Pre-treatment patient characteristics as predictors of drop-out and treatment outcome in individual and family therapy for adolescents and adults with anorexia nervosa: A systematic review and meta-analysis

Abstract Introduction Globally around one million children are infected with Tuberculosis. Childhood Tuberculosis is underestimated due diagnosis challenge. HIV infection can affect the TB disease progression and treatment outcome.Objectives The aim of this systematic review and meta-analysis is to determine the pooled estimates of childhood tuberculosis treatment outcome and to analyze the impact of HIV-co infection.Methods We searched all available articles using PubMed, Google scholar and a web of science. Additionally, reference lists of included studies and Ethiopian institutional research repositories were used. Searching was limited to studies conducted in Ethiopia and published in English language. Cohort, cross-sectional and case-control studies were included. A weighted inverse variance random effects- model was used. The overall variations between studies were checked by heterogeneity test Higgins’s method (I 2 ). All included studies were assessed with the JBI quality appraisal criteria. Publication bias was checked with the funnel plot and Egger’s regression test.Result A total of 6 studies with 5,389 participants were included in this systematic review and meta-analysis. The overall pooled estimate of successful treatment outcome was found to be 79.54% (95% CI: 73.00, 86.07). Of which 72.44% were treatment completed. Moreover, this study revealed that the treatment failure, defaulter and death were 0.15%, 5.36%, and 3.54%, respectively. Poor treatment outcome was higher among children with HIV co infection with an odds ratio of 3.15 (95% CI: 1.67, 5.94) as compared to HIV negative children.Conclusion The rate of successful treatment outcome of childhood tuberculosis in Ethiopia found to be low compared to the threshold suggested by the world health organization. HIV co infection is significantly associated with poor treatment outcome. Therefore, special attention better to be given for children infected with HIV.

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Treatment Outcome of Epileptic Patients Receiving Antiepileptic Drugs in Ethiopia: A Systematic Review and Meta-Analysis

Behavioural Neurology ◽

10.1155/2021/5586041 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Taklo Simeneh Yazie ◽

Belayneh Kefale ◽

Mulugeta Molla

Keyword(s):

Systematic Review ◽

Treatment Outcome ◽

Antiepileptic Drugs ◽

Addis Ababa ◽

Meta Analysis ◽

Age Groups ◽

Seizure Freedom ◽

Pharmacoresistant Epilepsy ◽

Pooled Prevalence ◽

Epileptic Patients

Background. The prevalence and incidence rate of epilepsy were found to be higher in low- and middle-income countries. Uncontrolled epilepsy has a high risk of disability, stigma, discrimination, human rights violations, and premature death. The available studies of controlled seizure in Ethiopia have showed inconsistent results which calls for systematic review and meta-analysis. Therefore, this review intended to show the pooled prevalence of controlled seizure among people with epilepsy receiving antiepileptic drugs at outpatient department. Methods. A systematic literature search was conducted using PubMed/Medline, Science Direct, PsycINFO, Hinnarri databases, and Google Scholar for grey literatures. Data were extracted with structured format prepared using Microsoft Excel and exported to Stata/MP 16.0 software for analyses. The I 2 test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). Results. A total of 23 primary studies were included in the review showing the pooled prevalence of controlled seizure to be 46% (95% CI: 35, 56). A subgroup analysis of the primary studies showed a considerable variation in magnitude of seizure freedom by study regions, age groups, and seizure-free period. The highest prevalence was found in Addis Ababa 52% (95% CI: 29, 75), pediatric patients 77% (95% CI: 71, 83), and a seizure-free period of less than six months 58% (95% CI: 32, 83). On the other hand, the lowest prevalence of controlled seizure was found in Tigray 27% (95% CI: 11, 65), adult patients 43% (95% CI: 32, 54), and a seizure-free period of six or more 41% (95% CI: 32, 51). Higher frequency of seizure before treatment (2.23, 95% CI: 1.15, 3.31) and medication nonadherence (2.7, 95% CI: 1.25, 4.15) had statistically significant association with uncontrolled seizure. Conclusion. In this review, the prevalence of controlled seizure was found to be low. This warrants that clinicians should give more focus to epileptic patients regarding monitoring and evaluation of treatment outcome of epilepsy and factors that affect seizure control in routine clinical services. The use of standardized definition of controlled seizure, designing strategies to identify pharmacoresistant epilepsy and its treatment, and increasing medication adherence are recommended in Ethiopia. The review protocol has been registered with PROSPERO registration number CRD42021215302.

