UNASSIGNED: Tuberculosis (TB) is a major cause of morbidity and mortality globally. Understanding its epidemiology and burden is critical for targeted interventions.
UNASSIGNED: To highlight the prevalence, incidence and treatment outcomes of TB in Egypt during the last 2 decades.
UNASSIGNED: For this systematic review and meta-analysis, we searched Medline/PubMed, ResearchGate, Google Scholar, and Scopus databases. We searched the local databases for unpublished studies, and the reports of international agencies, applying clear inclusion and exclusion criteria. The search covered prevalence; incidence; treatment outcomes; age, gender and residence of patients; and type of TB. Data were analyzed using STATA version 16.0. Pooled estimates with 95% confidence interval (CI) were calculated using a random effects model. Odds ratio (OR) with 95% CI was used as effect measures for related variables. Heterogeneity across studies was assessed using the I² statistic with sub-group analysis.
UNASSIGNED: A total of 23 studies from 22 governorates, out of 27 governorates, involving a 139 597 study population met the eligibility requirements with no publication bias. The pooled prevalence was 8.70 (95% CI: 5.80-12.41, I² = 92.7%) and the pooled incidence was 9.10 (95% CI: 6.65-14.86, I² = 95.5%) per 100 000 population. About 82.6% of cases showed cured/completed treatment, 4.4% failure of treatment, and 3.9% died. In the subgroup analyses, the odds of TB prevalence were higher among males than females (2.05; 95% CI: 1.44-3.28), among those living in rural than in urban areas (1.29; 95% CI: 0.61-1.97), in Upper Egypt and Greater Cairo than in Lower Egypt and Delta Region (1.85; 95% CI: 0.97-4.15). The odds of pulmonary TB prevalence were higher than the extrapulmonary TB (2.43; 95% CI: 1.63-5.71). The odds of the treatment cases who were cured/completed (1.04; 95% CI: 0.96-1.51), failed (1.71; 95% CI: 1.35-2.73), and died (1.12; 95% CI: 0.87-1.60) were higher in Lower Egypt than in Upper Egypt.
UNASSIGNED: TB incidence decreased in Egypt over the last two decades, but treatment outcomes were unsatisfactory, with variations across the different regions. To achieve TB eradication in Egypt, efforts should be made to sustain the TB control strategy by improving treatment outcomes and intensifying case finding and surveillance reporting.
استعراض منهجي وتحليل تلوي لمعدل انتشار السل ومعدلات الإصابة به ونتائج علاجه في مصر.
محمد أسامه نور، سامح أسامه نور.
UNASSIGNED: يُعَد السل مرضًا مداريًّا مهملًًا يُعرَف بأنه سبب رئيسي للمراضة والوفيات. ويتسم فَهْم خصائصه الوبائية وعبئه بأهمية بالغة في التدخلات المستهدفة.
UNASSIGNED: هدفت هذه الدراسة الى تسليط الضوء على معدل انتشار السل ومعدل الإصابة به ونتائج علاجه في مصر خلال العقدين الماضيين.
UNASSIGNED: لإجراء هذا الاستعراض المنهجي والتحليل التلوي، بحثنا في قواعد البيانات Medline/Pub Med وResearchGate وGoogle Scholar وScopus. وبحثنا في قواعد البيانات المحلية عن الدراسات غير المنشورة، وتقارير الوكالات الدولية، مع تطبيق معايير واضحة للإدراج والاستبعاد. وشمل البحث معدل الانتشار، ومعدل الإصابة، ونتائج العلاج، وعمر المرضى وجنسهم ومكان إقامتهم، ونوع السل. وحُُلِِّلت البيانات باستخدام الإصدار 16,0 من برنامج STATA. وحُُسبت التقديرات الُمُجمََّعة بفاصل الثقة ٪95 باستخدام نموذج التأثيرات العشوائية. واستُُخدمت نسبة الأرجحية بفاصل ثقة ٪95 بمثابة مقياس تأثير للمتغيرات ذات الصلة بالموضوع. وقُُيِِّمت التغايُُرِِيََّة على مستوى الدراسات باستخدام الاختبار الإحصائي I² مع تحليل المجموعات الفرعية.
