Epidemiology and aetiologies of cryptococcal meningitis in Africa, 1950–2017: protocol for a systematic review

IntroductionCryptococcal meningitis is a neglected disease and an AIDS-defining illness, responsible for 15% of all AIDS-related deaths globally. In 2014, the estimated number of incident cryptococcal meningitis cases was 223 100, with 73% of them occurring in Africa. Currently available data on the prevalence, incidence, aetiologies and mortality of cryptococcal meningitis across Africa are sparse and of limited quality. We propose to conduct the first systematic review to summarise the epidemiological data available on cryptococcal meningitis and its aetiological causes in Africa.Methods and analysisWe will search PubMed, MEDLINE, Excerpta Medica Database, ISI Web of Science, Africa Index Medicus, Cumulative Index to Nursing and Allied Health for studies on cryptococcal meningitis published between 1st January 1950 and 31st December 2017, involving adults and/or children residing in Africa. After study selection, full text paper acquisition and data extraction, we will use validated tools and checklists to assess the quality of reporting and risk of bias for each study. Heterogeneity across studies will be assessed using the χ2test on Cochrane’s Q statistic and a random effect meta-analysis will be used to estimate the overall prevalence, incidence density and mortality of cryptococcal meningitis across studies with similar characteristics. This protocol is prepared and presented in accordance with the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Reporting of the results will be compliant with the Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) guidelines.Ethics and disseminationThere is no requirement for ethical approval since we will be using data from published studies. The final report will be published in a peer-reviewed journal and further presented at conferences. This study is expected to provide useful contextual estimates needed to inform treatment policies on the African continent and assess the impact of diagnostic and prevention strategies on the burden of cryptococcal meningitis in the post antiretroviral therapy era.PROSPERO registration numberCRD42017081312.

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Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2019-031402 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031402 ◽

Cited By ~ 1

Author(s):

Philippe Armel Awana ◽

Celestin Danwang ◽

Joel Noutakdie Tochie ◽

Jean Joel Bigna

Keyword(s):

Systematic Review ◽

Venous Thromboembolism ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Active Tuberculosis ◽

Primary Data ◽

Final Report ◽

Cross Sectional ◽

Statistical Heterogeneity

IntroductionIn recent years, a hypothesis has been raised that people with tuberculosis are at risk for developing venous thromboembolism (VTE). However, much remains to be understood about the interplay between VTE and tuberculosis. Therefore, through a global systematic review and meta-analysis, the current study aims at investigating the association between exposure to active tuberculosis and risk of VTE, and determining the prevalence and incidence of VTE in people with active tuberculosis.Methods and designWe will include cohort studies, case–control and cross-sectional studies performed among adults (>15 years) with active tuberculosis. EMBASE, Medline, Global Index Medicus and Web of Knowledge will be searched for relevant records published until 31 August 2019, without any language restriction. The review will be reported according to the Meta-analysis Of Observational Studies in Epidemiology guidelines. After screening of titles and abstracts, study selection, data extraction and risk of bias assessment; we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Egger’s test and visual inspection of funnel plots will be used to assess publication bias. Results will be presented by country and region.Ethics and disseminationSince primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the epidemiology of VTE in people with tuberculosis. The final report will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019130347.

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Misuse of medication in adult substance misuse services: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-047283 ◽

2021 ◽

Vol 11 (6) ◽

pp. e047283

Author(s):

Rosalind Gittins ◽

Louise Missen ◽

Ian Maidment

Keyword(s):

Systematic Review ◽

Substance Misuse ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Opioid Analgesics ◽

Physical And Mental Health ◽

Qualitative Synthesis ◽

Treatment Services ◽

The Impact

IntroductionThere is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol outlines how a systematic review will be undertaken (during June 2021), which aims to examine the literature on the pattern of OTC and POM misuse among adults who are accessing substance misuse treatment services. It will include the types of medication being taken, prevalence and demographic characteristics of people who access treatment services.Methods and analysisAn electronic search will be conducted on the Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases as well as grey literature. Two independent reviewers will conduct the initial title and abstract screenings, using predetermined criteria for inclusion and exclusion. If selected for inclusion, full-text data extraction will be conducted using a pilot-tested data extraction form. A third reviewer will resolve disagreements if consensus cannot be reached. Quality and risk of bias assessment will be conducted for all included studies. A qualitative synthesis and summary of the data will be provided. If possible, a meta-analysis with heterogeneity calculation will be conducted; otherwise, Synthesis Without Meta-analysis will be undertaken for quantitative data. The reporting of this protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationEthical approval is not required. Findings will be peer reviewed, published and shared verbally, electronically and in print, with interested clinicians and policymakers.PROSPERO registration numberCRD42020135216.

