasis prevalence, chances of re-infection are high in endemic areas. Preventive chemotherapy without complementary interventions including safe water provision and proper sanitation, snail control and health education on the aetiology of schistosomiasis, transmission pattern and control practices might not eliminate schistosomiasis.
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  • 文章类型: Journal Article
    Anogeisisssleiocarpus(DC。)Guill。&Perr。属于Combretaceae家族,被非洲传统医生和牲畜饲养者用于治疗非洲锥虫病等疾病,动物腹泻,哮喘,癌症,咳嗽,糖尿病,痢疾,勃起功能障碍,发烧,贾第鞭毛虫病,蠕虫酶,脑膜炎,月经失调,猴痘,口腔感染,脊髓灰质炎,镰状细胞性贫血,蛇咬,牙痛,泌尿血吸虫病,黄热病。这些活性中的一些与植物中多酚的存在有关,其中包括鞣花酸衍生物,黄酮类化合物,二苯乙烯,单宁,和三萜。已经从A.leiocarpus鉴定了几种生物活性分子。这些包括主要的活性成分,ellagitannins,鞣花酸衍生物,类黄酮和三萜。药理学研究证实其抗菌作用,抗真菌药,抗高血糖,抗高血压药,抗疟药,抗氧化,抗寄生虫,抗肿瘤和抗溃疡作用。茎皮主要进行了生物活性和植物化学研究,它是传统用户在种族医学调查中强调的最多的植物部分。体外和体内模型,揭示了对寄生虫引起蠕虫病的广泛药理作用,利什曼病,疟疾和锥虫病,已被用于研究来自A.leiocarpus的化合物。由于它在非洲传统医学和兽医实践中的用途,A.leiocarpus已经受到了研究人员的极大关注。当前的审查提供了关于A.leiocarpus的科学报告的全面概述和批判性评估,涵盖其传统用途,药理活性和植物化学。
    Anogeissus leiocarpus (DC.) Guill. & Perr. belongs to the family Combretaceae and is used both by African traditional medical practitioners and livestock rearers to treat diseases such as African trypanosomiasis, animal diarrhoea, asthma, cancer, cough, diabetes, dysentery, erectile dysfunction, fever, giardiasis, helminthiases, meningitis, menstrual disorders, monkeypox, oral infections, poliomyelitis, sickle cell anaemia, snake bites, toothache, urinary schistosomiasis, and yellow fever. Some of these activities have been associated with the presence of polyphenols in the plant which include ellagic acid derivatives, flavonoids, stilbenes, tannins, and triterpenes. Several bioactive molecules have been identified from A. leiocarpus. These include the main active constituents, ellagitannins, ellagic acid derivates, flavonoids and triterpenes. Pharmacological studies have confirmed its antibacterial, antifungal, antihyperglycemic, antihypertensive, antimalarial, antioxidative, antiparasitic, antitumour and anti-ulcer effects. The stem bark has been investigated mainly for biological activities and phytochemistry, and it is the most mentioned plant part highlighted by the traditional users in ethnomedicinal surveys. In vitro and in vivo models, which revealed a wide range of pharmacological actions against parasites causing helminthiasis, leishmaniasis, malaria and trypanosomiasis, have been used to study compounds from A. leiocarpus. Because of its uses in African traditional medicine and veterinary practices, A. leiocarpus has received considerable attention from researchers. The current review provides a comprehensive overview and critical appraisal of scientific reports on A. leiocarpus, covering its traditional uses, pharmacological activities and phytochemistry.