UNASSIGNED: استوفى ما مجموعه 23 دراسة من 22 من أصل 27 محافظة، شملت 139,597 نسمة ، شروط الأهلية دون أي تحيز في النشر. وبلغ معدل الانتشار الُمُجمََّع 8,70 (فاصل الثقة ٪95: 5,80–12,41، I² = 92,7٪)، وبلغ معدل الإصابة الُمُجمََّع 9,10 (فاصل الثقة ٪95: 6,65–14,86، I² = 95,5٪) لكل 100,000 نسمة. وأظهرت نحو ٪82,6 من الحالات شفاءها أو اكتمال علاجها، وأظهرت ٪4,4 من الحالات فشالًا في العلاج، وتُُوفي ٪3,9 من الحالات. وفي تحليلات المجموعات الفرعية، كانت أرجحية انتشار السل أعلى بين الذكور منها بين الإناث (2,05؛ فاصل الثقة ٪95: 1,44–3,28)، وانتشاره بين أولئك الذين يعيشون في مناطق ريفية أكثر ممن يعيشون في مناطق حضرية (1,29؛ فاصل الثقة ٪95: 0,61–1,97)، وانتشاره في صعيد مصر والقاهرة الكبرى أكثر من شمال مصر ومنطقة الدلتا (1,85؛ فاصل الثقة ٪95: 0,97–4,15). وكانت أرجحية انتشار السل الرئوي أعلى من احتمالات انتشار السل خارج الرئة (2,43؛ فاصل الثقة ٪95: 1,63–5,71). وكانت أرجحية شفاء الحالات أو اكتمال علاجها (1,04؛ فاصل الثقة ٪95: 0,96–1,51)، وفشل العلاج (1,71؛ فاصل الثقة ٪95: 1,35–2,73)، والوفاة (1,12؛ فاصل الثقة ٪95: 0,87–1,60) أعلى في شمال مصر منها في صعيد مصر.
UNASSIGNED: انخفض معدل الإصابة بالسل في مصر على مدار العقدين الماضيين، ولكن نتائج العلاج لم تكن مُُرضية، مع وجود اختلافات بين المناطق المختلفة. ولاستئصال السل في مصر، ينبغي بذل الجهود لمواصلة استراتيجية مكافحة السل، من خلال تحسين نتائج العلاج وتكثيف تق ي صِّي الحالات والإبلاغ عن الترصُُّد.
Analyse systématique et méta-analyse de la prévalence et de l’incidence de la tuberculose et issue thérapeutique en Égypte : aperçu actualisé.
UNASSIGNED: La tuberculose est une cause majeure de morbidité et de mortalité dans le monde. Il est essentiel d\'en comprendre l\'épidémiologie et d\'appréhender le fardeau qu\'elle représente pour mener des interventions ciblées.
UNASSIGNED: Mettre en évidence la prévalence et l\'incidence de la tuberculose ainsi que les issues du traitement en Égypte au cours des deux dernières décennies.
UNASSIGNED: Pour réaliser la présente analyse systématique et méta-analyse, nous avons effectué des recherches dans les bases de données Medline/PubMed, ResearchGate, Google Scholar et Scopus. Nous avons également consulté les bases de données locales afin de trouver des études non publiées, ainsi que les rapports des agences internationales, en appliquant des critères d\'inclusion et d\'exclusion précis. La recherche a porté sur la prévalence, l\'incidence, les résultats du traitement, l\'âge, le genre et le lieu de résidence des patients, ainsi que sur le type de tuberculose. Les données ont été analysées à l\'aide du logiciel STATA version 16.0. Les estimations globales avec intervalle de confiance (IC) à 95 % ont été calculées à l\'aide d\'un modèle à effets aléatoires. L\'odds ratio (OR) avec IC à 95 % a été utilisé comme mesure de l\'effet pour les variables associées. La statistique I², combinée à une analyse de sous-groupes, a été utilisée pour mesurer l\'hétérogénéité entre les études.
