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  • 文章类型: Journal Article
    背景:由于过分拥挤的生活条件和有限的医疗保健资源,在监狱中,镰刀是一个普遍存在的问题。最近发表在《感染与公共卫生杂志》上的一项研究发现,在不同地区和设施的囚犯中,sc疮的患病率差异很大。本综述旨在通过进行系统评价和荟萃分析来确定囚犯中sc疮的全球患病率和预测因素。
    方法:我们遵循系统评价和荟萃分析检查表的首选报告项目来报告我们的系统评价和荟萃分析的结果。相关数据库,包括PubMed,科克伦图书馆,ScienceDirect,和其他灰色文献数据库被用来搜索和检索文章。该研究包括以英语编写的已发表和未发表的研究,用于报告囚犯中人sc疮的患病率。此评论已在PROSPERO上注册。使用I2统计量评估数据的异质性。使用STATA17软件进行荟萃分析,95%的置信区间。研究人员还进行了发表偏倚和敏感性分析。
    结果:该综述包括7项研究,涉及1,309,323名囚犯。所有纳入的研究都涉及横断面研究设计。囚犯中sc疮的患病率从意大利的0.72%到喀麦隆的41.01%不等。囚犯中人类sc疮的全球合并患病率为6.57%(95%CI;2.16-19.94)。根据亚组分析,非洲囚犯sc疮的总体患病率为19.55%(95%CI;9.44-40.45),而非洲以外囚犯的患病率为1.57%(95%CI;0.77-3.19)。在监狱里度过的时间,分享衣服或床,和卫生习惯被发现是与囚犯发展为人类sc疮的可能性显着相关的因素。
    结论:在全世界的囚犯中,人类sc疮的总体患病率很高。在监狱里呆更多时间的囚犯共用衣服或床位,卫生习惯差的人更有可能患上sc疮。因此,政策制定者和计划管理者应努力降低监狱中sc疮的患病率。本系统评价和荟萃分析的方案已在国际前瞻性系统评价注册簿中注册,注册号为CRD42024516064。
    BACKGROUND: Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis.
    METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis.
    RESULTS: The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16-19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44-40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77-3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies.
    CONCLUSIONS: The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.
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  • 文章类型: Journal Article
    众所周知,地中海饮食(DM)对健康有益,多年的全球研究已经证实。这项研究的目的是更新先前的系统评价,该评价通过评估这种饮食的经济绩效来评估坚持DM作为预防退行性疾病的策略的成本效益。研究方法利用了三个电子数据库:PubMed,Scopus,和WebofScience。进行了全面搜索,以检索基于PROSPERO中注册的PRISMA兼容协议的文章:CRD42023493562。对所有纳入的研究进行数据提取和分析。检索到一千二百八十二篇文章,一旦重复和不相关的文章被删除,审查了15篇有用的文章。研究表明,饮食习惯之间存在明显的联系,健康,以及与饮食成本和健康支出相关的经济方面。认识到与采用DM相关的重大健康益处以及医疗保健支出的潜在节省,国家公共卫生计划必须考虑支持这种生活方式的政策。
    It is well known that the Mediterranean diet (DM) is beneficial for health, as years of research globally have confirmed. The aim of this study was to update a previous systematic review that assessed the cost-effectiveness of adherence to the DM as a strategy for the prevention of degenerative diseases by evaluating the economic performance of this diet. The research approach utilized three electronic databases: PubMed, Scopus, and Web of Science. A comprehensive search was conducted to retrieve articles based on a PRISMA-compliant protocol registered in PROSPERO: CRD 42023493562. Data extraction and analysis were performed on all included studies. One thousand two hundred and eighty-two articles were retrieved, and once duplicates and irrelevant articles were removed, fifteen useful articles were reviewed. The studies indicated a clear link between dietary habits, health, and economic aspects related to dietary cost and health spending. Recognizing the significant health benefits associated with adopting DM and the potential savings on health care spending, it is important for national public health programs to consider policies that support this lifestyle.
