1453Mapping the prevalence of chronic noncommunicable diseases in Ethiopia: a systematic review and meta-analysis of evidence

Abstract Background Noncommunicable diseases (NCDs) are a growing global health challenge disproportionately impacting low- and middle-income settings, including Ethiopia. Currently, the body of evidence describing the burden of NCDs is fragmented, inconsistent, health facility- or institution-based, and out-dated in Ethiopia. We conducted a systematic review of the literature and meta-analysis of the prevalence of NCDs in community settings in Ethiopia. Review methodology Community-based quantitative studies published in English between 2012 and July 2020 that reported the prevalence of NCDs in Ethiopia were included. A systematic search of Medline, Embase, Scopus, CINHAL, and Global Health using pretested search terms related to NCDs was conducted, and data were extracted using a piloted data extraction proforma adapted from the Joanna Briggs Institute tool. Meta-analysis was performed using Stata 16. We measured the overall NCD prevalence using pooled odds ratios with 95% CIs. Pooled NCD prevalence was also computed and presented using forest plots. I2 was used to assess heterogeneity. Studies that did not fulfil the criteria for meta-analysis were narratively synthesised. Results Nineteen studies met the inclusion criteria. Four studies measured the prevalence of NCDs (all NCDs together), ranging from 29% to 35% (prevalence estimates not pooled). The pooled prevalence of Diabetes Mellites (DM) across ten studies was 5% (95% CI:4%−7%). Three studies each reported on the prevalence of undiagnosed DM (pooled prevalence 8%, 95% CI: 2%−14%) and pre-DM (pooled prevalence 12%, 95% CI:3%−21%). In a narrative analysis the prevalence of cardiovascular conditions ranged from 13.4% to 32.2% (n = 3 studies), cancer mortality ranged from 4% to 18% (n = 3 studies) and respiratory conditions ranged from 1% to 18% (n = 3 studies). Conclusion and recommendations Our analysis found that approximately one-third of Ethiopians have an NCD, with cardiovascular diseases the most common of all NCDs. The prevalence of respiratory conditions also appears high, but there are insufficient data for a pooled estimate. Whilst the prevalence of DM appears relatively low, there is evidence that the magnitude is increasing. Public health actions to address the high burden of cardiovascular and respiratory diseases, as well as the increasing magnitude of DM in Ethiopia, must be prioritised. Keywords: NCD, noncommunicable diseases, Ethiopia.

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Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis

BMJ ◽

10.1136/bmj.l4185 ◽

2019 ◽

pp. l4185 ◽

Cited By ~ 62

Author(s):

Maria Panagioti ◽

Kanza Khan ◽

Richard N Keers ◽

Aseel Abuzour ◽

Denham Phipps ◽

...

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Medical Care ◽

Data Extraction ◽

Meta Analysis ◽

Cost Effective ◽

Mitigation Strategies ◽

Patient Harm ◽

Pooled Prevalence ◽

Preventable Harm

Abstract Objective To systematically quantify the prevalence, severity, and nature of preventable patient harm across a range of medical settings globally. Design Systematic review and meta-analysis. Data sources Medline, PubMed, PsycINFO, Cinahl and Embase, WHOLIS, Google Scholar, and SIGLE from January 2000 to January 2019. The reference lists of eligible studies and other relevant systematic reviews were also searched. Review methods Observational studies reporting preventable patient harm in medical care. The core outcomes were the prevalence, severity, and types of preventable patient harm reported as percentages and their 95% confidence intervals. Data extraction and critical appraisal were undertaken by two reviewers working independently. Random effects meta-analysis was employed followed by univariable and multivariable meta regression. Heterogeneity was quantified by using the I 2 statistic, and publication bias was evaluated. Results Of the 7313 records identified, 70 studies involving 337 025 patients were included in the meta-analysis. The pooled prevalence for preventable patient harm was 6% (95% confidence interval 5% to 7%). A pooled proportion of 12% (9% to 15%) of preventable patient harm was severe or led to death. Incidents related to drugs (25%, 95% confidence interval 16% to 34%) and other treatments (24%, 21% to 30%) accounted for the largest proportion of preventable patient harm. Compared with general hospitals (where most evidence originated), preventable patient harm was more prevalent in advanced specialties (intensive care or surgery; regression coefficient b=0.07, 95% confidence interval 0.04 to 0.10). Conclusions Around one in 20 patients are exposed to preventable harm in medical care. Although a focus on preventable patient harm has been encouraged by the international patient safety policy agenda, there are limited quality improvement practices specifically targeting incidents of preventable patient harm rather than overall patient harm (preventable and non-preventable). Developing and implementing evidence-based mitigation strategies specifically targeting preventable patient harm could lead to major service quality improvements in medical care which could also be more cost effective.