UNASSIGNED: Au total, 23 études provenant de 22 gouvernorats sur 27 et réalisées auprès de 139 597 participants répondaient aux critères d\'admissibilité sans biais de publication. La prévalence globale était de 8,70 (IC à 95 % : 5,80-12,41, I² = 92,7 %) et l\'incidence globale était de 9,10 (IC à 95 % : 6,65-14,86, I² = 95,5 %) pour 100 000 personnes. Près de 82,6 % des cas ont été guéris ou ont terminé leur traitement, 4,4 % ont connu un échec thérapeutique et 3,9 % sont décédés. Dans les analyses de sous-groupes, les probabilités de prévalence de la tuberculose étaient plus élevées chez les hommes que chez les femmes (2,05 ; IC à 95 % : 1,44-3,28), chez les personnes vivant en zone rurale qu\'en zone urbaine (1,29 ; IC à 95 % : 0,61-1,97), en Haute Égypte et dans le Grand Caire qu\'en Basse Égypte et dans la région du Delta (1,85 ; IC à 95 % : 0,97-4,15). Les probabilités de prévalence de la tuberculose pulmonaire étaient plus élevées que celles de la tuberculose extrapulmonaire (2,43 ; IC à 95 % : 1,63-5,71). Les probabilités de guérison ou d\'achèvement du traitement (1,04 ; IC à 95 % : 0,96-1,51), d\'échec thérapeutique (1,71 ; IC à 95 % : 1,35-2,73) et de décès (1,12 ; IC à 95 % : 0,87-1,60) étaient plus élevées en Basse Égypte qu\'en Haute Égypte.
UNASSIGNED: L\'incidence de la tuberculose a diminué en Égypte ces vingt dernières années, mais les résultats du traitement n\'étaient pas satisfaisants, avec des variations d\'une région à l\'autre. Dans l\'objectif de parvenir à l\'éradication de la tuberculose en Égypte, il est nécessaire de déployer des efforts pour soutenir la stratégie de lutte antituberculeuse en améliorant les résultats du traitement et en renforçant la recherche de cas et les rapports issus de la surveillance.

OBJECTIVE: Identify potential barriers, delays, and missed opportunities in the prevention and diagnosis of childhood TB.
METHODS: Scoping review according to the PRISMA extension. The definitions considered for the selection followed the acronym PCC where the population (P) is children under 18 years of age with TB disease, the concept (C) refers to missed opportunities for prevention and diagnosis, and context (C) is defined as a diagnosis of TB disease. The authors searched systematically in the databases; VHL/Lilacs, Medline via PubMed, Cochrane, Scopus, and Web of Science, without date or language limitation.
RESULTS: Seven studies were included. In developed countries, with low disease burden, the main shortcoming is the delay in diagnosing bacilliferous adults in contact with young children. This problem is concentrated in the portion of the population with socioeconomic vulnerability. In underdeveloped countries, with a high burden of disease, the biggest challenge is tracking children who come into contact with bacilliferous patients.
CONCLUSIONS: There are still many missed opportunities in the prevention and diagnosis of childhood TB. The positive legacy of the COVID-19 pandemic should be taken advantage of and the encouragement of scientific development in the management of infectious diseases should be taken.

BACKGROUND: Transmission of drug-resistant tuberculosis (DR-TB) is ongoing. Finding individuals with DR-TB and initiating treatment as early as possible is important to improve patient clinical outcomes and to break the chain of transmission to control the pandemic. To our knowledge systematic reviews assessing effectiveness, cost-effectiveness, acceptability, and feasibility of different case-finding strategies for DR-TB to inform research, policy, and practice have not been conducted, and it is unknown whether enough research exists to conduct such reviews. It is unknown whether case-finding strategies are similar for DR-TB and drug-susceptible TB and whether we can draw on findings from drug-susceptible reviews to inform decisions on case-finding strategies for DR-TB.
OBJECTIVE: This protocol aims to describe the available literature on case-finding for DR-TB and to describe case-finding strategies.
METHODS: We will screen systematic reviews, trials, qualitative studies, diagnostic test accuracy studies, and other primary research that specifically sought to improve DR-TB case detection. We will exclude studies that invited individuals seeking care for TB symptoms, those including individuals already diagnosed with TB, or laboratory-based studies. We will search the academic databases including MEDLINE, Embase, The Cochrane Library, Africa-Wide Information, CINAHL, Epistemonikos, and PROSPERO with no language or date restrictions. We will screen titles, abstracts, and full-text articles in duplicate. Data extraction and analyses will be performed using Excel (Microsoft Corp).
