Global prevalence of diabetic retinopathy: protocol for a systematic review and meta-analysis

IntroductionWith increasing diabetes trends worldwide, morbidity, mortality and associated costs due to diabetes-related complications are a global public health concern. Diabetic retinopathy (DR) is among the leading causes of vision loss at the global level; accurate estimates of DR burden is of crucial importance for planning, implementing and evaluating DR prevention and care interventions.The available evidence on DR prevalence at the global level, dating back to 2008, only considered data from selected regions. Taking into account the rapidly changing patterns in DR epidemiology, the aim of the current study is to carry out a systematic review and meta-analysis to derive solid and updated estimates on global and setting-specific DR prevalence.Methods and analysisThe systematic review methods have been defined following PRISMA guidelines. Studies published from 2008 through 2018 will be identified searching the electronic databases Embase, Medline, Cochrane, ISI Web of Knowledge, as well as through grey literature search. Retrieved records will be independently screened by two authors and relevant data will be extracted from studies reporting data on DR prevalence among individuals with diabetes. Prevalence pooled estimates of any form of DR and vision-threatening DR will be computed applying random-effects meta-analysis. Interstudy heterogeneity will be assessed using the I2 statistic and explored through meta regressions and subgroup analyses. Depending on data availability, we plan to conduct subgroup analyses by study population, diabetes type, DR severity, geographical region and other selected clinical and sociodemographic variables of interest. Quality appraisal of the studies will be performed.Ethics and disseminationEthics approval is not required as this is a review of anonymised published data. Findings of the final report will be shared with the scientific community through publication in a peer-reviewed journal and presentation at conferences, as well as with key stakeholders, including national and international health authorities, health policy makers, healthcare professionals and the general population.Clinical trial registrationCRD42018085260.

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Mapping tuberculosis prevalence in Ethiopia: protocol for a geospatial meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034704 ◽

2020 ◽

Vol 10 (5) ◽

pp. e034704

Author(s):

Kefyalew Addis Alene ◽

Zeleke Alebachew Wagaw ◽

Archie C A Clements

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Scientific Journal ◽

Multivariable Analysis ◽

Spatial Prediction ◽

Health Concern ◽

Published Data ◽

Final Report ◽

Prevalence Survey ◽

Prevalence Data

IntroductionTuberculosis (TB), a major public health concern in Ethiopia, is distributed heterogeneously across the country. Mapping TB prevalence at national and subnational levels can provide information for designing and implementing control strategies. Data for spatial analysis can be obtained through systematic review of the literature, and spatial prediction can be done by meta-analysis of published data (geospatial meta-analysis). Geospatial meta-analysis can increase the power of spatial analytic models by making use of all available data. It can also provide a means for spatial prediction where new survey data in a given area are sparse or not available. In this report, we present a protocol for a geospatial meta-analysis to investigate the spatial patterns of TB prevalence in Ethiopia.Methods and analysisTo conduct this study, a national TB prevalence survey, supplemented with data from a systematic review of published reports, will be used as the source of TB prevalence data. Systematic searching will be conducted in PubMed, Scopus and Web of Science for studies published up to 15 April 2020 to identify all potential publications reporting TB prevalence in Ethiopia. Data for covariates for multivariable analysis will be obtained from different, readily available sources. Extracted TB survey and covariate data will be georeferenced to specific locations or the centroids of small administrative areas. A binomial logistic regression model will be fitted to TB prevalence data using both fixed covariate effects and random geostatistical effects based on the approach of model-based geostatistics. Markov Chain Monte Carlo simulation will be conducted to obtained posterior parameter estimations, including spatially predicted prevalence.Ethics and disseminationEthical approval will not be required for this study as it will be based on deidentified, aggregate published data. The final report of this review will be disseminated through publication in a peer-reviewed scientific journal and will also be presented at relevant conferences.

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Prevalence and associated factors of active smoking among individuals living with hypertension and/or diabetes in Africa: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2016-015444 ◽

2017 ◽

Vol 7 (10) ◽

pp. e015444 ◽

Cited By ~ 3

Author(s):

Guy S Wafeu ◽

Aurel T Tankeu ◽

Francky Teddy A Endomba ◽

Jobert Richie Nansseu ◽

Arnaud D Kaze ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Geographic Region ◽

