scholarly journals Estimating the burden of hypertension and its significant risk factors among male commercial drivers in sub-Saharan Africa: A systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053825
Author(s):  
Martin Ackah ◽  
Louise Ameyaw ◽  
Mohammed Gazali Salifu ◽  
Cynthia Osei Yeboah

ObjectiveThe study was designed to assess the burden and significant risk factors among male commercial drivers in sub-Saharan Africa (SSA).DesignSystematic review and meta-analysis.Data sourcesMedline via PubMed, Google Scholar, Cochrane databases and Africa Journal Online were searched from January 2010 to December 2020.Eligibility criteria for selecting studiesThe authors included observational studies reporting on the burden and/or risk factors for hypertension among commercial drivers in SSA. Male adult population ≥18 years working as a commercial driver in SSA as well articles published in English.Data extraction and synthesisTwo independent coauthors used a prepared data extraction form to extract data from the eligible published papers and assessed the risk of bias. DerSimonian and Laird random effects model was used to pool the burden of hypertension and significant risk factors among male commercial drivers in SSA. The presence of heterogeneity among studies was quantified by estimating variance using both Cochrane’s Q statistics and the I2 statistics. A subgroup and sensitivity analyses were performed.ResultsOverall, 14 articles met the inclusion criteria involving a total of 4285 male commercial drivers in SSA. The estimated pooled burden of hypertension among the male commercial drivers in SSA was 32% (95% CI 24% to 39%). The risk factors identified were age OR=1.10 (95% CI 1.06 to 1.15), overweight/obese OR=3.38 (95% CI 2.46 to 4.29), alcohol consumption OR=3.00 (95% CI 2.05 to 3.95) and duration of driving (≥5 years) OR=1.83 (95% CI 1.03 to 2.63). Funnel plot inspection and Egger’s regression test of small effect (0.5838) showed no evidence of publication bias.ConclusionsOur review showed that nearly one-third of male commercial drivers in SSA have hypertension. Reduction of modifiable risk factors such as overweight/obesity, alcohol consumption and long-term driving through multifaceted implementation strategies are recommended for prevention and control of hypertension among male commercial drivers in SSA.Trial registration numberCRD42021250910.

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418


Author(s):  
Alemu Earsido Addila ◽  
Telake Azale Bisetegn ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal Mengistu ◽  
Getnet Mihretie Beyene

Abstract Background Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries. Methods The results of the review were reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline and, it was registered in the Prospero database, number CRD42019127103. The available primary studies were collated from different databases: PubMed, CINAHL, Cochrane Library, PsycINFO, Google Scholar, African Journals Online and Centre for Addiction and Mental Health Library. The main search terms were [((alcohol consumption) OR (alcohol drinking) OR (alcohol use) OR (ethanol use) OR (alcohol exposure)) AND ((pregnant women) OR (pregnant mother) OR (during pregnancy)) AND (Sub-Saharan Africa)]. We used the Joanna Briggs Institute (JBI) for critical appraisal of studies. The random-effects model was computed to estimate the pooled prevalence. Heterogeneity between studies was checked using the I2 statistic and the Cochrane Q test. Results The review resulted in 963 original studies after searching various databases, and finally 37 studies in qualitative synthesis and 30 articles in the systematic review and meta-analysis were included. The overall summary estimate of the prevalence of alcohol consumption during pregnancy was found to be 20.83% (95% CI: 18.21, 23.46). The pooled estimate of meta-analysis showed that depression (OR: 1.572; 95% CI: 1.34, 1.845), partners’ alcohol use (OR: 1.32, 95% CI: 1.11, 1.57), knowledge on harmful effect of alcohol consumption (OR: 0.36, 95% CI: 0.29, 0.45) and, unplanned pregnancy (OR: 2.33, 95% CI: 1.17, 4.63) were statistically significant factors with alcohol consumption during pregnancy. Conclusions The result showed that there was high alcohol consumption during pregnancy in Sub- Saharan Africa. Alcohol consumption during pregnancy was associated with depression, partners’ alcohol use, unplanned pregnancy and knowledge of the harmful effects of alcohol consumption. Therefore, this will be a basis for public policy and resource allocation for prevention initiatives.


