AlKaabi NA

As infectious agents may be associated with neurodegenerative diseases, this systematic review and meta-analysis investigated whether prior influenza infection is associated with an increased odds of subsequent Parkinson's disease (PD) diagnosis. We searched PubMed, Web of Science, and Scopus for observational studies examining influenza infection and later PD diagnosis. Seven studies (comprising eight cohorts) were analyzed using frequentist and Bayesian random-effects meta-analyses. Meta-regression and subgroup analyses were conducted to explore the moderating effect of the time interval between influenza exposure and subsequent PD diagnosis (i.e. exposure window). A significant association was observed in both approaches: pooled OR = 1.87 (95% CI: 1.24-2.81) under the frequentist model, and posterior median OR = 1.88 (95% CrI: 1.07-3.36) under the Bayesian model. Meta-regression and subgroup analyses identified the influenza exposure window as a moderator (R² = 36.6%, p < 0.05), with studies reporting influenza exposure within five years before PD diagnosis showing the strongest associations. Our findings support a probable and temporally sensitive association between influenza infection and subsequent PD diagnosis. However, these findings should be interpreted cautiously, given the retrospective and heterogeneous nature of the available data.

Respiratory syncytial virus (RSV) poses a significant health risk to older adults, particularly those with chronic comorbidities, in the Gulf Cooperation Council (GCC) countries. Despite its high burden, RSV remains underrecognized among older adults in this region. This manuscript aims to highlight the burden of RSV among older adults in GCC countries and provide expert consensus recommendations for the implementation of targeted prevention measures, including vaccination strategies. A multidisciplinary panel of experts from GCC countries reviewed international, regional, and country-level data on RSV. The panel formulated recommendations on the basis of a comprehensive literature review and expert consensus, focusing on the integration of RSV vaccination into routine immunization programs for older adults. Older adults, especially those with chronic conditions including but not limited to cardiovascular disease, chronic kidney disease, chronic lung disease, and diabetes, are at an increased risk for severe RSV-related outcomes. Effective vaccines present an opportunity to significantly reduce the incidence and severity of RSV in this vulnerable population. Key recommendations for safeguarding older adults in GCC countries include implementing clear immunization schedules for adults at a country-level that include targeted RSV vaccination, especially among high-risk groups. Providing continuous education for healthcare professionals, increasing vaccine availability, equity, and affordability, conducting public awareness campaigns, and strengthening local surveillance systems also play a crucial role in addressing vaccine-preventable diseases such as RSV. Integrating RSV vaccination into routine immunization schedules, alongside other key vaccines, is essential for achieving comprehensive and optimal protection for older adults in GCC countries.

Tuberculosis (TB) remains a significant health concern in India, especially among households with children and young adolescents aged 6–17 years. Despite ongoing research, there is a knowledge gap regarding specific risk factors for TB within this demographic. This study aims to bridge this gap by examining the association between TB and various socio-demographic factors, including socioeconomic status, nutritional status, and environmental conditions. Utilizing data from the National Family Health Survey (NFHS) 4th and 5th round (2015-16 and 2019-21), this study conducted a comprehensive cross-sectional analysis. Unadjusted and Adjusted Logistic regression is utilized to identify key factors influencing TB. Furthermore, Wagstaff decomposition analysis is applied, to quantifying the factors that contributes to the inequalities in social determinants on the wealth-related inequality observed in the prevalence of TB. The study observed a notable decline in TB prevalence from 1.7 to 1.2% among individuals from households having children and young adolescents aged 6–17 years. Additionally, factors like the use of unclean cooking fuel, lack of electricity, and unimproved toilet facilities were associated with increased TB prevalence. Wealth-based inequality in TB prevalence was also evident, with the burden falling disproportionately on poorer households. Unclean fuel is the most significant determinant of wealth-based inequality in TB, contributing to nearly 2/5th (18.5% in NFHS-4) of the observed inequality. Notably, gender did not significantly influence TB prevalence. The decline in TB prevalence in India correlates with improvements in socio-economic and living conditions, as evidenced by increased access to better housing, clean fuel, and sanitation facilities. The study underscores the need for integrated public health strategies that address both medical and socio-environmental determinants of TB. Improving socio-economic conditions, alongside targeted healthcare interventions, appears vital in reducing the TB burden in high-prevalence settings like India. This research emphasizes the importance of comprehensive approaches to combat pediatric TB, combining clinical care with enhancements in living standards and access to basic amenities.

Alkaabi N, et al. Clin Exp Vaccine Res. 2025 Jul;14:e37. https://doi.org/10.7774/cevr.2025.14.e37

In the pursuit of global health security, continuous monitoring of vaccine effectiveness across various viral strains emerges as a crucial imperative. The emergence of SARS-CoV-2 major variants of concern (VOCs), including Alpha, Beta, Delta, and Omicron, has added complexity to the COVID-19 vaccination landscape. To assess illness severity, evaluate vaccine efficacy across varying doses and types, and determine effectiveness against major VOCs within the population. This retrospective cohort study, conducted in Abu Dhabi, United Arab Emirates, focuses on a cohort of 44,073 SARS-CoV-2 positive cases from February 2021 to May 2022, dominated by the Delta and Omicron variants. The study employed a nested case-control design, analyzing hospital admissions for confirmed SARS-CoV-2 infection. Vaccine effectiveness was higher among heterologus-boosted individuals at 87% (95% CI:79%-93%) compared to homologus-boosted individuals at 59% (95% CI: 48%-68%) and fully vaccinated, non-boosted adults at 53% (95% CI: 46%-59%). These findings highlight the importance of heterologous boosting, particularly against rapidly evolving viral variants, offering valuable insights for refining pandemic response strategies. The study underscores the critical need for ongoing assessment and adaptation of vaccination strategies to the evolving viral landscape.