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The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

Dysphagia ◽

10.1007/s00455-019-10066-1 ◽

2019 ◽

Vol 35 (5) ◽

pp. 745-761 ◽

Cited By ~ 4

Author(s):

Sana Smaoui ◽

Amy Langridge ◽

Catriona M. Steele

Keyword(s):

Systematic Review ◽

Resistance Training ◽

Data Extraction ◽

Meta Analysis ◽

Quality Data ◽

Tongue Pressure ◽

Swallowing Function ◽

Temporal Measures ◽

The Impact ◽

Training Protocols

Abstract Lingual resistance training has been proposed as an intervention to improve decreased tongue pressure strength and endurance in patients with dysphagia. However, little is known about the impact of lingual resistance training on swallow physiology. This systematic review scrutinizes the available evidence regarding the effects of lingual resistance training on swallowing function in studies using Videofluoroscopic Swallowing Studies (VFSS) with adults. Seven articles met the inclusion criteria and underwent detailed review for study quality, data extraction, and planned meta-analysis. Included studies applied this intervention to a stroke and brain injury patient populations or to healthy participants, applied different training protocols, and used a number of outcome measures, making it difficult to generalize results. Lingual resistance training protocols included anterior and posterior tongue strengthening, accuracy training, and effortful press against hard palate with varying treatment durations. VFSS protocols typically included a thin barium stimulus along with one other consistency to evaluate the effects of the intervention. Swallowing measures included swallow safety, efficiency, and temporal measures. Temporal measures significantly improved in one study, while safety improvements showed mixed results across studies. Reported improvements in swallowing efficiency were limited to reductions in thin liquid barium residue in two studies. Overall, the evidence regarding the impact of lingual resistance training for dysphagia is mixed. Meta-analysis was not possible due to differences in methods and outcome measurements across studies. Reporting all aspects of training and details regarding VFSS protocols is crucial for the reproducibility of these interventions. Future investigations should focus on completing robust analyses of swallowing kinematics and function following tongue pressure training to determine efficacy for swallowing function.

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How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-028280 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028280 ◽

Cited By ~ 20

Author(s):

Jan B. Schmutz ◽

Laurenz L. Meier ◽

Tanja Manser

Keyword(s):

Systematic Review ◽

Clinical Performance ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Performance Measure ◽

Task Type ◽

Eligibility Criteria ◽

Expert Rating ◽

The Relationship

ObjectivesTo investigate the relationship between teamwork and clinical performance and potential moderating variables of this relationship.DesignSystematic review and meta-analysis.Data sourcePubMed was searched in June 2018 without a limit on the date of publication. Additional literature was selected through a manual backward search of relevant reviews, manual backward and forward search of studies included in the meta-analysis and contacting of selected authors via email.Eligibility criteriaStudies were included if they reported a relationship between a teamwork process (eg, coordination, non-technical skills) and a performance measure (eg, checklist based expert rating, errors) in an acute care setting.Data extraction and synthesisModerator variables (ie, professional composition, team familiarity, average team size, task type, patient realism and type of performance measure) were coded and random-effect models were estimated. Two investigators independently extracted information on study characteristics in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsThe review identified 2002 articles of which 31 were included in the meta-analysis comprising 1390 teams. The sample-sized weighted mean correlation wasr=0.28 (corresponding to an OR of 2.8), indicating that teamwork is positively related to performance. The test of moderators was not significant, suggesting that the examined factors did not influence the average effect of teamwork on performance.ConclusionTeamwork has a medium-sized effect on performance. The analysis of moderators illustrated that teamwork relates to performance regardless of characteristics of the team or task. Therefore, healthcare organisations should recognise the value of teamwork and emphasise approaches that maintain and improve teamwork for the benefit of their patients.

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Epidemiology of gastric cancer in Africa: a systematic review and meta-analysis protocol

Systematic Reviews ◽

10.1186/s13643-019-1214-2 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Celestin Danwang ◽

Jean Joel Bigna

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Case Series ◽

Case Fatality ◽

Cross Sectional ◽

Statistical Heterogeneity ◽

The Usa

Abstract Background Gastric cancer is actually known as the sixth most frequent cancer and the second cancer-related cause of death worldwide. If studies giving an overview of current epidemiology of gastric cancer in Europe, Asia, and the USA are available, in Africa, studies reporting recent data on gastric cancer are sparse. This systematic review and meta-analysis aim therefore to provide relevant data on contemporary epidemiology of gastric cancer in Africa in terms of prevalence, incidence, and case fatality rate. Methods and design We will include cohort, case-control, cross-sectional studies, and case series with more than 30 participants. EMBASE, PubMed, Africa Index Medicus, Africa Journals Online, and Web of Science will be searched for relevant abstracts of studies published and unpublished between January 1, 2000, and April 30, 2019, without language restriction. The review will be reported according to the MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guideline. After screening of abstracts, study selection, data extraction, and risk of bias assessment, we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Egger test and visual inspection of funnel plots will be used to assess publication bias. Discussion This review will provide relevant data on the current burden of gastric cancer in Africa. Systematic review registration PROSPERO CRD42019130348.