2020 ◽  
pp. 152483802090656 ◽  
Author(s):  
Eric Y. Tenkorang ◽  
Michael Asamoah-Boaheng ◽  
Adobea Y. Owusu

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036645
Author(s):  
Akalewold T Gebremeskel ◽  
Arone W Fantaye ◽  
Lena E Faust ◽  
Sanni Yaya

IntroductionIn sub-Saharan African countries, low birthweight (LBW) accounts for three-quarters of under-five mortality and morbidity. However, there is no systematic evidence of sex differences in LBW survival risk. The aim of this protocol is to outline the methodological process of a systematic review that will gather qualitative and quantitative data on sex differences in survival among LBW newborns and infants in sub-Saharan Africa.MethodsThis protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. We will conduct a systematic review to retrieve all qualitative and quantitative studies. Electronic search strategies are being finalised on 24 February 2020 for Ovid Medline and EMBASE, and on 28 February 2020 for CINAHL, Scopus and Global Health in collaboration with a Health Sciences librarian. The primary outcome of interest is indicating sex differences in survival among LBW newborns and infants. Secondary outcomes are sex-disaggregated differences in morbidity among LBW newborns and infants. Screening, data extraction and assessments of risk of bias will be performed independently. Narrative synthesis and a meta-analysis will be conducted with studies that are compatible based on population and outcome. The systematic review is focused on the analysis of secondary data and does not require ethics approval.Ethics and disseminationAs it will be a systematic review, without human participants’ involvement, there will be no requirement for ethical approval. The systematic review will present key evidence of sex-disaggregated differences in mortality and morbidity among LBW newborns and infants in sub-Saharan Africa. Programme managers, policy-makers and researchers can use the findings to evaluate LBW health outcomes in different sexes. The final manuscript will be disseminated through a peer-reviewed journal and scientific conferences.PROSPERO registration numberCRD42020163470


2013 ◽  
Vol 8 (1) ◽  
Author(s):  
Cecily Banura ◽  
Florence M Mirembe ◽  
Jackson Orem ◽  
Anthony K Mbonye ◽  
Simon Kasasa ◽  
...  

2020 ◽  
Author(s):  
Micheal Abel Alao ◽  
Oluwakemi O Tongo ◽  
Idowu Adejumoke Ayede ◽  
Michael Udochukwu Diala ◽  
Olayinka Rasheed Ibrahim ◽  
...  

Abstract Background: The morbidity and mortality from neonatal septicaemia (NNS) in low-middle income country remain high at the background of strained health care delivery system.The burden, pooled risks and outcomes of NNS are largely unknown. We aimed to produce a protocol for synthesizing evidence from available data for neonatal septicaemia in sub-Saharan Africa.Methods: We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only Observational studies retrievable in the English Language will be included. The primary measurable outcome is the proportion of neonatal with septicaemia while secondary outcomes include proportion of bacterial isolates and their antibiogram, risk factors for NNS, in hospital mortality, length of hospital stay, frequency of necrotizing enterocolitis and other sequel . All identified studies will be screened based on the inclusion criteria. Data will be deduplicated in Endnote version 9, before exporting to Rayyan QCRI for screening. Extractable data will include first author’s name and year of publication, the country and regions in sub-Saharan Africa, total neonatal admissions, number with sepsis, the sample size, bacterial isolates, antibiogram, in-hospital mortality, length of hospital stay and frequency of necrotizing enterocolitis.All studies will be assessed for methodological, clinical and statistical heterogeneity. The NIH Quality assessment tool for observational studies and the Cochrane tool of risk of bias will be used to assess for the strength of evidence. Publication bias will be assessed using the funnel plot.Discussion: Results will be presented as the prevalence, standard error and confidence interval of newborns with neonatal septicaemia in sub-Saharan Africa. Subgroup analysis using categorical data such as risk factors, bacterial isolates, antibiogram and outcomes of neonatal septicaemia will also be reported. A cumulative meta-analysis will be done to assess the time trend of the risk factors, pathogens and antibiogram.The CMA version 3 will be used for statistical analysis. Results will be presented in forest plots.Systematic Review Registration: This protocol is registered in PROSPERO, registration number CRD42020219604.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049927
Author(s):  
Martin Ackah ◽  
Cynthia Osei Yeboah ◽  
Louise Ameyaw

