scholarly journals A systematic review and network meta-analyses to assess the effectiveness of HIV self-testing distribution strategies

2021 ◽  
Author(s):  
Ingrid Eshun-Wilson ◽  
Muhammad S Jamil ◽  
Witzel T. Charles ◽  
Dave V Glidden ◽  
Johnson Cheryl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Web Based ◽  
Standard Testing ◽  
Self Testing ◽  
Testing Uptake ◽  
Sub Saharan ◽  
Meta Analyses

Abstract Background We conducted a systematic review and network meta-analysis to identify which HIV self-testing (HIVST) distribution strategies are most effective. Methods We abstracted data from randomized controlled trials and observational studies published between June 4, 2006 and June 4, 2019. Results We included 33 studies, yielding six HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. Conclusion A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.

scholarly journals HIV Self-Testing Uptake and Intervention Strategies Among Men in Sub-Saharan Africa: A Systematic Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Akeen Hamilton ◽  
Noah Thompson ◽  
Augustine T. Choko ◽  
Mbuzeleni Hlongwa ◽  
Pauline Jolly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Sex Workers ◽  
Linkage To Care ◽  
Intervention Strategies ◽  
Sub Saharan Africa ◽  
Manual Search ◽  
Self Testing ◽  
Testing Uptake ◽  
Sub Saharan

Background: HIV testing is an essential gateway to HIV prevention and treatment services. However, HIV testing uptake remains low among men due to stigma, discrimination, and confidentiality concerns. HIV self-testing (HIVST) is an alternative HIV testing method that can address many of these barriers for men. We conducted a systematic review to examine HIVST uptake and intervention strategies among Men in Sub-Saharan Africa.Methods: We used a systematic approach to survey literature published from January 2010 to June 2020 using five electronic databases (PubMed-Medline, CINAHL Complete, PsychINFO, Google Scholar, and Web of Science) and a manual search. Studies were included if they were peer-reviewed, published in English, and examined HIVST willingness, uptake, and/or linkage to care and included men in Sub-Saharan Africa.Results: Sixty-three articles related to HIVST were reviewed. Of the included articles, 37 discussed HIVST uptake/acceptability and 24 discussed intervention strategies. Both oral swab and finger-prick methods had high acceptability with ease of access and availability of the test cited as important by men. Free HIVST kits were preferred by men. Secondary distribution of kits via peers, sexual partners, and female sex workers were successful.Conclusion: HIV self-testing is highly acceptable to men. More efforts are needed to develop policies to implement HIVST programs targeting men in Sub-Saharan Africa, including a focus on linkage to care in sub-Saharan Africa. Future interventions should directly target men independently in tandem with using peers and their romantic partners to promote self-testing among men in sub-Saharan Africa. HIVST kit distribution strategies should be combined with services that can offer confirmatory tests and counseling for men as well as linkage to care.

scholarly journals Enteric pathogens associated with gastroenteritis among children under 5 years in sub-Saharan Africa: a systematic review and meta-analysis

2020 ◽  
Vol 148 ◽  
Author(s):  
T. B. Oppong ◽  
H. Yang ◽  
C. Amponsem-Boateng ◽  
E. K. D Kyere ◽  
T. Abdulai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Acute Diarrhoea ◽  
Cochrane Collaboration ◽  
Original Data ◽  
Health Condition ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Meta Analyses ◽  
Children Under 5

Abstract Gastroenteritis remains a serious health condition among children under 5 years especially in Africa. We conducted a systematic review and meta-analysis to investigate the aetiologic pathogens of gastroenteritis in the region. We did a systematic search for articles with original data on the aetiology of gastroenteritis and acute diarrhoea among children younger than 5 years. Pooled results were extracted and analysed in STATA version 12.0 using random-effects for statistical test for homogeneity following the guidelines provided in the Cochrane Collaboration and Preferred reporting items for systematic reviews and meta-analyses. Overall, viruses accounted for 50.2% of the cases followed by bacteria with 31.6% of the cases. Parasites accounted for 12.1% of the case. Rotavirus was the most common cause of acute diarrhoea in all regions resulting in 29.2% of the cases followed by E. coli (15.6%) of diarrhoeal cases and Adenovirus (10.8%). The most prevalent parasite detected was Giardia lamblia (7.3%). Acute diarrhoea remains rampant with Rotavirus still being the major pathogen responsible for the disease in children less than 5 years old despite the introduction of vaccine. It is recommended that the vaccine should be promoted much more widely in the region.