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Efficacy of Modern Diabetes Treatments- Dpp-4i, Sglt-2i, Glp-1ra- in White and Asian Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

10.2337/figshare.12003276.v1 ◽

2020 ◽

Author(s):

Sushrima Gan1 ◽

Adem Y Dawed ◽

Louise A Donnelly ◽

ATN Nair ◽

Colin NA Palmer ◽

...

Keyword(s):

Systematic Review ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Meta Analysis ◽

Controlled Trials ◽

Glucose Lowering ◽

Asian Ethnicity ◽

Mesh Terms ◽

Oral Agents ◽

The Impact

Background and Purpose:The pathophysiology of Type 2 diabetes differs markedly by ethnicity. A systematic review and meta-analysis was conducted to assess the impact of ethnicity on the glucose lowering efficacy of the newer oral agents, SGLT-2is, GLP-1RAs and DPP-4is, using evidence from randomized clinical trials (RCTs). Data Sources:A literature search was conducted in PubMed of all randomized, placebo-controlled trials of DPP-4 inhibitors, SGLT-2 inhibitors and GLP-1RA. The search strategy was developed based on medical subject sub-headings (MeSH) terms and keywords. Study selection : 64 studies qualified for meta-analysis after full-text review based on pre-defined inclusion and exclusion criteria. RCTs with at least 50 patients in each arm; >70% of population from Asian or White group; duration>=24 weeks; published up to March 2019 were selected for systematic review and meta-analysis. Data extraction:Data extraction was done for aggregated study-level data , by two independent researchers. Absolute changes in HbA1c (%) from baseline to 24 weeks between the drug and placebo was considered as the primary endpoint of the study. Data synthesis: Change in HbA1c was evaluated by computing mean differences (MDs) and 95% confidence intervals (CI) between treatment and placebo arms. Limitations: Study is based on summarized data and could not be separated based on East Asians and South Asians. Conclusion : The glucose lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared to studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA.

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Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: A systematic review and meta-analysis protocol

HRB Open Research ◽

10.12688/hrbopenres.12827.1 ◽

2018 ◽

Vol 1 ◽

pp. 15

Author(s):

Nicla Manzari ◽

Karen Matvienko-Sikar ◽

Franco Baldoni ◽

Gerard W. O'Keeffe ◽

Ali S. Khashan

Keyword(s):

Systematic Review ◽

Maternal Stress ◽

Data Extraction ◽

Meta Analysis ◽

Autism Spectrum ◽

Prenatal Maternal Stress ◽

Cross Sectional ◽

Increased Risk ◽

Meta Analyses ◽

The Impact

Background: Prenatal maternal stress (PNMS) is defined as the experience of significant levels of prenatal stress, depression or anxiety during pregnancy. PNMS has been associated with increased risk of autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in exposed offspring. However, these findings are inconsistent and other studies found no association, meaning a clear consensus on the impact of PNMS on ASD and ADHD risk is required. The purpose of this systematic review and meta-analysis is to summarize and critically review the existing literature on the effects of PNMS on ASD and ADHD risk. Methods: Electronic databases (PubMed, PsycINFO, Web of Science, Scopus and EMBASE) will be searched for articles following a detailed search strategy. We will include cohort, case-control and cross-sectional studies that assessed maternal exposure to psychological and/or environmental stress and had ASD or ADHD as an outcome. Two reviewers will independently screen the titles, abstracts and full articles to identify eligible studies. We will use a standardised data extraction form for extracting data and a bias classification tool for assessing study quality. This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The generic inverse variance method will be used if possible to perform meta-analyses. Ethics and dissemination: Ethical approval is not required for this study because it will not involve the conduct or inclusion of any experimental or personal data that would require informed consent. The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018084222.

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Efficacy of Modern Diabetes Treatments- Dpp-4i, Sglt-2i, Glp-1ra- in White and Asian Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

10.2337/figshare.12003276 ◽

2020 ◽

Author(s):

Sushrima Gan1 ◽

Adem Y Dawed ◽

Louise A Donnelly ◽

ATN Nair ◽

Colin NA Palmer ◽

...