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  • 文章类型: Journal Article
    在贝宁,牲畜饲养者经常使用药用植物来治疗小反刍动物的胃肠道疾病。这篇评论的目的是列出在这种情况下传统上使用的植物,并介绍有关这些植物功效的科学发现。使用PubMed进行了广泛的搜索,Scopus,ScienceDirect,BiomedCentral和GoogleScholar数据库收集数据,结合相关的法语和英语关键字,如“民族植物学调查”,“驱虫特性”,“药用植物”,“胃肠道寄生虫”,“消化强体”,\"Haemonchus\",\"Trichostrongylus\",“小反刍动物”,\"绵羊\",“山羊”和“贝宁”。共有45篇发表的文章符合资格标准。这篇综述列出了育种者用于治疗小反刍动物胃肠道疾病的123种植物。最常用的部分是树叶和树皮,最常见的形式是汤剂,浸渍和粉末。科学研究已经证明了18种植物的驱虫特性,包括花椒,Newbouldialaevis,赤霉素和Combretum谷氨酸。这些植物的粉末或叶提取物在体内显示出卵排泄显着减少超过50%,幼虫建立,小反刍动物胃肠强体的生存能力和生育能力。这些植物的提取物对卵孵化的体外抑制活性也超过50%,幼虫迁移和胃肠强壮的运动性。该手稿强调了贝宁小反刍动物中驱虫植物的传统用途,并提供了支持这些植物功效的科学结果。
    In Benin, livestock breeders frequently use medicinal plants to treat gastrointestinal diseases in small ruminants. The aim of this review is to list the plants traditionally used in this context and to present the scientific findings on the efficacy of these plants. An extensive search was carried out using PubMed, Scopus, ScienceDirect, Biomed Central and Google Scholar databases to collect data, with combinations of relevant french and english keywords such as \"ethnobotanical survey\", \"anthelmintic properties\", \"medicinal plants\", \"gastrointestinal parasites\", \"digestive strongyles\", \"Haemonchus\", \"Trichostrongylus\", \"small ruminants\", \"sheep\", \"goats\" and \"Benin\". A total of 45 published articles met the eligibility criteria. This review listed 123 plants used by breeders to treat gastrointestinal ailments in small ruminants. The most commonly used parts are leaves and barks, and the most common forms are decoction, maceration and powder. Scientific studies have demonstrated the anthelmintic properties of 18 plants, including Zanthoxylum zanthoxyloides, Newbouldia laevis, Mitragyna inermis and Combretum glutinosum. The powders or leaf extracts of these plants showed in vivo significant reductions of over 50% in egg excretion, larval establishment, viability and fertility of gastrointestinal strongyles in small ruminants. Extracts of these plants also revealed in vitro inhibitory activity of over 50% on egg hatching, larval migration and motility of gastrointestinal strongyles. This manuscript highlights the traditional use of anthelmintic plants in small ruminants in Benin and provides scientific results supporting the efficacy of these plants.
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  • 文章类型: Journal Article
    胆道病在临床实践中并不常见。我们医院报告了两例病例。第一例患者被诊断为急性胆源性胰腺炎。内镜逆行胰胆管造影术(ERCP)显示白色,扁平,分段的1厘米宽的tape虫钻入十二指肠乳头,被鉴定为牛带虫。去除蚜虫后,胆管清扫,和驱虫药治疗,病人恢复顺利。第二名患者被诊断为急性胆管炎和胆总管和胆囊多发结石。急诊ERCP显示十二指肠内无疣。在随后的ERCP6天后,扁平的tape虫,还有T.saginata,被发现钻入十二指肠乳头。我们回顾了5例急性非结石性胆囊炎或由Saginata或猪带虫引起的胆管炎,和1名患者在T形管中钻孔。在处理胆胰疾病时,应考虑到带病。
    Biliary taeniasis is uncommon in clinical practice. We report two cases in our hospital. The first patient was diagnosed with acute biliary pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) showed a white, flat, segmented 1-cm-wide tapeworm drilling into the duodenal papilla that was identified as Taenia saginata. After tapeworm removal, bile duct sweeping, and anthelmintic therapy, the patient recovered uneventfully. The second patient was diagnosed with acute cholangitis and multiple stones in the common bile duct and gallbladder. Emergency ERCP showed no tapeworm in the duodenum. During a subsequent ERCP 6 days later, a flat tapeworm, also T. saginata, was identified drilling into the duodenal papilla. We review five patients cases with acute acalculous cholecystitis or cholangitis caused by T. saginata or Taenia solium, and 1 patient with T. saginata drilling into the T-tube. Taeniasis should be taken into consideration when dealing with biliary and pancreatic disease.
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  • 文章类型: Systematic Review
    播散性囊虫病由多个脑部病变和其他身体部位的累及定义。播散性囊虫病的杀细胞治疗被认为是危及生命的。我们对所有已发表的病例和病例系列进行了系统评价,以评估杀螺旋体治疗的安全性和有效性。我们根据系统评价和荟萃分析(PRISMA)指南(PROSPEROCRD42022331895)的首选报告项目进行了系统评价,以评估杀半胱氨酸治疗的安全性和有效性。使用搜索词“播散性神经囊虫病或播散性囊虫病,“像PubMed这样的数据库,Scopus,Embase,和谷歌学者被搜索。结果包括死亡和次要措施,如临床改善和病变减少。我们使用二元逻辑回归分析计算了主要结局(死亡)的预测因子。我们回顾了101种出版物中已发表的222例。大约87%的病例来自印度。222例,134(60%)接受了杀细胞治疗。随访信息来自180名患者,其中11人死亡,169显示临床改善。在使用杀膀胱药物加皮质类固醇治疗的患者中,死亡率为4%(114人中有5人),相比之下,仅接受皮质类固醇治疗的患者为13%(38例中的5例)。所有仅使用吡喹酮的患者均面临死亡。确定的死亡预测因素是感觉神经改变和缺乏阿苯达唑治疗。我们注意到,死于膀胱治疗后的死亡风险并不像我们预期的那样,需要一项多中心随机对照试验来解决这一问题.