RESULTS: We will provide a narrative report with supporting figures or tables to summarize the data. A systems-based logic model, developed from a synthesis of case-finding strategies for drug-susceptible TB, will be used as a framework to describe different strategies, resulting pathways, and enhancements of pathways. The search will be conducted at the end of 2021. Title and abstract screening, full text screening, and data extraction will be undertaken from January to June 2022. Thereafter, analysis will be conducted, and results compiled.
CONCLUSIONS: This scoping review will chart existing literature on case-finding for DR-TB-this will help determine whether primary studies on effectiveness, cost-effectiveness, acceptability, and feasibility of different case-finding strategies for DR-TB exist and will help formulate potential questions for a systematic review. We will also describe case-finding strategies for DR-TB and how they fit into a model of case-finding pathways for drug-susceptible TB. This review has some limitations. One limitation is the diverse, inconsistent use of intervention terminology within the literature, which may result in missing relevant studies. Poor reporting of intervention strategies may also cause misunderstanding and misclassification of interventions. Lastly, case-finding strategies for DR-TB may not fit into a model developed from strategies for drug-susceptible TB. Nevertheless, such a situation will provide an opportunity to refine the model for future research. The review will guide further research to inform decisions on case-finding policies and practices for DR-TB.
UNASSIGNED: DERR1-10.2196/40009.

Background: Mass testing and adequate management are essential to terminate the spread of coronavirus disease 2019 (COVID-19). This testing is due to the possibility of unidentified cases, especially ones without COVID-19 related symptoms. This review aimed to examine the outcome of the existing studies on the ways of identifying COVID-19 cases, and determine the populations at risk, symptom and diagnostic test management of  COVID-19. Methods: The articles reviewed were scientific publications on the PubMed, Science Direct, ProQuest, and Scopus databases. The keywords used to obtain the data were COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and case detection, case management or diagnostic test. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Population, Intervention, Control and Outcomes (PICO) approaches. Results: A total of 21 articles from 13 countries met the inclusion criteria and were further analyzed qualitatively. However, 62% of the articles used a rapid antibody test for screening rather than a rapid antigen test. According to the rapid antigen test, 51.3% were positive, with men aged above 50 years recording the highest number of cases. Furthermore, 57.1% of patients were symptomatic, while diagnostic tests\' sensitivity and specificity increased to 100% in 14 days after the onset. Conclusion s:  Real-time polymerase chain reaction (RT-PCR)  is recommended by the World Health Organization for detection of COVID-19. Suppose it is unavailable, the rapid antigen test is used as an alternative rather than the rapid antibody test. Diagnosis is expected to be confirmed using the PCR and serological assay to achieve an early diagnosis of COVID-19, according to disease progression, gradual rapid tests can be used, such as rapid antigen in an earlier week and antibody tests confirmed by RT-PCR and serological assay in the second week of COVID-19.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) causes significant morbidity and mortality worldwide. Estimation of incidence, prevalence and disease burden through routine insurance data is challenging because of under-diagnosis and under-treatment, particularly for early stage disease in health care systems where outpatient International Classification of Diseases (ICD) diagnoses are not collected. This poses the question of which criteria are commonly applied to identify COPD patients in claims datasets in the absence of ICD diagnoses, and which information can be used as a substitute. The aim of this systematic review is to summarize previously reported methodological approaches for the identification of COPD patients through routine data and to compile potential criteria for the identification of COPD patients if ICD codes are not available.
METHODS: A systematic literature review was performed in Medline via PubMed and Google Scholar from January 2000 through October 2018, followed by a manual review of the included studies by at least two independent raters. Study characteristics and all identifying criteria used in the studies were systematically extracted from the publications, categorized, and compiled in evidence tables.