scholarly journals Effect of HIV-related knowledge on utilisation of voluntary HIV testing service among university students in Sub-Saharan Africa: a systematic review and meta-analysis protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045748
Author(s):  
Gedefaw Diress ◽  
Amanuel Addisu ◽  
Melese Linger Endalifer
Keyword(s):  
Systematic Review ◽  
University Students ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Preventive Measure ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
Service Utilisation ◽  
Testing Service ◽  
Sub Saharan

IntroductionVoluntary HIV testing is a vital preventive measure to reduce HIV transmission. Existing evidence on the association between HIV-related knowledge and HIV testing service utilisation shows inconsistent findings. Therefore, the aim of this review is to assess whether knowledge of HIV is related to improvement in voluntary HIV testing service utilisation among university students in Sub-Saharan Africa.Methods and analysisA systematic review of studies on the association of HIV-related knowledge and voluntary HIV testing service utilisation among university students will be conducted. We will search several electronic databases, including PubMed/MEDLINE, African Journals Online, Web of Science and Cochrane Library, for all study types looking at the association between HIV-related knowledge and voluntary HIV testing service utilisation. Two reviewers will independently screen all retrieved records and full-text articles and extract data. The Higgins I2 test will be used to assess heterogeneity between studies. Random-effects meta-analysis will be conducted, if feasible and appropriate. Additional analyses will be performed to explore potential sources of heterogeneity. Stata statistical software (V.14) will be used to analyse the data.Ethics and disseminationFormal ethical approval is not required because the systematic review relies on primary studies. The results will be disseminated through a peer-reviewed publication, conference presentation and the popular press.

scholarly journals Uptake of Home-Based Voluntary HIV Testing in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

PLoS Medicine ◽  
2012 ◽  
Vol 9 (12) ◽  
pp. e1001351 ◽  
Author(s):  
Kalpana Sabapathy ◽  
Rafael Van den Bergh ◽  
Sarah Fidler ◽  
Richard Hayes ◽  
Nathan Ford
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Home Based ◽  
Sub Saharan

scholarly journals Treatment outcomes in adult tuberculous meningitis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Anna M Stadelman ◽  
Jayne Ellis ◽  
Thomas H A Samuels ◽  
Ernest Mutengesa ◽  
Joanna Dobbin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Tuberculous Meningitis ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Significant Heterogeneity ◽  
Hiv Positive Adults ◽  
Sub Saharan ◽  
Meta Analyses

Abstract Background There is substantial variation in the reported treatment outcomes for adult tuberculous meningitis (TBM). Data on survival and neurological disability by continent and HIV serostatus are scarce. Methods We performed a systematic review and meta-analysis to characterize treatment outcomes for adult TBM. Following a systematic literature search (MEDLINE and EMBASE), studies underwent duplicate screening by independent reviewers in two stages to assess eligibility for inclusion. Two independent reviewers extracted data from included studies. We employed a random effects model for all meta-analyses. We evaluated heterogeneity by the I2 statistic. Results We assessed 2,197 records for eligibility; 39 primary research articles met our inclusion criteria reporting on treatment outcomes for 5,752 adults with TBM. The commonest reported outcome measure was six-month mortality. Pooled six-month mortality was 24% and showed significant heterogeneity (I2 >95%; p<0·01). Mortality ranged from 2% to 67% in Asian studies and from 23% to 80% in sub-Saharan African studies. Mortality was significantly worse in HIV-positive adults at 57% (95%CI; 48-67%), compared with 16% (95%CI; 10-24%) in HIV-negative adults (p<0·01). Physical disability was reported in 32% (95%CI; 22-43%) of adult TBM survivors. There was considerable heterogeneity between studies in all meta-analyses with I2 statistics consistently >50%. Conclusions Mortality in adult TBM is high and varies considerably by continent and HIV-status. The highest mortality is amongst HIV-positive adults in sub-Saharan Africa. Standardized reporting of treatment outcomes will be essential to improve future data quality and increase potential for data sharing, meta-analyses, and facilitating multi-center tuberculosis research to improve outcomes.