IntroductionWhile individual studies have reported on in-hospital stroke mortality rates in sub-Saharan Africa (SSA), the estimates are highly variable and inconclusive, buttressing the need for precise and reliable estimations. To overcome these inconsistencies, a well-structured systematic review and meta-analytical models are necessary. However, to the best of our knowledge, there is no published systematic review and meta-analysis on risk factors for 30-day mortality for in-hospital patients with stroke in SSA.Method and analysisWe will include all retrospective and prospective facility-based observational studies reporting on the incidence and/or risk factors for in-hospital stroke mortality in SSA. Electronic databases such as PubMed, Google scholar and Africa Journal Online (AJOL) will be searched for potentially relevant studies on in-hospital stroke mortality and risk factors in SSA. The search will be limited to studies conducted from January 1990 to December 2020. Two independent authors will screen titles and abstract to find studies that meet the prespecified eligibility criteria for inclusion in the review. The incidence of 30-day in hospital stroke mortality will be pooled. Meta-regression will be used to assess the factors associated with in-hospital stroke mortality in SSA. If possible, subgroup analysis will be performed based on subregion, publication year and study design, and quality score to determine possible source of heterogeneity. If possible, a sensitivity analysis will be performed to determine the robustness of the estimates obtained from the meta-analysis.Ethics and disseminationEthical approval is not required as this is a secondary research and will use reported data in scientific literature. A full manuscript will be submitted to a reputable peer-review journal for publication.PROSPERO registration numberCRD42021227367.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sphamandla Josias Nkambule ◽  
Indres Moodley ◽  
Desmond Kuupiel ◽  
Tivani P. Mashamba-Thompson

AbstractIn previous studies, food insecurity has been hypothesised to promote the prevalence of metabolic risk factors on the causal pathway to diet-sensitive non-communicable diseases (NCDs). This systematic review and meta-analysis aimed to determine the associations between food insecurity and key metabolic risk factors on the causal pathway to diet-sensitive NCDs and estimate the prevalence of key metabolic risk factors among the food-insecure patients in sub-Saharan Africa. This study was guided by the Centre for Reviews and Dissemination (CRD) guidelines for undertaking systematic reviews in healthcare. The following databases were searched for relevant literature: PubMed, EBSCOhost (CINAHL with full text, Health Source - Nursing, MedLine). Epidemiological studies published between January 2015 and June 2019, assessing the associations between food insecurity and metabolic risk outcomes in sub-Saharan African populations, were selected for inclusion. Meta-analysis was performed with DerSimonian-Laird’s random-effect model at 95% confidence intervals (CIs). The I2 statistics reported the degree of heterogeneity between studies. Publication bias was assessed by visual inspection of the funnel plots for asymmetry, and sensitivity analyses were performed to assess the meta-analysis results’ stability. The Mixed Methods Appraisal Tool (MMAT) – Version 2018 was used to appraise included studies critically. The initial searches yielded 11,803 articles, 22 cross-sectional studies were eligible for inclusion, presenting data from 26,609 (46.8% males) food-insecure participants, with 11,545 (42.1% males) reported prevalence of metabolic risk factors. Of the 22 included studies, we identified strong evidence of an adverse association between food insecurity and key metabolic risk factors for diet-sensitive NCDs, based on 20 studies. The meta-analysis showed a significantly high pooled prevalence estimate of key metabolic risk factors among food-insecure participants at 41.8% (95% CI: 33.2% to 50.8%, I2 = 99.5% p-value < 0.00) derived from 14 studies. The most prevalent type of metabolic risk factors was dyslipidaemia 27.6% (95% CI: 6.5% to 54.9%), hypertension 24.7% (95% CI: 15.6% to 35.1%), and overweight 15.8% (95% CI: 10.6% to 21.7%). Notably, the prevalence estimates of these metabolic risk factors were considerably more frequent in females than males. In this systematic review and meta-analysis, exposure to food insecurity was adversely associated with a wide spectrum of key metabolic risk factors, such as obesity, dyslipidaemia, hypertension, underweight, and overweight. These findings highlight the need to address food insecurity as an integral part of diet-sensitive NCDs prevention programmes. Further, these findings should guide recommendations on the initiation of food insecurity status screening and treatment in clinical settings as a basic, cost-effective tool in the practice of preventive medicine in sub-Saharan Africa.PROSPERO registration number: PROSPERO 2019 CRD42019136638.


Sign in / Sign up

Export Citation Format

Share Document