Background The massive abundance of studies relating to tropical medicine and health has increased strikingly over the last few decades. In the field of tropical medicine and health, a well-conducted systematic review and meta-analysis (SR/MA) is considered a feasible solution for keeping clinicians abreast of current evidence-based medicine. Understanding of SR/MA steps is of paramount importance for its conduction. It is not easy to be done as there are obstacles that could face the researcher. To solve those hindrances, this methodology study aimed to provide a step-by-step approach mainly for beginners and junior researchers, in the field of tropical medicine and other health care fields, on how to properly conduct a SR/MA, in which all the steps here depicts our experience and expertise combined with the already well-known and accepted international guidance. We suggest that all steps of SR/MA should be done independently by 2–3 reviewers’ discussion, to ensure data quality and accuracy. Conclusion SR/MA steps include the development of research question, forming criteria, search strategy, searching databases, protocol registration, title, abstract, full-text screening, manual searching, extracting data, quality assessment, data checking, statistical analysis, double data checking, and manuscript writing. Electronic supplementary material The online version of this article (10.1186/s41182-019-0165-6) contains supplementary material, which is available to authorized users.

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This systematic review and meta‐analysis aimed to study the efficacy and safety of chamomile for the treatment of state anxiety, generalized anxiety disorders (GADs), sleep quality, and insomnia in human. Eleven databases including PubMed, Science Direct, Cochrane Central, and Scopus were searched to retrieve relevant randomized control trials (RCTs), and 12 RCTs were included. Random effect meta‐analysis was performed by meta package of R statistical software version 3.4.3 and RevMan version 5.3. Our meta‐analysis of three RCTs did not show any difference in case of anxiety (standardized mean difference = −0.15, 95% CI [−0.46, 0.16], P = 0.4214). Moreover, there is only one RCT that evaluated the effect of chamomile on insomnia and it found no significant change in insomnia severity index (P > 0.05). By using HAM‐A scale, there was a significant improvement in GAD after 2 and 4 weeks of treatment (mean difference = −1.43, 95% CI [−2.47, −0.39], P = 0.007), (MD = −1.79, 95% CI [−3.14, −0.43], P = 0.0097), respectively. Noteworthy, our meta‐analysis showed a significant improvement in sleep quality after chamomile administration (standardized mean difference = −0.73, 95% CI [−1.23, −0.23], P < 0.005). Mild adverse events were only reported by three RCTs. Chamomile appears to be efficacious and safe for sleep quality and GAD. Little evidence is there to show its effect on anxiety and insomnia. Larger RCTs are needed to ascertain these findings.

Summary SARS Coronavirus‐2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid‐19 patients and the prognosis of this disease during follow‐up. Cases in this study were divided according to severity and death status and meta‐analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid‐19, of which 148 studies were meta‐analysed. Symptoms clearly emerged in an escalating manner from mild‐moderate symptoms, pneumonia, severe‐critical to the group of non‐survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35–0.61]), diabetes (PP: 0.23 [95% CI: 0.16–0.33]) and smoking (PP: 0.12 [95% CI: 0.03–0.38]) were highest regarding pre‐infection comorbidities in the non‐survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29–0.78]), (PP: 0.63 [95% CI: 0.34–0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground‐glass opacification (PP: 0.68 [95% CI: 0.59–0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06–0.19]), (PP: 0.03 [95% CI: 0.01–0.05]), and (PP: 0.01 [95% CI: 0–0.3]) in severe‐critical, pneumonia and mild‐moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid‐19, graded from mild to severe, and for special forms like pneumonia and death groups.

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