Almigdad H. M. Ali

Background: Biliary atresia (BA) is a leading cause of end-stage liver disease and the most common indication of liver transplantation in children. Several reports attributed BA to both prenatal and perinatal aetiologies, including a viral infection-induced auto-immune response that targets the bile ducts. Cytomegalovirus (CMV) remains the most common virus being linked to BA. This meta-analysis estimates to what extent CMV infection is detected in patients with BA. Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), ScienceDirect, and Google Scholar were used for the systematic search. Random effects model was used to estimate the pooled prevalence estimate with the corresponding 95% confidence interval (CI) using StatsDirect statistical software. Heterogeneity among the included studies was estimated using the I ² statistics. Publication bias was determined based on Begg’s test, Egger’s test, and examination of the funnel plot. Subgroup analyses and meta-regression were used to explore the moderators of heterogeneity between studies. Results: A total of 13 studies that fulfilled the eligibility criteria were included in the meta-analysis. The pooled overall prevalence of CMV infection in patients with BA was 24.5% (95% CI 11.9 %– 33.9%). In subgroup and meta-regression analyses, the prevalence of CMV infection in patients with BA was correlated with the geographical areas (p = .001) but not with the study year (p = .153). Conclusions: The available data demonstrate that the detection of CMV infection is common in infants with BA. There is still a need for large studies with appropriate controls to examine various aspects of the association between CMV infection and BA. Abbreviations: BA = biliary atresia, CMV = cytomegalovirus .

The rapid progression of Coronavirus disease 2019 (COVID-19) and its increasing burden on health systems necessitate the identification of parameters of severe infection to help in monitoring, prognoses and development of treatment algorithms. This review aims to investigate the association of lymphocyte count, CRP, LDH, and D-Dimer with the severe form of COVID-19. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), and ScienceDirect were used for the systematic search. Random effects model was used to estimate the pooled standardized mean differences (SMD) with the corresponding 95% confidence interval (CI), using OpenMeta Analyst software. A total of 11 studies, with 2437 COVID-19 patients, which fulfilled the eligibility criteria were included in the meta-analysis. The analysis revealed that lymphocyte count was significantly lower in patients with the severe form of COVID-19 (SMD = - 1.025, P value <.001). Also, the analysis of SMD showed that patients with severe COVID-19 have a significantly higher serum levels of CRP (SMD = 3.363, P value <.001), D-Dimer (SMD = 1.073, P value <.001), and LDH (SMD = 3.345, P value <.001). Low lymphocyte count and high levels of CRP, LDH, and D-Dimer are associated with severe COVID-19. These laboratory markers could be used as clinical indicators of worsening illness and poor prognosis of COVID-19.

Background: The rapid progression of Coronavirus disease 2019 (COVID-19) and its increasing burden on health systems necessitate the identification of parameters of severe infection to help in monitoring, prognoses and development of treatment algorithms. Objectives: This review aims to investigate the association of lymphocyte count, CRP, LDH, and D-Dimer with the severity of COVID-19. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), and ScienceDirect were used for the systematic search. Random effects model was used to estimate the pooled standardized mean differences (SMD) with the corresponding 95% confidence interval (CI), using OpenMeta Analyst software. Results: A total of 11 studies, with 2437 COVID-19 patients, which fulfilled the eligibility criteria were included in the meta-analysis. The analysis revealed that lymphocyte count was significantly lower in patients with the severe form of COVID-19 (SMD = - 1.025, P value <.001). Also, the analysis of SMD showed that patients with severe COVID-19 have a significantly higher serum levels of CRP (SMD = 3.363, P value <.001), D-Dimer (SMD = 1.073, P value <.001), and LDH (SMD = 3.345, P value <.001). Conclusion: Low lymphocyte count and high levels of CRP, LDH, and D-Dimer are associated with severe COVID-19. These laboratory markers could be used as clinical indicators of worsening illness and poor prognosis of COVID-19.

Mothers are the major role players with regard to their children’s immunisation. The aim of this study is to assess the knowledge, attitude and practice of mothers of children below 5 years of age with regard to immunisation in Northern State, Sudan. This was a cross-sectional survey which was conducted in three villages in 2016. All mothers having at least one child below the age of 5 years were included. Data were collected by interviews using a self-structured questionnaire. Descriptive statistics were displayed and chi-square test was used to assess associations. A total of 127 mothers of 191 children were included. The mean knowledge score about the names of vaccines/diseases prevented was 3.47 out of 10. The most correctly named vaccines by the mothers were measles (87.4%) and polio (86.6%), whereas the least ones were hepatitis (7.1%) and diphtheria (8.7%). The majority (99.2%) of the mothers had a positive attitude. The mean knowledge score about the timing of doses was 4.12 out of 5. The most correctly timed dose by the mothers was the dose at 6 weeks ‘dose 1’ (96.1%) and the least one was the dose at birth ‘dose 0’ (60.6%). About half (48.7%) of the children were completely immunised, 46% were only missing their ‘dose 0’, mostly because of closed vaccination units on the day of birth (73.6%), and 5.3% were incompletely immunised. Hospital delivery, availability of vaccination card and good socioeconomic status were associated with complete immunisation status, with p-values equal to 0.00, 0.00 and 0.03, respectively. Educating mothers about immunisation, increasing the days of immunisation and providing outreach services for home-delivered newborns are important interventions to increase the immunisation coverage.