Dengue fever, caused by the dengue virus and transmitted through Aedes mosquitoes, is a growing public health concern, particularly in tropical and subtropical regions. Traditionally associated with febrile and hemorrhagic symptoms, recent research suggests a potential link between dengue and cognitive impairments. This systematic review assessed existing research to understand the association between dengue virus infection and cognitive impairments, including dementia, Alzheimer disease, memory loss, and confusion. This systematic review followed preferred reporting items for systematic reviews and meta-analyses guidelines. A comprehensive literature search was conducted in PubMed, EMBASE, and Web of Science up to January 18, 2024. Studies examining the prevalence and association of cognitive impairments in dengue patients were included. Data extraction and quality assessment were performed using Nested Knowledge software and the Newcastle-Ottawa Scale. Of the 1129 articles identified, 5 were included in the review, covering a total of 200 873 participants from Taiwan, Brazil, and France. Evidence from population-based cohort studies indicated short-term cognitive impairments, including confusion and memory loss, in some dengue patients. Additionally, long-term risks of dementia, including Alzheimer disease and vascular dementia, were observed, particularly among older adults. Although the findings suggest there might be an association between dengue infection and cognitive decline, the mechanisms underlying this link remain unclear. This systematic review suggests that dengue virus infection may affect cognitive function in both acute and long-term contexts. However, the current evidence is not strong enough to establish a conclusive link. Further research with larger sample sizes and longitudinal studies is essential to confirm the impact of dengue virus on cognitive health.

Mpox is a severe viral zoonosis that has emerged as a public health concern due to its potential for human-to-human transmission and severe illness. Understanding its clinical manifestations is crucial for effective management and control. Several systematic reviews have assessed various manifestations of Mpox. This umbrella review synthesizes evidence on Mpox’s manifestations across different organ systems. We conducted an umbrella review, adhering to Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on systematic reviews of Mpox manifestations. We performed a literature search up to 25th September 2023, in databases like PubMed, Embase, and Web of Science. We included systematic reviews of observational studies, case reports, case series, or RCTs reporting any manifestations of Mpox in humans, focusing on a global scope. AMSTAR 2 was used to evaluate the quality of systematic reviews, and data has been synthesized in narrative and tabular manners. A total of 25 systematic reviews were included, uncovering diverse manifestations of Mpox, such as cutaneous, cardiovascular, oral, ophthalmic, gastrointestinal, respiratory, and pregnancy-related. Cutaneous manifestations (up to 100%) were the most prevalent, featuring lesions and rashes. Constitutional symptoms of viral illness were reported in ~ 60% to > 85% of the cases. Significant respiratory symptoms were present in ~ 50% of cases overall. Headaches were the leading neurological symptom present in > 30%. Symptoms of gastrointestinal involvement ranged from 39% (oral lesions) with decreasing frequency to low diarrhea at ~ 5%, with proctitis percentages ranging from high teens to mid-twenties. Ophthalmic manifestations (6% but with wide variations among studies). Many primary studies included in the systematic reviews consisted of case reports and case series. A wide range of manifestations across different organ systems was observed. Negative outcomes for pregnancies were reported, but evidence is limited. Adverse cardiovascular and neurological outcomes were identified, though only a few studies provided insights into these findings. Mpox exhibits diverse manifestations, impacting multiple organ systems, with substantial variations. The findings highlight the importance of ongoing, nuanced, and region-specific research and management strategies for Mpox. The reliance on case reports and series underscores the need for more high-quality, long-term studies to deepen our understanding and management of this significant public health concern.

Background: Cervical cancer, predominantly caused by the human papillomavirus (HPV), is a major health challenge in India, with high morbidity and mortality rates. Given India’s vast geographic and socio-economic diversity, understanding regional variations in HPV prevalence is crucial for developing targeted and effective public health interventions. This systematic review and meta-analysis were conducted to elucidate the prevalence of HPV among cervical cancer patients in India. Methods: A literature search was executed across PubMed, EMBASE, and Web of Science up to December 07, 2023. Observational studies reporting HPV prevalence among cervical cancer patients in India are included. A Modified Newcastle-Ottawa scale was used for quality assessment. A random-effects meta-analysis was used to determine pooled HPV prevalence, and heterogeneity was evaluated using the I² statistic. Subgroup and sensitivity analyses were performed to assess result stability and investigate heterogeneity sources. All statistical analyses were performed using R software version 4.3. Results: The meta-analysis included 17 studies with a total of 2529 cervical cancer cases, of which 1977 were HPV-positive. The pooled HPV prevalence was 85% (95% CI: 71–92%), with substantial heterogeneity (I² = 94%). Subgroup analysis by geographic zones showed notable differences: South (88%, 95% CI: 76–95%), North (73%, 95% CI: 1–100%), East (99%, 95% CI: 1–100%), Central (71%, 95% CI: 54–84%), and West (77%, 95% CI: 0–100%). Sensitivity analysis demonstrated the consistency of the results, and a reanalysis, excluding influential studies, yielded a prevalence of 82% (95% CI: 67–91%). Conclusion: Our analysis reveals a high prevalence of HPV in cervical cancer patients in India, with significant regional variations. The observed heterogeneity highlights the complexity of HPV epidemiology in India and necessitates further research to explore underlying causes and regional characteristics. Future studies should aim to expand geographic representation and deepen understanding of the factors contributing to the variability in HPV prevalence.