RESULTS: In total, the systematic search yielded 151 publications. After title and abstract screening, 38 publications were included into the systematic assessment. In these studies, the most frequently used (22/38) criteria set to identify COPD patients included ICD codes, hospitalization, and ambulatory visits. Only four out of 38 studies used methods other than ICD coding. In a significant proportion of studies, the age range of the target population (33/38) and hospitalization (30/38) were provided. Ambulatory data were included in 24, physician claims in 22, and pharmaceutical data in 18 studies. Only five studies used spirometry, two used surgery and one used oxygen therapy.
CONCLUSIONS: A variety of different criteria is used for the identification of COPD from routine data. The most promising criteria set in data environments where ambulatory diagnosis codes are lacking is the consideration of additional illness-related information with special attention to pharmacotherapy data. Further health services research should focus on the application of more systematic internal and/or external validation approaches.

Introduction: Tuberculosis (TB) is among the 10 most common causes of death worldwide and it is the leading cause of mortality in people with human immunodeficiency virus (HIV). Clinical scoring systems have the potential to improve case finding and to prioritize patients for TB testing. Areas covered: This systematic review investigated the utility of prediction models to improve pulmonary tuberculosis (pTB) case finding. Studies were searched through PubMed until 15th of August 2018 and 20 studies were eligible according to the inclusion criteria. Data on study population, outcome measurements, predictors, and performance were extracted. Many studies showed promising results but lacked external validation. Furthermore, head-to-head studies are needed to compare the different prediction models. Sensitivities of the prediction models ranged from 26% to 96% and specificities from 18% to 92%, negative likelihood ratios (LR-) from 0.22 to 0.8 and positive likelihood ratios(LR+) 1.07 to 7.32. Composite scores including paraclinical measures added to sensitivity. Expert opinion: TB case finding is of utmost importance to advance the quest for global TB elimination, and simple measures to identify high-risk populations or persons to undergo further diagnostic evaluation are highly needed. A number of clinical scores are available and could be implemented in practice to improve case finding.

Depression is prevalent across the life span worldwide. It is a common problem encountered in primary care settings. The World Health Organization recommends the integration of mental health into general health care in order to seal the existing gap between the number of patients who need mental health care and those who actually receive it. Addressing the burden of mental health problems in primary care settings has its limitations, particularly because of the time constraints in busy primary care clinics as well as the inadequate training of staff and physicians in mental health disorders. That is why reliable, brief, and easy to administer depression screening instruments are important in helping physicians identify patients at risk. The 2-item Patient Health Questionnaire (PHQ-2) is a suitable primary screening tool for depression. If positive, other tools should be administered, such as the PHQ-9 in adults, the PHQ-9 or Geriatric Depression Scale-15 in older adults, or the Arroll\'s help question or the Edinburgh Postnatal Depression Scale in ante- or postpartum women. Patients with positive scores ought to be interviewed more thoroughly. Computerized depression screening instruments that are interfaced or integrated into electronic health records seem to be promising steps toward optimizing diagnosis, treatment, and follow-up. The availability of adequate management and follow-up are ethical requirements for the utilization of any screening instrument for depression.

Schistosomiasis is a chronic and debilitating parasitic disease acquired through contact with infested freshwater. An essential component of its control is passive case finding, which, in order to be effective, requires a detailed understanding of health-seeking behaviour. This study aimed to systematically review evidence on health-seeking behaviour for schistosomiasis, in order to determine factors influencing use or non-use of modern health services for the infection. Quantitative, qualitative and mixed method studies reporting on factors related to seeking treatment from modern health services for schistosomiasis were obtained, combining electronic and hand searching. Data extraction and quality assessment of the included articles were performed, with all studies qualitatively analysed using thematic synthesis. A total of 19 studies were included in the review. Six themes were identified from the analysis: biomedical knowledge on schistosomiasis, perceptions of modern treatment and health services, financial considerations of treatment, perceptions on the symptoms, stigma of the infection, and physical location and community. These findings were consistent across studies of different design, setting and quality. Many of the themes identified echo existing literature on health-seeking behaviour. The synthesis also highlighted the role of stigma, and aspects of the physical location and community that may affect treatment-seeking for schistosomiasis. Health education programmes that intend to improve the utilisation of modern health services for the infection need to acknowledge the multiple determinants influencing their use. Future research should move beyond describing health-seeking behaviour to identifying the factors that underlay such behaviour.