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Relationship between eating disorder duration and treatment outcome: Systematic review and meta‐analysis

International Journal of Eating Disorders ◽

10.1002/eat.23373 ◽

2020 ◽

Vol 53 (11) ◽

pp. 1761-1773 ◽

Cited By ~ 1

Author(s):

Marcela Radunz ◽

Ella Keegan ◽

Ivana Osenk ◽

Tracey D. Wade

Keyword(s):

Systematic Review ◽

Treatment Outcome ◽

Eating Disorder ◽

Meta Analysis

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Apixaban for Stroke Prevention in Atrial Fibrillation: Why are Event Rates Higher in Clinical Practice than in Randomized Trials?—A Systematic Review

Thrombosis and Haemostasis ◽

10.1055/s-0040-1713889 ◽

2020 ◽

Vol 120 (09) ◽

pp. 1323-1329 ◽

Cited By ~ 1

Author(s):

Tim A. C. de Vries ◽

Jack Hirsh ◽

Ke Xu ◽

Imaad Mallick ◽

Vinai C. Bhagirath ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Thromboembolic Event ◽

Meta Analysis ◽

Patient Characteristics ◽

Thromboembolic Events ◽

Off Label Use ◽

Off Label ◽

Event Rates ◽

Label Use

Abstract Background Recent reports suggest an important contribution from frequent off-label use of apixaban 2.5 mg twice daily to the higher rates of thromboembolic events observed in observational studies (OSs) relative to in randomized controlled trials (RCTs), and consequently, advocate against such use in all patients. Objectives To examine factors contributing to the higher thromboembolic event rates, we estimated the prevalence of off-label use in contemporary practice, and compared patient characteristics and rates of stroke/systemic embolism, major bleeding, and mortality by apixaban dose and by study design in a systematic review and meta-analysis. Results and Discussion We identified 18 OSs and 2 RCTs that included 155,228 and 11,928 patients, respectively. Patients in OSs more often received apixaban 2.5 mg twice daily (31.3% vs. 5.1%), were older (mean age 73.8 vs. 69.8 years), and had higher CHA2DS2-VASc scores (mean 3.6 vs. 2.9) versus those in RCTs. We observed a consistent pattern of higher rates of thromboembolic events, bleeding, and mortality in patients treated with 2.5 versus 5 mg twice daily apixaban in both OSs and RCTs. Conclusion The higher risk profiles of patients in OSs versus RCTs, and higher rates of both bleeding and mortality not attributable to thromboembolism in patients treated with apixaban 2.5 versus 5 mg twice daily suggest that differences in patient characteristics are additional important contributors to the higher than expected thromboembolic event rates in clinical practice.

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How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

Clinical Oral Investigations ◽

10.1007/s00784-020-03201-y ◽

2020 ◽

Vol 24 (5) ◽

pp. 1623-1636 ◽

Cited By ~ 4

Author(s):

C.H. Splieth ◽

P. Kanzow ◽

A. Wiegand ◽

J. Schmoeckel ◽

A. Jablonski-Momeni

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Proximal Caries ◽

Adolescents And Adults

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Post-natalizumab disease reactivation in multiple sclerosis: systematic review and meta-analysis

Therapeutic Advances in Neurological Disorders ◽

10.1177/1756286419837809 ◽

2019 ◽

Vol 12 ◽

pp. 175628641983780 ◽

Cited By ~ 9

Author(s):

Luca Prosperini ◽

Revere P. Kinkel ◽

Augusto A. Miravalle ◽

Pietro Iaffaldano ◽

Simone Fantaccini

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Disease Activity ◽

Meta Analysis ◽

Random Effect ◽

Patient Characteristics ◽

Increased Risk ◽

Disease Reactivation ◽

Definition Of ◽

High Level

Background: Natalizumab (NTZ) is sometimes discontinued in patients with multiple sclerosis, mainly due to concerns about the risk of progressive multifocal leukoencephalopathy. However, NTZ interruption may result in recrudescence of disease activity. Objective: The objective of this study was to summarize the available evidence about NTZ discontinuation and to identify which patients will experience post-NTZ disease reactivation through meta-analysis of existing literature data. Methods: PubMed was searched for articles reporting the effects of NTZ withdrawal in adult patients (⩾18 years) with relapsing–remitting multiple sclerosis (RRMS). Definition of disease activity following NTZ discontinuation, proportion of patients who experienced post-NTZ disease reactivation, and timing to NTZ discontinuation to disease reactivation were systematically reviewed. A generic inverse variance with random effect was used to calculate the weighted effect of patients’ clinical characteristics on the risk of post-NTZ disease reactivation, defined as the occurrence of at least one relapse. Results: The original search identified 205 publications. Thirty-five articles were included in the systematic review. We found a high level of heterogeneity across studies in terms of sample size (10 to 1866 patients), baseline patient characteristics, follow up (1–24 months), outcome measures (clinical and/or radiological), and definition of post-NTZ disease reactivation or rebound. Clinical relapses were observed in 9–80% of patients and peaked at 4–7 months, whereas radiological disease activity was observed in 7–87% of patients starting at 6 weeks following NTZ discontinuation. The meta-analysis of six articles, yielding a total of 1183 patients, revealed that younger age, higher number of relapses and gadolinium-enhanced lesions before treatment start, and fewer NTZ infusions were associated with increased risk for post-NTZ disease reactivation ( p ⩽ 0.05). Conclusions: Results from the present review and meta-analysis can help to profile patients who are at greater risk of post-NTZ disease reactivation. However, potential reporting bias and variability in selected studies should be taken into account when interpreting our data.

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