A systematic review and meta-analysis of the association between Giardia lamblia and endemic pediatric diarrhea in developing countries.
A systematic review and meta-analysis of the association between Giardia lamblia and endemic pediatric diarrhea in developing countries.
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DOI：
10.1093/cid/cis762
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发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Levine MM
中科院分区：
文献类型：
--
作者：
Muhsen K;Levine MM
在这项系统回顾和荟萃分析中，蓝氏贾第鞭毛虫与非工业化环境中的急性儿科腹泻无关，但与持续性腹泻呈正相关。我们进行了系统的文献回顾和荟萃分析，研究了非工业化环境中幼儿腹泻与蓝氏贾第鞭毛虫感染之间的关系。符合条件的是病例/对照和纵向研究，这些研究将结果定义为急性或持续性(14天)腹泻，经混杂因素调整后持续至少1年。从腹泻患者和非腹泻对照中提取兰氏革兰氏菌的检测数据(主要在粪便中)。随机效应模型Meta分析得到合并优势比(OR)和95%可信区间(CI)。12项非工业化设置的儿科急性腹泻研究符合荟萃分析纳入标准。综合结果(9774例急性腹泻病例和8766例对照)的随机效应模型荟萃分析得出合并OR为0.60(95%CI，0.38-0.94；P<0.05)，表明兰氏革兰氏菌与急性腹泻无关。然而，有限的数据表明，婴儿早期感染贾第鞭毛虫可能与腹泻呈正相关。对5项持续性腹泻研究的Meta分析显示，合并OR为3.18(95%CI，1.50-6.76；P<；7.001)，将贾第鞭毛虫与该综合征正相关。这项功能强大的全球肠道多中心研究(GEMS)正在前瞻性地研究发展中国家儿童中蓝氏菌感染和腹泻之间的关系。
In this systematic review and meta-analysis, Giardia lamblia was not associated with acute pediatric diarrhea in nonindustrialized settings but was positively linked to persistent diarrhea. We performed a systematic literature review and meta-analysis examining the association between diarrhea in young children in nonindustrialized settings and Giardia lamblia infection. Eligible were case/control and longitudinal studies that defined the outcome as acute or persistent (>14 days) diarrhea, adjusted for confounders and lasting for at least 1 year. Data on G. lamblia detection (mainly in stools) from diarrhea patients and controls without diarrhea were abstracted. Random effects model meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Twelve nonindustrialized-setting acute pediatric diarrhea studies met the meta-analysis inclusion criteria. Random-effects model meta-analysis of combined results (9774 acute diarrhea cases and 8766 controls) yielded a pooled OR of 0.60 (95% CI, .38–.94; P = .03), indicating that G. lamblia was not associated with acute diarrhea. However, limited data suggest that initial Giardia infections in early infancy may be positively associated with diarrhea. Meta-analysis of 5 persistent diarrhea studies showed a pooled OR of 3.18 (95% CI, 1.50–6.76; P < .001), positively linking Giardia with that syndrome. The well-powered Global Enteric Multicenter Study (GEMS) is prospectively addressing the association between G. lamblia infection and diarrhea in children in developing countries.
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影响因子：
--
作者：
ALBWARDY, MAA;RAMIA, S;SALMAN, H
通讯作者：
SALMAN, H
影响因子：
6.4
作者：
BAQUI, AH;SACK, RB;SIDDIQUE, AK
通讯作者：
SIDDIQUE, AK
影响因子：
7.5
作者：
BACK, E;JONSSON, M;WADSTROM, T
通讯作者：
WADSTROM, T
影响因子：
5
作者：
BIRKHEAD, G;VOGT, RL
通讯作者：
VOGT, RL
影响因子：
25.7
作者：
Boggild, Andrea K.;Yohanna, Seychelle;Kain, Kevin C.
通讯作者：
Kain, Kevin C.