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Myelodysplastic syndrome (MDS) describes a group of bone marrow malignancies with variable morphologies and heterogeneous clinical features. The aim of this study was to systematically appraise the published clinical, laboratory, and pathologic characteristics and identify distinct clinical features of MDS in the Middle East and North Africa (MENA) region. We conducted a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from 2000 to 2021 to identify population-based studies of MDS epidemiology in MENA countries. Of 1935 studies, 13 independent studies published between 2000 and 2021 representing 1306 patients with MDS in the MENA region were included. There was a median of 85 (range 20 to 243) patients per study. Seven studies were performed in Asian MENA countries (732 patients, 56%) and six in North African MENA countries (574 patients, 44%). The pooled mean age was 58.4 years (SD 13.14; 12 studies), and the male-to-female ratio was 1.4. The distribution of WHO MDS subtypes was significantly different between MENA, Western, and Far East populations (n = 978 patients, p < 0.001). More patients from MENA countries were at high/very high IPSS risk than in Western and Far East populations (730 patients, p < 0.001). There were 562 patients (62.2%) with normal karyotypes and 341 (37.8%) with abnormal karyotypes. Our findings establish that MDS is prevalent within the MENA region and is more severe than in Western populations. MDS appears to be more severe with an unfavorable prognosis in the Asian MENA population than the North African MENA population.
Background: West Nile virus (WNV) is one of the most widely spread arboviruses worldwide and a highly significant pathogen in humans and animals. Despite frequent outbreaks and endemic transmission being reported in the Middle East and North Africa (MENA), seroprevalence studies of WNV in Qatar are highly lacking. Aim: This study aims to investigate the actual prevalence of WNV among local and expatriate communities in the Qatar using a large sample size of seemingly healthy donors. Method: A total of 1992 serum samples were collected from donors of age 18 or older and were tested for the presence of WNV antibodies. Serion enzyme-linked immunosorbent assay (ELISA) commercial microplate kits were used to detect the presence of the WNV IgM and IgG. The seropositivity was statistically analyzed using SPSS software with a confidence interval of 95%. Results: The seroprevalence of anti-WNV IgG and IgM in Qatar was 10.3% and 3.4%, respectively. The country-specific seroprevalence according to nationality for WNV IgG and IgM, respectively, were Sudan (37.0%, 10.0%), Egypt (31.6%, 4.4%), India (13.4%, 3.2%), Yemen(10.2%, 7.0%), Pakistan (8.6%, 2.7%), Iran (10.6%, 0.0%), Philippines (5.4%, 0.0%), Jordan(6.8%, 1.1%), Syria (2.6%, 9.6%), Palestine (2.6%, 0.6%), Qatar (1.6%, 1.7%), and Lebanon (0.9%, 0.0%). The prevalence of both IgM and IgG was significantly correlated with the nationality (p≤0.001). Conclusion: Among these tested nationalities, Qatar national has a relatively low burden of WNV disease. The highest prevalence of WNV was found in the Sub Saharan African nationalities like Sudan and Egypt. The seroprevalence of WNV is different from the previously reported arboviruses such as CHIKV and DENV, which was highest among Asian countries (India and Philippines). Further confirmatory tests such as viral neutralization assays are needed to confirm the IgM seropositivity in these samples since these samples could be a source of viral transmission through blood donation.
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