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  • 文章类型: Journal Article
    新生儿血斑筛查(NBS)始于1960年代初,基于布法罗的Robert\“Bob\”Guthrie博士的工作,NY,美国。他对吸收到特殊滤纸上的血液进行苯丙酮尿症筛查测试,并将其运送到远程测试实验室,这一切都开始了。NBS扩展到大量无症状的先天性疾病在许多环境中蓬勃发展,而在其他环境中尚未实现。NBS作为一种有效和有效的公共卫生预防战略的必要性,有助于在任何地方持续降低发病率和死亡率,这在医学领域是众所周知的,但政治政策制定者不一定。认识到2007年发布的国家国家统计局报告的价值,作者合作在2015年创建了全球国家统计局更新。为了继续审查国家统计局在全球的进展,并朝着更加协调和公平的筛查系统迈进,我们更新了2015年报告,提供了2024年初的信息。关于撒哈拉以南非洲和加勒比的报告,2015年失踪,已包括在内。上次报告中流行的表格已经更新,着眼于统一的比较。为了强调需要全球关注的领域,我们使用了包含类似筛选条件列表的区域表,筛选实验室的数量,以及建议采集标本的时间。讨论仅限于血斑筛查。
    Newborn bloodspot screening (NBS) began in the early 1960s based on the work of Dr. Robert \"Bob\" Guthrie in Buffalo, NY, USA. His development of a screening test for phenylketonuria on blood absorbed onto a special filter paper and transported to a remote testing laboratory began it all. Expansion of NBS to large numbers of asymptomatic congenital conditions flourishes in many settings while it has not yet been realized in others. The need for NBS as an efficient and effective public health prevention strategy that contributes to lowered morbidity and mortality wherever it is sustained is well known in the medical field but not necessarily by political policy makers. Acknowledging the value of national NBS reports published in 2007, the authors collaborated to create a worldwide NBS update in 2015. In a continuing attempt to review the progress of NBS globally, and to move towards a more harmonized and equitable screening system, we have updated our 2015 report with information available at the beginning of 2024. Reports on sub-Saharan Africa and the Caribbean, missing in 2015, have been included. Tables popular in the previous report have been updated with an eye towards harmonized comparisons. To emphasize areas needing attention globally, we have used regional tables containing similar listings of conditions screened, numbers of screening laboratories, and time at which specimen collection is recommended. Discussions are limited to bloodspot screening.
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  • 文章类型: Journal Article
    背景:全球年轻年龄组中的卒中正在增加。虽然有一个重点是对65岁以下中风患者进行的研究,关于年轻人(≤30岁)中卒中的发生率和危险因素的数据很少.这项范围审查审查了围产期发病率和危险因素的证据,全球儿童和年轻成人中风。
    方法:审查是由JoannaBriggs研究所的范围审查方法指导的。2022年3月23日,在MedlineOvid进行了系统搜索,Embase,护理和相关健康文献的PsycINFO和累积指数(CINAHL)。资格标准包括所有研究设计,提供了过去十年中年轻人(≤30岁)中风的发生率和危险因素的信息。
    结果:共鉴定出5750篇文章。筛选后,471篇文献(224项队列研究(47.6%),164个案例研究/案例系列(34.8%),35条评论(7.4%),包括30例病例对照(6.4%)和18种设计组合(3.8%)。有来自50个不同国家的数据,199项研究来自高收入国家,中高收入(n=38),中低收入(n=39),低收入(n=3)国家,国际研究(n=7)和另外185篇文章没有说明研究的国家。大多数研究(63%)集中在危险因素上,而发病率占37%。发病率数据在研究中报告不均匀,导致无法合成数据。三个最常报告的围产期中风的危险因素是感染,心脏病,和产时因素。血管病变,感染和心脏疾病占儿科卒中的大多数报告危险因素,而慢性疾病如糖尿病,血管病变和心脏病是年轻人中报告最多的危险因素.