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Prevalence of Invasive Streptococcus pneumoniae Infections among Iranian Children: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v50i6.6412 ◽

2021 ◽

Author(s):

Arshid Yousefi Avarvand ◽

Mehrdad Halaji ◽

Donya Zare ◽

Meysam Hasannejad-Bibalan ◽

Hadi Sedigh Ebrahim-Saraie

Keyword(s):

Systematic Review ◽

Streptococcus Pneumoniae ◽

Web Of Science ◽

Data Extraction ◽

Meta Analysis ◽

Single Center ◽

Inclusion Criteria ◽

Pooled Prevalence ◽

Iranian Children ◽

The Web

Background: Streptococcus pneumoniae is an important pathogen of children, mostly in developing countries. We aimed to investigate the prevalence of invasive S. pneumoniae among Iranian children using a systematic review and meta-analysis. Methods: A systematic search was carried out to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, and Google Scholar electronic databases from January of 2010 to December of 2017. Then, seven publications that met our inclusion criteria were selected for data extraction and analysis. Results: Totally, one study was multicenter, and six were single-center based studies. Meanwhile, all of the included studied performed among hospitalized patients. Seven studies reported the prevalence of invasive S. pneumoniae isolated from children, of these the pooled prevalence of S. pneumoniae was 2.5% (95% CI: 0.7%-9.1%). Conclusion: The overall prevalence of invasive S. pneumoniae infections among Iranian children is low (2.5%). However, further clinical studies are required to elucidate the burden of infections among Iranian children, especially in eastern regions.

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Self-Medication with Antibiotics among University Students in LMIC: A systematic review and meta-analysis

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11359 ◽

2019 ◽

Vol 13 (08) ◽

pp. 678-689 ◽

Cited By ~ 1

Author(s):

Rixiang Xu ◽

Tingyu Mu ◽

Guan Wang ◽

Jing Shi ◽

Xin Wang ◽

...

Keyword(s):

Systematic Review ◽

University Students ◽

Meta Analysis ◽

Antibiotic Use ◽

Self Medication ◽

Middle Income ◽

Inappropriate Use ◽

Middle Income Countries ◽

Effective Interventions ◽

Pooled Prevalence

Introduction: Self-medication with antibiotics (SMA) is common among university students in low and middle-income countries (LMICs). However, there has been no meta-analysis and systematic review in the population. Methodology: A literature search was conducted using PubMed, Embase and Web of Science for the period from January 2000 to July 2018. Only observational studies that had SMA among university students from LMICs were included. A random-effects model was applied to calculate the pooled effect size with 95% confidence interval (CI) due to the expected heterogeneity (I2 over 50%). Results: The pooled prevalence of SMA of overall included studies was 46.0% (95% CI: 40.3% to 51.8%). Africa had the highest pooled prevalence of SMA among university students (55.30%), whereas South America had the lowest prevalence (38.3%). Among individual LMICs, the prevalence of SMA among university students varied from as low as 11.1% in Brazil to 90.7% in Congo. Conclusions: The practice of SMA is a widespread phenomenon among university students in LMICs and is frequently associated with inappropriate use. Effective interventions such as medication education and stricter governmental regulation concerning antibiotic use and sale are required to be established in order to deal with SMA properly.