    Disseminated cysticercosis is defined by multiple brain lesions and involvement of other body sites. Cysticidal treatment in disseminated cysticercosis is considered life-threatening. We conducted a systematic review of all published cases and case series to assess the safety and efficacy of cysticidal treatment. We conducted a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42022331895) to assess the safety and efficacy of cysticidal treatment. Using the search term \"disseminated neurocysticercosis OR disseminated cysticercosis,\" databases like PubMed, Scopus, Embase, and Google Scholar were searched. Outcomes included death and secondary measures like clinical improvement and lesion reduction. We calculated the predictors of primary outcome (death) using the binary logistic regression analysis. We reviewed 222 published cases from 101 publications. Approximately 87% cases were reported from India. Of 222 cases, 134 (60%) received cysticidal treatment. Follow-up information was available from 180 patients, 11 of them died, and 169 showed clinical improvement. The death rate was 4% (5 out of 114) in patients treated with cysticidal drugs plus corticosteroids, in comparison with 13% (5 out of 38) in patients who were treated with corticosteroids alone. All patients using only praziquantel faced fatality. Death predictors identified were altered sensorium and lack of treatment with albendazole. We noted that the risk of death after cysticidal treatment is not as we expected, and a multicentric randomized controlled trial is needed to resolve this issue.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Meta-Analysis
    背景:当前的土壤传播蠕虫(STH)控制指南认可将阿苯达唑或甲苯达唑用于基于学校的靶向预防性化疗(PC),然而,它们对胸骨圆线虫和毛虫的疗效降低存在显著的局限性。新出现的证据表明,使用伊维菌素的全社区PC[或大规模药物管理(MDA)],常用于其他被忽视的热带病(NTD)控制程序,可能在控制这些寄生虫方面发挥重要作用。我们进行了系统评价和荟萃分析,以评估伊维菌素PC在降低流行人群中STH患病率的有效性。
    方法:我们搜索了Pubmed,EMBASE,和WebofScience于2023年2月14日发布,用于研究伊维菌素PC的有效性,单独或与其他驱虫药联合使用,关于STH感染,并提供了PC前后STH患病率的衡量标准。我们使用随机效应荟萃分析计算了每种STH的合并患病率降低。我们的协议可在PROSPERO上获得(注册号CRD42023401219)。
    结果:共有21人符合系统评价的条件,其中15人符合荟萃分析的条件.所有研究均通过MDA递送伊维菌素。在5项研究中,仅使用伊维菌素的MDA后,胸骨链球菌的合并患病率降低为84.49%(95%CI54.96-94.66),在使用或不使用阿苯达唑的7项研究中,为81.37%(95%CI61.62-90.96)。在5项单独使用伊维菌素的研究中,TrichiuraT.trichiura的患病率降低为49.93%(95%CI18.23-69.34),在添加阿苯达唑的三项研究中,89.40%(95%CI73.66-95.73)。所有合成都存在高度异质性(I2>65%)。
    结论:本研究强调了基于伊维菌素的MDA在解决当前全球STH指南中对胸骨链球菌和Trichiura疗效有限的局限性方面的关键作用。基于这些发现,修订国际STH准则以包括伊维菌素是一个有希望的选择,以促进对STH和其他NTD的控制和最终消除。
    BACKGROUND: Current soil-transmitted helminth (STH) control guidelines endorse the use of albendazole or mebendazole for school-based targeted preventive chemotherapy (PC), yet their reduced efficacy against Strongyloides stercoralis and Trichuris trichiura presents significant limitations. Emerging evidence indicates that community-wide PC [or mass drug administration (MDA)] using ivermectin, commonly used in other neglected tropical disease (NTD) control programs, may play an important role in controlling these parasites. We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations.
    METHODS: We searched Pubmed, EMBASE, and Web of Science on February 14, 2023, for studies that investigated the effectiveness of ivermectin PC, either alone or in combination with other anthelmintic drugs, on STH infections, and provided a measure of STH prevalence before and after PC. We calculated pooled prevalence reductions for each STH using random-effects meta-analyses. Our protocol is available on PROSPERO (registration number CRD42023401219).