    结论:本综述强调了30岁以下人群的不同卒中危险因素。流行病学研究的数量较少,这表明需要进一步研究这种类型,以充分了解青年中风的发病率和危险因素。必须对发病率数据的年龄分组进行标准化报告,以便能够比较来自不同地理位置的数据。
    BACKGROUND: Stroke among younger age groups is increasing globally. While there is a focus on research conducted on people under 65 years who have had a stroke, there is a paucity of data on the incidence and risk factors of stroke among younger people (≤ 30 years). This scoping review examines evidence on incidence and risk factors for perinatal, paediatric and young adult stroke globally.
    METHODS: The review was guided by the Joanna Briggs Institute\'s scoping review methodology. A systematic search was conducted on 23rd March 2022 across Medline Ovid, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The eligibility criteria included all study designs providing information on the incidence and risk factors of stroke among young people (≤ 30 years) in the last ten years.
    RESULTS: A total of 5750 articles were identified. After screening, 471 articles (224 cohort studies (47.6%), 164 case studies/case series (34.8%), 35 reviews (7.4%), 30 case-control (6.4%) and 18 combinations of designs (3.8%) were included. There was data from 50 different countries, 199 studies were from high-income countries, upper and middle income (n = 38), lower middle-income (n = 39), low-income (n = 3) countries, international study (n = 7) and a further 185 articles did not state the country of research. Most of the studies (63%) focused on risk factors while incidence constituted 37%. Incidence data were reported heterogeneously across studies, leading to an inability to synthesise data. The three most frequently reported risk factors for perinatal stroke were infections, cardiac conditions, and intrapartum factors. Vasculopathies, infection and cardiac conditions accounted for most reported risk factors for paediatric stroke, while chronic conditions such as diabetes mellitus, vasculopathies and cardiac conditions accounted for the most reported risk factors among young adults.
    CONCLUSIONS: This review has highlighted different stroke risk factors for each age cohort of people under 30 years. The low number of epidemiological studies suggests that further research of this type is needed to fully understand the incidence and risk factors in young stroke. A standardised reporting of age groupings of incidence data is imperative to enable the comparison of data from different geographical locations.
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  • 文章类型: Journal Article
    背景:许多患有风湿病和肌肉骨骼疾病的儿童尚未被识别。识别这些儿童需要医疗保健提供者的意识,知识,以及识别疾病特征以及如何(以及何时)转诊给专科护理的技能。本文的目的是强调需要更好地获得医疗保健,审查教育和虚拟护理在解决资源匮乏地区未满足的需求,特别是扩大劳动力能力方面发挥的重要作用。利用合作伙伴关系,虚拟平台,和创新的评估方法,可以提供肌肉骨骼护理和教育,以达到比以往任何时候都更大的受众。通过多种举措和随时可用的资源提高意识对于改善全球风湿病护理至关重要。
    结论:患有风湿病和肌肉骨骼疾病的儿童的需求在世界范围内远远得不到满足,导致可预防的发病率和死亡率。虚拟教育和电子卫生保健平台的扩大实施为全球儿童提供了机会。
    BACKGROUND: Many children with rheumatic and musculoskeletal diseases are unrecognized. Identifying these children requires health care provider awareness, knowledge, and skills to recognize disease features and how (and when) to refer to specialist care. The aim of this paper is to highlight the need for better access to health care, review the essential role that education and virtual care play to address unmet need in low resource areas and especially to expand workforce capacity. Using collaborative partnerships, virtual platforms, and innovative assessment methods, musculoskeletal care and education can be delivered to reach a greater audience than ever before. Increased awareness through multiple initiatives and readily available resources are imperative to improve global rheumatology care.
    CONCLUSIONS: The needs of children with rheumatic diseases and musculoskeletal conditions are vastly underserved around the world resulting in preventable morbidity and mortality. Expanded implementation of virtual education and e-health care platforms provides an opportunity to increase access to care for children globally.