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Evidence on the effect of position change on pressure ulcer among hospitalized adult patients in Ethiopia: systematic review and meta-analysis

10.21203/rs.2.16853/v2 ◽

2019 ◽

Author(s):

wondimeneh shibabaw shiferaw ◽

Yared Asmare Aynalem ◽

Tadesse Yirga Akalu

Keyword(s):

Systematic Review ◽

Pressure Ulcer ◽

Care Service ◽

Meta Analysis ◽

Health Care Service ◽

Random Effect ◽

Random Effect Model ◽

The Body ◽

Position Change ◽

Pooled Prevalence

Abstract Background Pressure ulcers (PU) aﬀect millions of people worldwide and always occur over bony areas of the body where pressure and tissue distortion is greatest. The national pooled prevalence of pressure ulcer remains unknown. Hence, this meta-analysis aimed to determine the effect of position change on pressure ulcer among hospitalized clients in Ethiopia. Methods Studies were retrieved through search engines in PubMed, Scopus, WHO afro library, Google Scholar, Africa journal online, PsycINFO and web-science following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Analysis was done using STATA version 14 software. Heterogeneity between-study was checked using the I 2 and examined a potential publication bias by visual inspection of the funnel plot and Egger’s regression test statistic. The random-effect model was fitted to estimate the summary effects, odds ratios (ORs), and 95% confidence interval (CIs) across studies. Results Out of the reviewing 401 studies, 7 studies fulfilled the inclusion criteria and were included in the meta-analysis. The estimated pooled prevalence of pressure ulcer in Ethiopia was 11.7% (95% CI (7.28, 16.13%)). Based on the subgroup analysis, the estimated magnitude of pressure ulcer was 15.89% (95% CI: 35.34, 54.04) among studies their sample size were greater than or equals to 250. Those clients who have position change during hospitalization were 82% less likely to develop pressure ulcer [(OR: 0.18 (95% CI (0.07, 0.46)) than their counter part. Conclusion The overall prevalence of pressure ulcer in Ethiopia was relatively high. Position change of the client during hospitalization had paramount benefit to reduce the burden of pressure ulcer. Therefore, policymakers (federal minister of health) could give special attention to minimize the magnitude of pressure ulcer, and to improve the overall quality of healthcare service. Further, meta-analysis study could be conducted to identify individual and health care service related factors to the occurrence of pressure ulcer.

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Estimating neoplasia detection rate (NDR) in patients with Barrett’s oesophagus based on index endoscopy: a systematic review and meta-analysis

Gut ◽

10.1136/gutjnl-2018-317800 ◽

2019 ◽

Vol 68 (12) ◽

pp. 2122-2128 ◽

Cited By ~ 9

Author(s):

Sravanthi Parasa ◽

Madhav Desai ◽

Anusha Vittal ◽

Viveksandeep T Chandrasekar ◽

Asad Pervez ◽

...

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Data Extraction ◽

Meta Analysis ◽

Quality Measure ◽

Barrett’S Oesophagus ◽

Oesophageal Adenocarcinoma ◽

Cochrane Library ◽

Barrett's Oesophagus ◽

Pooled Prevalence

BackgroundBiopsies are obtained to confirm intestinal metaplasia and rule out prevalent dysplasia and cancer when Barrett’s oesophagus (BE) is detected at index upper endoscopy (oesophagogastroduodenoscopy [EGD]).AimThe purpose of this systematic review was to obtain summary estimates of the prevalence of high-grade dysplasia (HGD) and oesophageal adenocarcinoma (EAC) associated with BE during index EGD for chronic GERD symptoms, defined as neoplasia detection rate (NDR) which could be used as a quality measure.MethodsAn extensive search was performed within PUBMED, EMBASE and the Cochrane Library databases to identify studies in which patients underwent index endoscopy for the evaluation of the presence of BE. Two reviewers independently evaluated both the study eligibility and methodological quality and data extraction. A random-effects model (REM) based on the binomial distribution was used to calculate the pooled effects of the prevalence of BE-associated dysplasia and EAC.ResultsFor the calculation of dysplasia and EAC prevalence rates, a total of 11 studies with 10 632 patients met the inclusion criteria including 80.4% men with a mean age of 58.7 years and average BE length of 3.5 cm. The pooled prevalence of EAC, HGD and LGD was 3%(95% CI 2 to 5, 9 studies: 396/10 539 patients), 3%(95% CI 2 to 5 [REM], 9 studies: 388/10 539 patients) and 10%(95% CI 7 to 15 [REM], 10 studies: 907/8945 patients), respectively. For NDR, that is, the pooled prevalence of HGD/EAC was 7%(95% CI 4 to 10 [REM], 10 studies: 795/10 632 patients).ConclusionNDR is approximately 4% and could be used as a quality measure.