scholarly journals Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa

Nature ◽  
2015 ◽  
Vol 528 (7580) ◽  
pp. S77-S85 ◽  
Author(s):  
Monisha Sharma ◽  
Roger Ying ◽  
Gillian Tarr ◽  
Ruanne Barnabas
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Linkage To Care ◽  
Sub Saharan Africa ◽  
Care Gaps ◽  
Sub Saharan

scholarly journals Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045880
Author(s):  
Shukri F Mohamed ◽  
Olalekan A Uthman ◽  
Martin K Mutua ◽  
G Asiki ◽  
Mustapha S Abba ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Uncontrolled Hypertension ◽  
Diabetic Patients ◽  
Registration Number ◽  
Sub Saharan ◽  
Meta Analyses

BackgroundThe burden of uncontrolled hypertension in sub-Saharan Africa (SSA) is high and hypertension is known to coexist with other chronic diseases such as kidney disease, diabetes among others. This is the first systematic review and meta-analysis to determine the burden of uncontrolled hypertension among patients with comorbidities in SSA.MethodsA comprehensive search was conducted on MEDLINE, Excerpta Medica Database (Embase) and Web of Science to identify all relevant articles published between 1 January 2000 and 17 June 2021. We included studies that reported on the prevalence of uncontrolled hypertension among people in SSA who report taking antihypertensive treatment and have another chronic condition. A random-effects meta-analysis was performed to obtain the pooled estimate of the prevalence of uncontrolled hypertension among patients with comorbid conditions while on treatment across studies in SSA.ResultsIn all, 20 articles were included for meta-analyses. Eleven articles were among diabetic patients, five articles were among patients with HIV, two were among patients with stroke while chronic kidney disease and atrial fibrillation had one article each. The pooled prevalence of uncontrolled hypertension among patients with comorbidities was 78.6% (95% CI 71.1% to 85.3%); I² 95.9%, varying from 73.1% in patients with stroke to 100.0% in patients with atrial fibrillation. Subgroup analysis showed differences in uncontrolled hypertension prevalence by various study-level characteristicsConclusionThis study suggests a high burden of uncontrolled hypertension in people with comorbidities in SSA. Strategies to improve the control of hypertension among people with comorbidities are needed.PROSPERO registration numberCRD42019108218.

Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis

2021 ◽  
pp. 174749302199094
Author(s):  
Thierry Adoukonou ◽  
Oyéné Kossi ◽  
Pervenche Fotso Mefo ◽  
Mendinatou Agbétou ◽  
Julien Magne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
Risk Of Mortality ◽  
Stroke Case ◽  
Sub Saharan ◽  
One Year ◽  
Few Data ◽  
Meta Analyses

Background The burden of stroke is high in sub-Saharan Africa; however, few data are available on long-term mortality. Objective To estimate over one-month stroke case fatality in sub-Saharan Africa. Methods A systematic review and meta-analysis were performed according to meta-analysis of observational studies in epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO protocol: CRD42020192439), on five electronic databases (PubMed, Science direct, AJOL, EMBASE, and Web of Sciences). We searched all studies on stroke case fatality over one month in sub-Saharan Africa published between 1st January 2000 and 31st December 2019. Results We included 91 studies with a total of 34,362 stroke cases. The one-month pooled stroke case-fatality rate was 24.1% [95% CI: 21.5–27.0] and 33.2% [95% CI: 23.6–44.5] at one year. At three and five years, the case-fatality rates were respectively 40.1% [95% CI: 20.8–63.0] and 39.4% [95% CI: 14.3–71.5] with high heterogeneity. Hemorrhagic stroke was associated with a higher risk of mortality at one month, but ischemic stroke increased the risk of mortality over six months. Diabetes was associated with poor prognosis at 6 and 12 months with odds ratios of 1.64 [95% CI: 1.22–2.20] and 1.85 [1.25–2.75], respectively. Conclusion The stroke case fatality over one month was very high, compared to case fatalities reported in Western countries and can be explained by a weak healthcare systems and vascular risk factors.

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