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  • 文章类型: Journal Article
    世界各地都报道了呼吸道合胞病毒(RSV)的各种季节性模式。我们根据2020年1月1日之前收集的数据,对PubMed报告RSV季节性的文章进行了系统评价。RSV季节性模式按地理位置进行了检查,日历月,分析方法,和气象因素,包括温度和绝对湿度。进行了相关和回归分析,以探讨RSV季节性与研究方法和研究地点特征之间的关系。在1973-2023年发表的209篇文章中,报道了77个国家317个地点的RSV季节。在温带地区的国家中,定期RSV季节也有类似的报道,在亚热带和热带国家具有高度可变的季节。RSV季节的持续时间较长与较高的日平均平均温度和日平均绝对湿度相关。RSV的全球季节性模式为优化针对RSV感染的干预措施提供了重要信息。
    Varied seasonal patterns of respiratory syncytial virus (RSV) have been reported worldwide. We conducted a systematic review on articles identified in PubMed reporting RSV seasonality based on data collected before 1 January 2020. RSV seasonal patterns were examined by geographic location, calendar month, analytic method, and meteorological factors including temperature and absolute humidity. Correlation and regression analyses were conducted to explore the relationship between RSV seasonality and study methods and characteristics of study locations. RSV seasons were reported in 209 articles published in 1973-2023 for 317 locations in 77 countries. Regular RSV seasons were similarly reported in countries in temperate regions, with highly variable seasons identified in subtropical and tropical countries. Longer durations of RSV seasons were associated with a higher daily average mean temperature and daily average mean absolute humidity. The global seasonal patterns of RSV provided important information for optimizing interventions against RSV infection.
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  • 文章类型: Journal Article
    最近,在2019年冠状病毒病(COVID-19)大流行期间,基于废水的流行病学(WBE)研究受到了强大的推动。然而,一些与监视策略有关的技术问题,例如从抽样到测试协议的标准化程序,需要解决为未来的传染病爆发做准备。这篇综述突出了研究特点,WBE的潜在用途和方法概述,以及用于检测严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的方法,包括其在废水中的变体。根据2020年1月至2022年3月发表的相关同行评审文章的PRISMA指南,在PubMed和Scopus中进行了电子文献检索。搜索确定了588篇文章,其中221项符合必要的标准,并在本次审查中进行讨论。大多数全球WBE研究是在北美进行的(n=75,34%),其次是欧洲(n=68,30.8%),亚洲(n=43,19.5%)。该综述还表明,观察到的WBE的大多数应用都是将污水中的SARS-CoV-2核糖核酸(RNA)趋势与流行病学数据相关联(n=90,40.7%)。通常在全球范围内用于样品收集的技术,浓度,还讨论了优选的基质回收率控制和各种样品类型。总的来说,这篇综述为专门研究WBE的研究人员提供了一个框架,将战略方法应用于他们的研究问题,以获得更好的功能见解。此外,需要更深入分析的领域,数据收集,并确定了新倡议的想法。
    Recently, wastewater-based epidemiology (WBE) research has experienced a strong impetus during the Coronavirus disease 2019 (COVID-19) pandemic. However, a few technical issues related to surveillance strategies, such as standardized procedures ranging from sampling to testing protocols, need to be resolved in preparation for future infectious disease outbreaks. This review highlights the study characteristics, potential use of WBE and overview of methods, as well as methods utilized to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) including its variant in wastewater. A literature search was performed electronically in PubMed and Scopus according to PRISMA guidelines for relevant peer-reviewed articles published between January 2020 and March 2022. The search identified 588 articles, out of which 221 fulfilled the necessary criteria and are discussed in this review. Most global WBE studies were conducted in North America (n = 75, 34 %), followed by Europe (n = 68, 30.8 %), and Asia (n = 43, 19.5 %). The review also showed that most of the application of WBE observed were to correlate SARS-CoV-2 ribonucleic acid (RNA) trends in sewage with epidemiological data (n = 90, 40.7 %). The techniques that were often used globally for sample collection, concentration, preferred matrix recovery control and various sample types were also discussed. Overall, this review provided a framework for researchers specializing in WBE to apply strategic approaches to their research questions in achieving better functional insights. In addition, areas that needed more in-depth analysis, data collection, and ideas for new initiatives were identified.
