The Global Prevalence of HTLV-1 and HTLV-2 Infections among Immigrants and Refugees—A Systematic Review and Meta-Analysis
Thaís Augusto MarinhoMichele Tiemi OkitaRafael Alves GuimarãesAna Laura de Sene Amâncio ZaraKarlla Antonieta Amorim CaetanoSheila Araújo TelesMárcia Alves Dias de MatosMegmar Aparecida dos Santos CarneiroRegina Maria Bringel Martins
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This is the first systematic review and meta-analysis to estimate the prevalence of human T-lymphotropic virus 1 and 2 (HTLV-1 and 2) infections among immigrants and refugees worldwide. PubMed/MEDLINE, Scopus, EMBASE, Web of Science, and Virtual Health Library (VHL) databases were searched for studies published from their inception to 6 January 2023. A meta-analysis using a generalized linear mixed model with a random effect was performed for HTLV-1 and HTLV-2. Subgroup analyses were performed based on the decade of study, sample size, confirmatory methods, region of study, risk group, and region of origin. Of the 381 studies initially identified, 21 were included. The pooled prevalence of HTLV-1 and HTLV-2 was 1.28% (95% CI: 0.58, 2.81) and 0.11% (95% CI: 0.04, 0.33), respectively. HTLV-1 prevalence differed significantly by region of origin, with the highest prevalence among those from the Western Pacific Region (7.27%; 95% CI: 2.94, 16.83). The subgroup analysis also showed significant differences between the estimates of HTLV-1 considering the decade of study, sample size, and region of study. For HTLV-2, significant differences were shown in relation to sample size, confirmatory methods, and risk group. The higher HTLV-1 prevalence found deserves public health attention in immigrant and refugee-receiving non-endemic countries.Keywords:
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To explore the role and application of Meta-regression and subgroup analyses to recognize and control the heterogeneity in Meta-analysis, Meta-regression models were established by secondary data to screen the factors resulting heterogeneity,and subgroup analyses were used to compare the change of heterogeneity before and after.The heterogeneity was found in the Meta-analysis(Q=44.71,df=27,P=0.017).Sample size and region were selected(P=0.012 and P=0.091,respectively)by Meta-regression from many possible factors such as sample size,year,region and case/contml ratio.The Q values were lowered from 44.71 to 32.11 after subgroup analyses.Thus,Metaregression method was convenient and reliable to screen the affected factors of heterogeneity,and subgroup analyses based on the hypothesis that could significantly lower the heterogeneity.It was recommended to a combined use when an obvious heterogeneity existed but was in need to get an overall result in Metaanalysis.We could correctly judge and lower the heterogeneity to increase the robustness and rationality of results from Meta-analysis.
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Meta-analysis; Heterogeneity; Meta-regression; Subgroup analyses
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Atrial fibrillation (AF) is one of the most common persistent arrhythmia, and its complications include cerebral embolism, arterial embolism and heart failure. Some studies have found that elevated Homocysteine (HCY) levels is a new risk factor for AF. Currently, there is no meta-analysis to explore whether the HCY levels is related to AF. Therefore, a meta-analysis was conducted to evaluate the relationship between the HCY levels and AF, in order to draw the attention of clinicians to the HCY levels. A meta-analysis was performed in the study to evaluated the association between the HCY levels and AF. In order to identify eligible original articles, The EMBASE, PubMed, and web of science were systematically searched until November 2020. All data were analyzed with Review Manager 5.3. The meta-analysis results were evaluated depending on standardized mean differences (SMD) with 95% confidence intervals (CI). Moreover, the subgroup analysis and sensitivity analysis were also analyzed. The HCY levels was significantly associated with AF (WMD = 0.81, 95% CI: 0.58 to 1.03; P < .00001). In the analysis, there was a medium degree of heterogeneity (I2 = 73%). Subgroup analysis showed that female < 60, BMI≥25, BMI <25, age ≥60 and publication year ≥2010 were identified as possible sources of heterogeneity. Sensitivity analysis showed that the main results remained unchanged after omitting any single study or converting the random effects model (REM) to fixed effects model (FEM). The meta-analysis showed that there is a significant correlation between the HCY levels and AF, and the role of HCY in AF patients should not be ignored in clinical.
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To perform a systematic review and meta-analysis on the efficacy and safety of sialendoscopy in the treatment of obstructive diseases of the major salivary glands.
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The refugee situation is one of the burning issues in today's world, where refugees make up more than 1 per cent of the whole population.1 Moreover, a great majority – of over 80 per cent – of refugees are women and their dependent children. The world's refugee situation is thus strongly manifested in and lived through the gendered experiences of women refugees. Yet, even in the face of the telling figures there however exists a striking disparity between the reality of the refugee situation and the business-as-usual of the refugee regime – refugee women's experiences are deemed to fundamental otherness. According to UN High Commissioner for Refugees (UNHCR), ‘(H)istorically, the refugee definition has been interpreted through a framework of male experiences’. […]
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Increasing backlogs are preventing individual refugee status determination systems from functioning, even in some of the most well developed asylum systems. This means that asylum seekers must spend the first, most vulnerable, years in their countries of refuge without having been individually adjudicated to meet the international refugee definition. Decline in individual refugee status determination hastens an overall decline in refugee rights. It is essential to find means of maintaining viable individual refugee status determination systems, even as large refugee movements seem to make this impractical.
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