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Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies

Journal of Comorbidity ◽

10.1177/2235042x19870934 ◽

2019 ◽

Vol 9 ◽

pp. 2235042X1987093 ◽

Cited By ~ 28

Author(s):

Hai Nguyen ◽

Gergana Manolova ◽

Christina Daskalopoulou ◽

Silia Vitoratou ◽

Martin Prince ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

Middle Income ◽

Middle Income Countries ◽

Final Sample ◽

Pooled Prevalence ◽

Gender And Age ◽

Resources Distribution ◽

Newcastle Ottawa Scale

Background: With ageing world populations, multimorbidity (presence of two or more chronic diseases in the same individual) becomes a major concern in public health. Although multimorbidity is associated with age, its prevalence varies. This systematic review aimed to summarise and meta-analyse the prevalence of multimorbidity in high, low- and middle-income countries (HICs and LMICs). Methods: Studies were identified by searching electronic databases (Medline, Embase, PsycINFO, Global Health, Web of Science and Cochrane Library). The term ‘multimorbidity’ and its various spellings were used, alongside ‘prevalence’ or ‘epidemiology’. Quality assessment employed the Newcastle-Ottawa scale. Overall and stratified analyses according to multimorbidity operational definitions, HICs/LMICs status, gender and age were performed. A random-effects model for meta-analysis was used. Results: Seventy community-based studies (conducted in 18 HICs and 31 LMICs) were included in the final sample. Sample sizes ranged from 264 to 162,464. The overall pooled prevalence of multimorbidity was 33.1% (95% confidence interval (CI): 30.0–36.3%). There was a considerable difference in the pooled estimates between HICs and LMICs, with prevalence being 37.9% (95% CI: 32.5–43.4%) and 29.7% (26.4–33.0%), respectively. Heterogeneity across studies was high for both overall and stratified analyses ( I 2 > 99%). A sensitivity analysis showed that none of the reviewed studies skewed the overall pooled estimates. Conclusion: A large proportion of the global population, especially those aged 65+, is affected by multimorbidity. To allow accurate estimations of disease burden, and effective disease management and resources distribution, a standardised operationalisation of multimorbidity is needed.

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Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-020-00601-8 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Ermias Getaneh Ayele ◽

Zelalem Tenaw ◽

Anmut Alebel ◽

...

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Children And Adolescents ◽

Meta Analysis ◽

Middle Income ◽

Middle Income Countries ◽

Pooled Prevalence ◽

Obese Population ◽

Low And Middle Income

Abstract Background Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. Methods Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. Conclusion This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.

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Association between vision impairment and mortality: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-037556 ◽

2020 ◽

Vol 10 (6) ◽

pp. e037556

Author(s):

Joshua R Ehrlich ◽

Jacqueline Ramke ◽

David Macleod ◽

Bonnielin K Swenor ◽

Helen Burn ◽

...

Keyword(s):

Systematic Review ◽

Global Health ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Vision Impairment ◽

Published Data ◽

Assessment Development ◽

Evaluation Approach ◽

Meta Analyses

IntroductionDue to growth and ageing of the world’s population, the number of individuals worldwide with vision impairment (VI) and blindness is projected to increase rapidly over the coming decades. VI and blindness are an important cause of years lived with disability. However, the association of VI and blindness with mortality, including the risk of bias in published studies and certainty of the evidence, has not been adequately studied in an up-to-date systematic review and meta-analysis.Methods and analysisThe planned systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases, including MEDLINE Ovid, Embase Ovid and Global Health, will be searched for relevant studies. Two reviewers will then screen studies and review full texts to identify studies for inclusion. Data extraction will be performed, and for included studies, the risk of bias and certainty of the evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The prognostic factor in this study is visual function, which must have been measured using a standard objective ophthalmic clinical or research instrument. We will use standard criteria from WHO to categorise VI and blindness. All-cause mortality may be assessed by any method one or more years after baseline assessment of vision. Results from included studies will be meta-analysed according to relevant sections of the Meta-analysis Of Observational Studies in Epidemiology checklist.Ethics and disseminationThis review will only include published data; therefore, ethics approval will not be sought. The findings of this review and meta-analysis will be published in an open-access, peer-reviewed journal and will be included in the ongoing Lancet Global Health Commission on Global Eye Health.

