scholarly journals Integrated chronic disease care delivery at a primary care level in sub-Saharan Africa: A systematic review, best fit framework synthesis, and new conceptual model

2021 ◽  
Author(s):  
Simon R Harrison ◽  
Aileen M Jordan
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Disease ◽  
Conceptual Model ◽  
Conceptual Models ◽  
A Priori ◽  
Sub Saharan Africa ◽  
Chronic Disease Care ◽  
African Context ◽  
Sub Saharan

Background: Existing chronic care conceptual models were not designed for sub-Saharan Africa, where there is a growing burden of chronic disease. This review provides a qualitative synthesis and new conceptual model for primary care approaches to the integration of chronic communicable and non-communicable disease care in a sub-Saharan African context. Methods: A best fit framework synthesis comprising two systematic reviews, with information retrieved from PubMed, Embase, CINAHL plus, Global Health, and Global Index Medicus databases between 1st and 30th April 2020. Articles on chronic care conceptual models were included if they were developed for application in a primary care context and described a framework for long-term management of chronic disease care, and themes extracted to construct an a priori framework. A second systematic review included articles focussing on integrated HIV and diabetes care at a primary care level in sub-Saharan Africa, with thematic analysis carried out against the a priori framework. A new conceptual model was constructed from a priori themes and new themes. Risk of bias of included studies was assessed using CASP and MMAT. Results: Two conceptual models of chronic disease care, comprising 6 themes, were used to build the a priori framework. The systematic review of primary research identified 12 articles, with all 6 of the a priori framework themes, and 5 new themes identified. A new patient-centred conceptual model for integrated HIV and diabetes care was constructed, specific to a sub-Saharan African context. Discussion: Improving patient access to chronic disease care through implementing decentralised, integrated, affordable and efficient primary care services should be prioritised in sub-Saharan Africa. Services must be acceptable to patients, viewing them as partners, addressing their concerns, and seeking to safeguard confidentiality. Limitations of this study include potential publication bias, and impact of policy environment and economic factors in sub-Saharan Africa.

scholarly journals Impact of Practice Facilitation in Primary Care on Chronic Disease Care Processes and Outcomes: a Systematic Review

2018 ◽  
Vol 33 (11) ◽  
pp. 1968-1977 ◽  
Author(s):  
Andrew Wang ◽  
Teresa Pollack ◽  
Lauren A. Kadziel ◽  
Samuel M. Ross ◽  
Megan McHugh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Disease ◽  
Practice Facilitation ◽  
Chronic Disease Care ◽  
Care Processes

scholarly journals Social, Behavioral, and Cultural factors of HIV in Malawi: Semi-Automated Systematic Review

10.2196/18747 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18747
Author(s):  
Amaury Thiabaud ◽  
Isotta Triulzi ◽  
Erol Orel ◽  
Kali Tal ◽  
Olivia Keiser
Keyword(s):  
Systematic Review ◽  
Open Access ◽  
Hiv Infection ◽  
A Priori ◽  
Sub Saharan Africa ◽  
Topic Modelling ◽  
African Countries ◽  
Comprehensive Overview ◽  
Quantitative Analyses ◽  
Sub Saharan

Background Demographic and sociobehavioral factors are strong drivers of HIV infection rates in sub-Saharan Africa. These factors are often studied in qualitative research but ignored in quantitative analyses. However, they provide in-depth insight into the local behavior and may help to improve HIV prevention. Objective To obtain a comprehensive overview of the sociobehavioral factors influencing HIV prevalence and incidence in Malawi, we systematically reviewed the literature using a newly programmed tool for automatizing part of the systematic review process. Methods Due to the choice of broad search terms (“HIV AND Malawi”), our preliminary search revealed many thousands of articles. We, therefore, developed a Python tool to automatically extract, process, and categorize open-access articles published from January 1, 1987 to October 1, 2019 in the PubMed, PubMed Central, JSTOR, Paperity, and arXiV databases. We then used a topic modelling algorithm to classify and identify publications of interest. Results Our tool extracted 22,709 unique articles; 16,942 could be further processed. After topic modelling, 519 of these were clustered into relevant topics, of which 20 were kept after manual screening. We retrieved 7 more publications after examining the references so that 27 publications were finally included in the review. Reducing the 16,942 articles to 519 potentially relevant articles using the software took 5 days. Several factors contributing to the risk of HIV infection were identified, including religion, gender and relationship dynamics, beliefs, and sociobehavioral attitudes. Conclusions Our software does not replace traditional systematic reviews, but it returns useful results to broad queries of open-access literature in under a week, without a priori knowledge. This produces a “seed dataset” of relevance that could be further developed. It identified known factors and factors that may be specific to Malawi. In the future, we aim to expand the tool by adding more social science databases and applying it to other sub-Saharan African countries.

scholarly journals The efficiency of chronic disease care in sub-Saharan Africa

BMC Medicine ◽  
2016 ◽  
Vol 14 (1) ◽  
Author(s):  
Pascal Geldsetzer ◽  
Katrina Ortblad ◽  
Till Bärnighausen
Keyword(s):  
Chronic Disease ◽  
Sub Saharan Africa ◽  
Chronic Disease Care ◽  
Sub Saharan

scholarly journals Social, Behavioral, and Cultural factors of HIV in Malawi: Semi-Automated Systematic Review (Preprint)

