Asymptomatic cases of SARS-CoV-2 can be unknown carriers magnifying the transmission of COVID-19. This study appraised the frequency of asymptomatic individuals and estimated occurrence by age group and gender by reviewing the existing published data on asymptomatic people with COVID-19. Three electronic databases, PubMed, Embase, and Web of Science (WoS), were used to search the literature following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The study population for this review included asymptomatic individuals infected with SARS-CoV-2 reported in original articles published up to 30 April 2020. A random effects model was applied to analyze pooled data on the prevalence of asymptomatic cases among all COVID-19 patients and also by age and gender. From the meta-analysis of 16 studies, comprising 2,788 SARS-CoV-2 infected patients, the pooled prevalence according to the random effect size of asymptomatic cases was 48.2% (95% CI, 30–67%). Of the asymptomatic cases, 55.5% (95% CI, 43.6–66.8%) were female and 49.6% (95% CI, 20.5–79.1%) were children. Children and females were more likely to present as asymptomatic COVID-19 cases and could act as unknown carriers of SARS-CoV-2. Symptom-based screening might fail to identify all SARS-CoV-2 infections escalating the threat of global spread and impeding containment. Therefore, a mass surveillance system to track asymptomatic cases is critical, with special attention to females and children.

Background. Antimicrobial resistance has become a huge problem in animal and public health worldwide. Inadvertent use of antibiotics in poultry has led to the emergence of resistance against many antibiotics, even to last resort of drugs like colistin. Aim. This study aimed to provide uniform quantitative estimate on the percentage prevalence of E. coli as well as to analyze their colistin resistance in poultry in South Asian developing countries. Methods. Two electronic databases, PubMed and Research4Life, were used to search studies as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The pooled data on the prevalence of E. coli and colistin resistance were analyzed. Results. In the meta-analysis of 9 studies in South Asian region (Nepal, Bangladesh, Pakistan, and India), the pooled prevalence of E. coli was 73% (95% CI, 0.549–0.916). The pooled prevalence of colistin resistance against E. coli from poultry was found to be 28% (95% CI, 0.158–0.438). Conclusion. There is high prevalence of E. coli and their resistance rate against colistin in poultry. Therefore, antimicrobials in raising livestock should be supervised.

Background The asymptomatic patients with SARS-CoV-2 can act as an unseen carrier for magnifying the transmission of COVID-19. Aims This study was designed to appraise the burden of asymptomatic individuals and estimate their occurrence among different age groups and gender by reviewing the existing published data on asymptomatic people with COVID-19. Methods Three electronic databases: PubMed, Embase and Web of Science (WoS) were used to search studies as per the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the search was limited to English language. The study population of this review includes asymptomatic individuals infected by COVID-19. All original articles which have reported cases of the COVID-19 patients with no symptoms until 31 April 2020 were included in the study. Random effects model was applied to analyze pooled data on the prevalence of symptomless cases among total COVID-19 infected patients and also on different age groups and gender. Results In the meta-analysis of 16 studies, comprising 2,788 COVID-19 infected patients, the pooled prevalence of asymptomatic cases was 48.2% (95% CI, 30%-67%). Among the asymptomatic patients, 55.5% (95% CI, 43.6%-66.8%) were female and 49.6% (95% CI, 20.5%-79.1%) were children. Conclusion About half of the COVID-19 infected patients were asymptomatic cases. Children and females were more apparent to be asymptomatic patient of COVID-19 and could act as unseen carrier of SARS-CoV-2. Symptom based screening only, might fail to identify all SARS-CoV-2 infections escalating the threat of global spread of SARS-CoV-2. Therefore, mass surveillance system tracking asymptomatic cases is a pressing need of public health, paying special attention to female and young children, which could aid in prevention and containment of this unprecedented pandemic.

Background. Multidrug-resistant Klebsiella pneumoniae (MDR-KP) are becoming increasingly common over the world. The focus of this research was to get a quantitative assessment of K. pneumoniae and their multidrug resistance (MDR) profile in Nepal. Methods. Three electronic databases: PubMed, Google Scholar, and Research4Life were used to search publications specifying K. pneumoniae infections and/or their MDR status from January 2015 to October 2021. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was followed for the review, and R language 4.1.1 was used for analysis. Depending upon heterogeneity of data, we used random model for pooled data to examine the prevalence of the organism and the multidrug resistance. Results. Evaluation included 16 studies, and the pooled estimation of K. pneumoniae in total clinical samples was 3% (95% CI; 0.01–0.05). In the meta-analysis, 14 studies were combined for determining the prevalence of K. pneumoniae in total positive clinical isolates which was 16% (95% CI: 0.11–0.20), while from 12 research studies, MDR status in the pathogen was found to be 64% (95% CI, 0.53–0.74). Conclusion. The MDR status of K. pneumoniae as well as the prevalence of the bacteria in Nepal was analyzed which showed alarming situation about administration of antibiotics and indicated choosing and developing reliable antibiotic strategies.

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