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Menstrual Hygiene Preparedness Among Schools in India: A Systematic Review and Meta-Analysis of System-and Policy-Level Actions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020647 ◽

2020 ◽

Vol 17 (2) ◽

pp. 647 ◽

Cited By ~ 2

Author(s):

Shantanu Sharma ◽

Devika Mehra ◽

Nele Brusselaers ◽

Sunil Mehra

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

A Priori ◽

Common Source ◽

Menstrual Hygiene ◽

Pooled Prevalence ◽

Data Extraction Form ◽

School Preparedness ◽

The Government

With increasing girls’ enrolment in schools, school preparedness to ensure a menstrual friendly environment is crucial. The study aimed to conduct a systematic review regarding the existing evidence on menstrual hygiene management (MHM) across schools in India. It further aimed to highlight the actions that have been taken by the government to improve the MHM situation in India. We conducted the systematic literature search using PubMed, EMBASE, and Web of Science for searching the peer-reviewed articles and Google Scholar for anecdotal reports published from inception until 30 October 2019. Of 1125 publications retrieved through the search, 183 papers were included in this review, using a priori created data-extraction form. Meta-analysis was used to estimate the pooled prevalence (PP) of MHM practices in schools. Less than half of the girls were aware of menstruation before menarche (PP 0.45, 0.39 to 0.51, I2 = 100.0%, n = 122). Teachers were a less common source of information about menstruation to girls (PP 0.07, 0.05 to 0.08, I2 = 100.0%, n = 86). Separate toilets for girls were present in around half of the schools (PP 0.56, 0.42 to 0.75, I2 100.0%, n = 11). MHM in schools should be strengthened with convergence between various departments for explicit implementation of guidelines.

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The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis

Fertility Research and Practice ◽

10.1186/s40738-021-00098-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Zahra Kiani ◽

Masoumeh Simbar ◽

Sepideh Hajian ◽

Farid Zayeri

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Depression Symptoms ◽

Middle Income ◽

Infertile Women ◽

Middle Income Countries ◽

Pooled Prevalence ◽

Prevalence Of Depression ◽

Low And Middle Income

Abstract Background Infertile women’s mental health problems, including depression, are key fertility health issues that affect infertile women more severely than infertile men. Depression may threaten the health of individuals and reduce the quality of their lives. Considering the role and impact of depression on responses to infertility treatments, a systematic review and meta-analysis were conducted to investigate the prevalence of depression symptoms among infertile women. Methods International databases (PubMed, Cochrane Library, Web of Sciences, Scopus, Embase, and PsycINFO), national databases (SID and Magiran), and Google Scholar were searched by two independent reviewers for articles published from 2000 to April 5, 2020. The search procedure was performed in both Persian and English using keywords such as “depression,” “disorders,” “infertility,” “prevalence,” and “epidemiology.” The articles were evaluated in terms of their titles, abstracts, and full texts. The reviewers evaluated the quality of the articles using the Newcastle–Ottawa Scale, after which they analyzed the findings using STATA version 14. The I2 and Egger’s tests were performed to examine heterogeneity and publication bias, respectively. Results Thirty-two articles were subjected to the meta-analysis, and a random effects model was used in the examination given the heterogeneity of the articles. The samples in the reviewed studies encompassed a total of 9679 infertile women. The lowest and highest pooled prevalence rates were 21.01% (95% confidence interval [CI]: 15.61–34.42), as determined using the Hospital Anxiety and Depression Scale, and 52.21% (95% CI: 43.51–60.91), as ascertained using the Beck Depression Inventory, respectively. The pooled prevalence values of depression among infertile women were 44.32% (95% CI: 35.65–52.99) in low- and middle-income countries and 28.03% (95% CI: 19.61–36.44) in high-income countries. Conclusion The prevalence of depression among infertile women was higher than that among the general population of a given country. Especially in low- and middle-income countries, appropriate measures, planning, and policy that target the negative effects of depression on infertile women’s lives should be established to reduce related problems.

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