ABSTRACT
@#Our group sought to determine the global status of T. gondii infection and to evaluate any continental and geographical trends by systematically examining the currently available epidemiological data on the prevalence of T. gondii infection. A comprehensive literature search was conducted from 10 electronic databases (Google Scholar, Science Direct, Embase, PubMed, PLOS ONE, Web of Knowledge, SciELO, MyAIS, Free Medical Journals, and Scopus) without date or language restrictions. Specific medical subject heading terms were used to search for human T. gondii seroprevalence studies that recruited subjects from general apparently healthy populations. The data were collated and analysed for both continental and global trends. The search identified 152 published studies that examined a total of 648,010 subjects. From these, 166,255 were seropositive for T. gondii infection indicating an average global seroprevalence rate of 25.7% (95% CI: 25.6 – 25.8%). The overall range of seroprevalence was determined to be 0.5 – 87.7%. African countries had the highest average seroprevalence rate of 61.4%, followed by Oceania with 38.5%, South America with 31.2%, Europe with 29.6%, USA/Canada with 17.5%, and Asia with 16.4%. Numerous environmental and human factors affect the differences in T. gondii seroprevalence rates observed between the various countries and continents. Monitoring the source and transmission may assist public health authorities to clarify the risk factors involved, as well as focus on implementing optimal state-specific health policies targeting T. gondii transmission control.
ABSTRACT
BACKGROUND: Fresh frozen plasma (FFP) is a major source of coagulation factor replacement therapy for patients with clotting factor deficiency. Although FFP is readily available for use in clinical practice its administration isn't without risk. Studies on the use of FFP reveal that it is often overused or inappropriately used. We undertook an audit to assess the appropriateness of FFP transfusion in Gorgan's hospitals. METHODS: This was a retrospective, audit done at 5 hospitals in Gorgan city regarding the use of 1592 units of FFP issued to 346 patients from March 2006 to March 2007. The appropriateness of FFP transfusion was analyzed according to British Council for Standardization in Hematology (BCSH) Guidelines 2004. RESULTS: In this audit we identified a high rate of inappropriate FFP usage (53% of transfusion episodes). Most 'Inappropriate' FFP usage occurred when there was active bleeding, with normal (or unmeasured) coagulation tests (30% of transfusion episodes). In only 66% of FFP-transfused patients were coagulation variable measured at any point in the hospital episode. CONCLUSION: Inappropriate usage of FFP is often seen in medical facility and the right solution is needed to curb the misuse of this component. Regular utilization audit can identify correctable errors in transfusion practices. Formal education programs and existing information on FFP use should be directed to professionals ordering FFP.