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  • 文章类型: Journal Article
    动脉瘤性蛛网膜下腔出血(aSAH)与高死亡率相关。在描述人口统计学全球差异的文献中存在显著差距,管理,aSAH患者的结局。我们旨在进行系统评价和荟萃分析,以评估aSAH表达和管理方面的全球差异。PubMed和Embase数据库从最早的记录查询到2022年11月的aSAH文献。介绍,人口统计,合并症,治疗方法,并收集结果数据。未报告aSAH特异性患者管理和结果的文章被排除。计算合并加权患病率。报告了随机效应模型率。筛选后,包括代表10,553名患者的33篇文章。Fisher3级或4级aSAH在高收入和低收入国家的患病率(HIC和LIC),分别,分别为79.8%(P<0.01)和84.1(P<0.01)。男性aSAH患者在HIC和LIC中的患病率,分别,分别为35.8%(P<0.01)和45.0%(P<0.01)。ASAH患者的HIC和LIC治疗患病率分别为99.5%(P<0.01)和99.4%(P=0.16),分别。在HIC,aSAH患者中35%(P<0.01)的动脉瘤接受了盘绕治疗。无LIC报告aSAH治疗的盘绕;LIC仅报告手术夹闭率,总患病率为92.4%(P<0.01)。HIC为65.6%(P<0.01)。在这个分析中,我们发现HIC和LIC中高级别SAH出血的发生率相似,但LIC中缺乏血管内弹簧圈栓塞治疗.需要进一步的研究和讨论来确定治疗差异的原因和可干预的社会因素,以改善全球aSAH结果。
    OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality rates. There is a significant gap in the literature describing global disparities in demographics, management, and outcomes among patients with aSAH. We aimed to conduct a systematic review and meta-analysis to assess global disparities in aSAH presentation and management.
    METHODS: PubMed and Embase databases were queried from earliest records to November 2022 for aSAH literature. Presentation, demographics, comorbidities, treatment methods, and outcomes data were collected. Articles that did not report aSAH-specific patient management and outcomes were excluded. Pooled weighted prevalence rates were calculated. Random effects model rates were reported.
    RESULTS: After screening, 33 articles representing 10,553 patients were included. The prevalence of Fisher grade 3 or 4 aSAH in high- and lower-income countries (HIC and LIC), respectively, was 79.8% (P < 0.01) and 84.1 (P < 0.01). Prevalence of male aSAH patients in HIC and LIC, respectively, was 35.8% (P < 0.01) and 45.0% (P < 0.01). Prevalence of treatment in aSAH patients was 99.5% (P < 0.01) and 99.4% (P = 0.16) in HIC and LIC, respectively. In HIC, 35% (P < 0.01) of aneurysms in aSAH patients were treated with coiling. No LIC reported coiling for aSAH treatment; LIC only reported rates of surgical clipping, with a total prevalence of 92.4% (P < 0.01) versus 65.6% (P < 0.01) in HIC.
    CONCLUSIONS: In this analysis, we found similar rates of high-grade SAH hemorrhages in HIC and LIC but a lack of endovascular coil embolization treatments reported in LIC. Additional research and discussion are needed to identify reasons for treatment disparities and intervenable societal factors to improve aSAH outcomes worldwide.