Keyword(s):

Systematic Review ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Meta Analysis ◽

Controlled Trials ◽

Glucose Lowering ◽

Asian Ethnicity ◽

Mesh Terms ◽

Oral Agents ◽

The Impact

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Prevalence of multimorbid degenerative lumbar spinal stenosis with knee and/or hip osteoarthritis: protocol for a systematic review and meta-analysis

10.21203/rs.3.rs-20819/v2 ◽

2020 ◽

Author(s):

James J. Young ◽

Jan Hartvigsen ◽

Rikke K. Jensen ◽

Ewa M. Roos ◽

Carlo Ammendolia ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Hip Osteoarthritis ◽

Healthcare Setting ◽

Risk Of Bias ◽

Sample Population ◽

Case Definitions ◽

Prevalence Estimates ◽

The Impact

Abstract Background: Lumbar spinal stenosis (LSS) and knee and hip osteoarthritis (OA) are prevalent conditions in the aging population and published literature suggests they share many symptoms and often are present at the same time in patients. However, no prevalence estimates of multimorbid LSS and knee and/or hip OA are currently available. The primary objective of this systematic review is therefore to estimate the prevalence of multimorbid LSS with knee and/or hip OA using radiological, clinical, and combined case definitions. Methods: This systematic review protocol has been designed according to the guidelines from the Cochrane Collaboration and are reported according the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A comprehensive search will be performed in the following databases: MEDLINE, EMBASE, CENTRAL, and CINAHL. Forward citation tracking will be performed in Web of Science. No restriction for publication data and language will be applied in the literature search, but only articles in English will be included. The search strategy will include the following domains: LSS, knee OA, and hip OA. Retrieved citations will be screened by two authors independently. Disagreements will be discussed until consensus, and a third reviewer will be consulted if consensus cannot be reached. Data extraction and assessment of methodological quality will be done by two authors independently, using a standardized data extraction form and a modified Risk of Bias Tool for Prevalence studies. Meta-analysis estimating prevalence with 95% CI will be performed using a random effects model. Meta-regression analyses will be performed to investigate the impact of the following covariates: LSS clinical presentations, sample population, healthcare setting, risk of bias, and other patient characteristics on prevalence estimates for multimorbid LSS and knee and/or hip OA.Discussion: The results of this review will provide the first estimates of the prevalence of multimorbid LSS and hip and knee OA based on various case definitions. The impact of covariates such as LSS clinical presentations, sample population, healthcare setting, risk of bias, and patient characteristics on prevalence estimates will also be presented. Systematic review registration: Submitted to PROSPERO, awaiting registration

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Prevalence, awareness and control of hypertension in Malaysia 1980 – 2017: A Systematic Review and Meta-Analysis

10.1101/625004 ◽

2019 ◽

Author(s):

Zhen Yee Chow ◽

Soo Man Jun ◽

Siew Mooi Ching ◽

Chun Han Tan ◽

Kai Wei Lee ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Public Health Problem ◽

High Morbidity ◽

Hypertension Status ◽

Increased Risk ◽

And Control

AbstractBackgroundHypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there is no systematic review and meta-analysis that has been done in a multi-ethnic population like Malaysia. This systematic review aims to determine the trend in prevalence, awareness and control of hypertension in Malaysia.MethodsSystematic searches were conducted in PubMed, Scopus, Ovid, Cumulative Index to Nursing and Allied Health Literature, Malaysian Medical Repository and Malaysia Citation Index published between 1980 and 2017. All original articles in English were included. Studies included were those on adults aged 18 years and above. Studies of prevalence in children and adolescents and pregnancy related hypertension were excluded. Two authors independently reviewed the studies, carried out data extraction and performed quality assessment. Heterogeneity between studies and publication bias was assessed and effect size was pooled by the random effect model.ResultsFifty-six studies with a total of 241,796 subjects were included. The prevalence of hypertension throughout Malaysia varied (I2= 99.3%). The overall pooled prevalence of hypertension over the past 4 decades was 28.2% in adults aged 18 years and older (95% CI: 26.1 – 33.3) and the prevalence in those 30 years and older was 40.0% (95% CI: 35.3-44.8).For subgroup analysis, the prevalence of hypertension in male aged 18 and above was 31.4% (95% CI: 26.5 - 36.2) and 27.8% in female (95% CI: 20.7 – 34.9). The prevalence of hypertension among the ethnic groups aged 18 years and above were 37.3% in Malays (95% CI: 32.9 – 41.7); 36.4% in Chinese (95% CI 31.6 - 41.2) and 34.8% in Indians (95% CI: 31.2-38.4). The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% CI: 13.4-19.0%), increases up to 36.8% in the 1990s (95% CI: 6.1-67.5), then came down to 28.7% (95% CI: 21.7-35.8) in the 2000s and 29.2% (95% CI: 24.0-34.4) in the 2010s. The prevalence of awareness was 38.7% (95% CI: 31.7 – 45.8) whereas the control of hypertension of those on treatment was 33.3% (95% CI: 28.4 – 38.2).ConclusionThree in 10 adults aged 18 years old and above have hypertension, whereas four in 10 adults aged 30 years old and above have hypertension. Four out of 10 are aware of their hypertension status and only one-third of them who were under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve the awareness and control of hypertension should be of high priority.

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