2020 ◽  
Author(s):  
Amaury Thiabaud ◽  
Isotta Triulzi ◽  
Erol Orel ◽  
Kali Tal ◽  
Olivia Keiser
Keyword(s):  
Systematic Review ◽  
Open Access ◽  
Hiv Infection ◽  
A Priori ◽  
Sub Saharan Africa ◽  
Topic Modelling ◽  
African Countries ◽  
Comprehensive Overview ◽  
Quantitative Analyses ◽  
Sub Saharan

BACKGROUND Demographic and sociobehavioral factors are strong drivers of HIV infection rates in sub-Saharan Africa. These factors are often studied in qualitative research but ignored in quantitative analyses. However, they provide in-depth insight into the local behavior and may help to improve HIV prevention. OBJECTIVE To obtain a comprehensive overview of the sociobehavioral factors influencing HIV prevalence and incidence in Malawi, we systematically reviewed the literature using a newly programmed tool for automatizing part of the systematic review process. METHODS Due to the choice of broad search terms (“HIV AND Malawi”), our preliminary search revealed many thousands of articles. We, therefore, developed a Python tool to automatically extract, process, and categorize open-access articles published from January 1, 1987 to October 1, 2019 in the PubMed, PubMed Central, JSTOR, Paperity, and arXiV databases. We then used a topic modelling algorithm to classify and identify publications of interest. RESULTS Our tool extracted 22,709 unique articles; 16,942 could be further processed. After topic modelling, 519 of these were clustered into relevant topics, of which 20 were kept after manual screening. We retrieved 7 more publications after examining the references so that 27 publications were finally included in the review. Reducing the 16,942 articles to 519 potentially relevant articles using the software took 5 days. Several factors contributing to the risk of HIV infection were identified, including religion, gender and relationship dynamics, beliefs, and sociobehavioral attitudes. CONCLUSIONS Our software does not replace traditional systematic reviews, but it returns useful results to broad queries of open-access literature in under a week, without a priori knowledge. This produces a “seed dataset” of relevance that could be further developed. It identified known factors and factors that may be specific to Malawi. In the future, we aim to expand the tool by adding more social science databases and applying it to other sub-Saharan African countries.

scholarly journals Routes to diagnosis of symptomatic cancer in sub-Saharan Africa: systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038605
Author(s):  
Tanimola Martins ◽  
Samuel William David Merriel ◽  
William Hamilton
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Complementary Medicine ◽  
Cancer Diagnosis ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Sub Saharan Africa ◽  
Considerable Proportion ◽  
Care Providers ◽  
Sub Saharan

BackgroundMost cancers in sub-Saharan Africa (SSA) are diagnosed at advanced stages, with limited treatment options and poor outcomes. Part of this may be linked to various events occurring in patients’ journey to diagnosis. Using the model of pathways to treatment, we examined the evidence regarding the routes to cancer diagnosis in SSA.Design and settingsA systematic review of available literature was performed.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Between 30 September and 30 November 2019, seven electronic databases were searched using terms relating to SSA countries, cancer and routes to diagnosis comprising the population, exposure and outcomes, respectively. Citation lists of included studies were manually searched to identify relevant studies. Furthermore, ProQuest Dissertations & Theses Global was searched to identify appropriate grey literature on the subject.Results18 of 5083 references identified met the inclusion criteria: eight focused on breast cancer; three focused on cervical cancer; two each focused on lymphoma, Kaposi’s sarcoma and childhood cancers; and one focused on colorectal cancer. With the exception of Kaposi’s sarcoma, definitive diagnoses were made in tertiary healthcare centres, including teaching and regional hospitals. The majority of participants initially consulted within primary care, although a considerable proportion first used complementary medicine before seeking conventional medical help. The quality of included studies was a major concern, but their findings provided important insight into the pathways to cancer diagnosis in the region.ConclusionThe proportion of patients who initially use complementary medicine in their cancer journey may explain a fraction of advanced-stage diagnosis and poor survival of cancer in SSA. However, further research would be necessary to fully understand the exact role (or activities) of primary care and alternative care providers in patient cancer journeys.

Khat chewing and risky sexual behavior in Sub-Saharan Africa: a systematic review protocol

2013 ◽  
Vol 11 (12) ◽  
pp. 59-67 ◽  
Author(s):  
Amanuel Tesfay Gebremedhin ◽  
Hailay Abrha Gesesew ◽  
Tariku Dejene Demissie ◽  
Mirkuzie Woldie Kerie ◽  
Morankar Sudhakar
Keyword(s):  
Systematic Review ◽  
Sexual Behavior ◽  
Risky Sexual Behavior ◽  
Sub Saharan Africa ◽  
Systematic Review Protocol ◽  
Khat Chewing ◽  
Review Protocol ◽  
Sub Saharan

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

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

scholarly journals Behavioural interventions promoting condom use among female sex workers in sub-Saharan Africa: a systematic review

2017 ◽  
Vol 16 (3) ◽  
pp. 257-268 ◽  
Author(s):  
Uchenna O Okafor ◽  
Rik Crutzen ◽  
Yauri Aduak ◽  
Sylvia Adebajo ◽  
Hubertus W Van den Borne
Keyword(s):  
Systematic Review ◽  
Condom Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Sub Saharan Africa ◽  
Behavioural Interventions ◽  
Female Sex ◽  
Sub Saharan
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