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  • 文章类型: Journal Article
    斑疹伤寒,被忽视的疾病,是亚太地区Tsumgamushi三角地区的一个重大健康问题,由于最近发生在该地区以外的病例,引起了全球的关注。为了估计全球斑疹伤寒的患病率,我们进行了系统评价和荟萃分析.我们对PubMed进行了系统搜索,Scopus,和Embase数据库,用于斑疹伤寒的观察研究。使用随机效应模型,我们将患病率估计值与逆方差权重相结合,同时评估异质性和发表偏倚.在筛选的3551份报告中,我们确定了181项研究和1,48,251个样本纳入我们的合成。斑疹伤寒感染的总体合并血清阳性率(95%置信区间)为24.93%(23.27-26.60)。男性按性别汇总的患病率估计为50.23%(47.05-53.40),女性为48.84%(45.87-51.80)。在阳性病例中,焦粒患病率为30.34%(22.54-38.15)。所有样本中,有四分之一的斑疹伤寒和焦痂呈阳性,在这些总阳性病例中,有三分之一的样本中存在,涵盖Tsutsumgamushi三角形以外的区域。这种估计强调了这种被忽视的疾病作为公共卫生问题的重要性。受影响地区需要加强监测和实施疾病控制措施。
    Scrub typhus, a neglected disease, is a significant health concern in the Tsutsugamushi triangle of the Asia-Pacific and has raised global concerns due to recent cases occurring outside this region. To estimate the global prevalence of scrub typhus, we conducted a systematic review and meta-analysis. We conducted a systematic search of PubMed, Scopus, and Embase databases for observational studies on scrub typhus. Using a random-effects model, we combined the prevalence estimates with inverse-variance weights while also evaluating heterogeneity and publication bias. Among 3551 reports screened, we identified 181 studies with 1,48,251 samples for inclusion in our synthesis. The overall pooled seroprevalence (95% confidence intervals) of scrub typhus infections was 24.93% (23.27-26.60). Gender-wise pooled prevalence was estimated to be 50.23% (47.05-53.40) for males and 48.84% (45.87-51.80) for females. Eschar prevalence was observed to be 30.34% (22.54-38.15) among the positive cases. One-fourth of all the samples tested positive for scrub typhus and eschar was present in one-third of these total positive cases, encompassing regions beyond the Tsutsugamushi triangle. This estimation underlines the importance of this neglected disease as a public health problem. Strengthening surveillance and implementing disease control measures are needed in the affected regions.
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  • 文章类型: Journal Article
    斜视在脑瘫(CP)中比在正常人群中更常见,但报告不同,它增加了多少。我们在这里检查了CP中斜视的全球患病率和类型,内斜视或外斜视更频繁,以及患病率是否在种族和/或国家收入水平之间有所不同,几代人之间。
    我们在系统评价和荟萃分析中汇编了147项CP研究的结果,这些研究报告了斜视的患病率或内斜视与外斜视的比率,我们对地区(收入水平)和种族进行了分组分析。我们对CP斜视患病率进行了汇总分析,并估计全球斜视CP病例数。
    高收入国家斜视的合并患病率为49.8%,低收入国家为39.8%。我们估计CP中斜视的全球数量为1220万,有760万男性和460万女性,根据目前估计的2960万例全球CP病例。高加索人的内斜视比外斜视更频繁,而在西班牙裔和一些亚洲和非洲人群中,外斜视比内斜视更常见。CP的斜视患病率随着国家收入水平的增加而增加。
    斜视患病率的代际变化似乎反映了CP类型的转变和患病率的增加,因为各国获得了更高的收入和更有效的孕产妇保健。内斜视和外斜视在CP患者中的分布在很大程度上反映了水平斜视类型,在受试者的种族中占主导地位。
    UNASSIGNED: Strabismus is more frequent in cerebral palsy (CP) than in the normal population, but reports differ how much it is increased. We here examined the global prevalence and types of strabismus in CP, whether esotropia or exotropia is more frequent, and whether the prevalence differs between ethnicities and/or country income levels, and between generations.
    UNASSIGNED: We compiled in a systematic review and meta-analysis the results of 147 CP studies that report the prevalence of strabismus or the ratio of esotropia to exotropia, and we conducted subgroup analyses for region (income level) and ethnicity. We performed a pooled analysis for the CP strabismus prevalence, and estimated the global number of CP cases with strabismus.
    UNASSIGNED: The pooled prevalence of strabismus in CP is 49.8% in high-income countries and 39.8% in lower-income countries. We estimate the global number of strabismus cases in CP as 12.2 million, with 7.6 million males and 4.6 million females, based on current estimates of 29.6 million global CP cases. Esotropia is more frequent than exotropia in Caucasians, while exotropia is more frequent than esotropia in Hispanic and in some Asian and African populations. The strabismus prevalence in CP increases with increasing country income levels.
    UNASSIGNED: Generational changes in strabismus prevalence appear to reflect a transition of CP types and an increase in prevalence as countries attain higher income and more effective maternal health care. The distribution of esotropia and exotropia in CP patients largely reflects the horizontal strabismus type that is predominant in the subject\'s ethnicity.
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