    RESULTS: A total of 21 were eligible for the systematic review, of which 15 were eligible for meta-analysis. All studies delivered ivermectin through MDA. The pooled prevalence reduction of S. stercoralis following MDA with ivermectin alone was 84.49% (95% CI 54.96-94.66) across five studies and 81.37% (95% CI 61.62-90.96) across seven studies with or without albendazole. The prevalence reduction of T. trichiura was 49.93% (95% CI 18.23-69.34) across five studies with ivermectin alone, and 89.40% (95% CI 73.66-95.73) across three studies with the addition of albendazole. There was high heterogeneity for all syntheses (I2 > 65%).
    CONCLUSIONS: This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S. stercoralis and T. trichiura. Based on these findings, revising international STH guidelines to include ivermectin is a promising option to progress the control and eventual elimination of STHs and other NTDs.
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  • 文章类型: Journal Article
    背景:在全球范围内,数百万人受到欺诈性药品的影响,尤其是发展中国家。尽管人们承认伪造和不合格药物的问题,问题的程度是千变万化的,具有动态性质,并且应该在最近的快照中进行量化和捕获。
    目的:本系统评价旨在研究可以量化的数据,并提供选定东非国家SF抗菌药物流行的最新快照。
    方法:在PubMed,Embase,Scopus,和谷歌学者从2017年到2023年2月。搜索策略的重点是以英文撰写的同行评审科学期刊上发表的科学文章,以及在东非任何选定国家进行的专门研究。这些文章由两个人仔细审查,以便独立纳入,首先是标题,然后是摘要和全文检索。为了最大限度地减少与数据收集方法相关的偏差,根据医学质量评估报告指南(MEDQUARG)对研究质量进行评估.本系统评价的报告是在系统评价和荟萃分析(PRISMA)的首选报告项目之后进行的。
    结果:纳入了15项研究,这些研究估计了在选定的四个东非国家中低质量抗菌药物的流行情况。至少一次质量检测失败的抗菌药物样本的总百分比为22.6%(151/669),每一类抗生素的患病率为17%(73/432),24%的抗疟药(41/171),在驱虫药中占56%(37/66)。原料药含量的质量控制参数是纳入研究中最常检查的参数,占14/15(93%)的研究。50份(33.1%)的失败样品未能通过测定API含量测定,而26.5%(n=40)未通过目视检查和包装分析;19.2%(29)未溶解;14%(n=21)有缺陷的硬度或脆性;4%(n=6)未达到均匀性,以及3.2%(n=5)的质量控制参数未通过崩解试验。
    结论:发现该综述在这些选定的东非国家具有普遍性,并且是对抗影响数百万人生命的劣质药物威胁的催化剂。
    BACKGROUND: Globally, millions of people have been affected by fraudulent pharmaceutical products, particularly those in developing countries. Although the problem of falsified and substandard drugs is acknowledged, the extent of the issue is ever-changing, has a dynamic nature, and should be quantified and captured in a recent snapshot.
    OBJECTIVE: This systematic review seeks to examine the data that can quantify and provide a current snapshot of the prevalence of SF antimicrobials in selected east Africa countries.
    METHODS: Scientific studies on antimicrobial quality were searched in PubMed, Embase, Scopus, and Google Scholar from 2017 to February 2023. The search strategy focused on scientific articles published in peer-reviewed scientific journals written in English and the studies exclusively done in any of the selected countries of east Africa. The articles were carefully reviewed by two individuals for inclusion independently, first by title followed by abstract and the full-text retrieval. To minimize bias associated with the methodology used for data collection, the quality of the studies was assessed for quality according to the Medicine Quality Assessment Reporting Guidelines (MEDQUARG). The reporting of this systematic review was done following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA).
    RESULTS: Fifteen studies that estimated the prevalence of poor-quality antimicrobial medicines in selected four east African countries were included. The overall percentage of samples of antimicrobials that failed at least one quality test was 22.6% (151/669) with each class\'s prevalence of 17% in antibiotics (73/432), 24% in antimalarial (41/171), and 56% in anthelmintics (37/66). Quality control parameters of API content were the most commonly examined in the included studies, accounting for 14/15 (93%) studies. Fifty (33.1%) of the failing samples failed assay API- content determination, while 26.5% (n = 40) failed the visual inspection and packaging analysis; 19.2% (29) failed dissolution; 14% (n = 21) flawed hardness or friability; 4%(n = 6) failed uniformity, as well as 3.2% (n = 5) failed disintegration test of the quality control parameter.
    CONCLUSIONS: It was found that this review was general in these selected east African countries and was a catalyst for combating the menace of poor-quality medications that affect millions of lives.
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