Future Research ◽

P Value ◽

Published Data ◽

Final Report ◽

Active Smoking ◽

Analysis Model ◽

Factors Associated

IntroductionTobacco use significantly increases cardiovascular complications in people living with hypertension and/or diabetes. We aim to summarise data on the prevalence and factors associated with active smoking in these conditions in Africa.Method and analysisWe will search PubMed, Embase, Google Scholar and African Journals Online for relevant abstracts of studies on active smoking in individuals living with diabetes and/or hypertension published from 1 January 2000 to 31 December 2016, with no language restriction. Additionally, relevant unpublished papers and conference proceedings will be checked, as well as references of included articles. Two investigators will independently screen, select studies, extract data and assess the risk of bias in each study. Data will be analysed using Stata software (Stata V.14, Texas, USA). The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate of the prevalence of smoking across studies. Also, we will assess factors associated to smoking. Heterogeneity of studies will be evaluated by the χ2 test on Cochrane’s Q statistic. Funnel plots analysis and Egger’s test will be done to detect publication bias. Results will be presented by geographic region (central, eastern, northern, southern and western Africa). A p value less than 0.05 will be considered significant for factors associated to smoking.Ethics and disseminationThis study is based on published data, and therefore ethical approval is not a requirement. This systematic review and meta-analysis is expected to serve as a basis for designing cost-effective interventions to reduce and prevent smoking in patients with diabetes and/or hypertension, and as a guide for future research based on the remaining gaps. The final report of this study in the form of a scientific paper will be published in peer-reviewed journals. Findings will further be presented at conferences and submitted to relevant health authorities.

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Prevalence of respiratory bacterial infections in people with lower respiratory tract infections in Africa: the BARIAFRICA systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2018-023592 ◽

2018 ◽

Vol 8 (9) ◽

pp. e023592

Author(s):

Serges Tchatchouang ◽

Jean Joel Bigna ◽

Ariane Nzouankeu ◽

Marie-Christine Fonkoua ◽

Jobert Richie Nansseu ◽

...

Keyword(s):

Systematic Review ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Bacterial Infections ◽

Respiratory Tract Infections ◽

Meta Analysis ◽

Health Concern ◽

Published Data ◽

Lower Respiratory Tract Infections ◽

Tract Infections

IntroductionThe burden of lower respiratory tract infections (LRTIs) is a substantial public health concern. However, the epidemiology of LRTI and its bacterial aetiologies are poorly characterised, particularly in the African continent. Providing accurate data can help design cost-effective interventions to curb the burden of respiratory infections in Africa. Therefore, the aim of this systematic review and meta-analysis will be to determine the prevalence of respiratory Bacterial Aetiologies in people with low Respiratory tract Infections in Africa (BARIAFRICA) and associated factors.Methods and analysisWe will search PubMed, EMBASE, Web of Science, African Journals Online, Cumulative Index to Nursing and Allied Health Literature, and Global Index Medicus to identify studies that reported the prevalence (of enough data to compute this estimate) of respiratory bacterial infections in people with LRTIs in Africa from 1 January 2000 to 31 March 2018, without any linguistic restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently by two investigators. Heterogeneity will be evaluated using the χ² test on Cochran’s Q statistic and quantified with H and I² statistics. Prevalence will be pooled using a random-effect meta-analysis model. Subgroup and meta-regression analyses will be used to identify sources of heterogeneity of prevalence estimates. This study will be reported according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationSince this study will be based on published data, it does not require ethical approval. This systematic review and meta-analysis is intended to serve as a basis for determining the burden of LRTIs, for identifying data gaps and for guiding future investigations in Africa. The final report will be published in peer-reviewed journals, presented in conferences and submitted to relevant health policy makers.PROSPERO registration numberCRD42018092359.

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Neuroimaging of headaches in patients with normal neurological examination: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-020190 ◽

2018 ◽

Vol 8 (2) ◽

pp. e020190 ◽

Cited By ~ 1

Author(s):

Bernold Kenteu ◽

Yannick F Fogang ◽

Ulrich Flore Nyaga ◽

Joseline G Zafack ◽

Jean Jacques Noubiap ◽

...

Keyword(s):

Systematic Review ◽

Neurological Examination ◽

Incidental Findings ◽

Visual Analysis ◽

Data Extraction ◽

Meta Analysis ◽

Published Data ◽

Final Report ◽

Standard Data ◽

Ethical Approval

IntroductionHeadache disorders (HD) are among the most frequent neurological disorders seen in neurology practice. Because secondary HD are rare, patients’ examination is most often unremarkable. However, the will to relieve patients’ anxiety and the fear of prosecutions lead to overuse of neuroimaging thus resulting in the discovery of incidental findings (IF) or normal variants that can lead to futile or harmful procedures. Knowing the probability of identifying a potentially clinically significant lesion in patients with isolated headache could facilitate decision-making and reduce health costs. This review aims to determine the prevalence of incidental findings and normal anatomic variants (NAV) on neuroimaging studies performed in patients presenting with headache and normal neurological examination.Method and analysisStudies reporting neuroimaging findings in patients with headache and normal neurological examination and published before the 30 September 2017 will be identified by searching PubMed, Medline and EMBASE (Excerpta Medica Database). Relevant unpublished papers and conference proceedings will also be checked. Full texts of eligible studies will then be accessed and data extracted using a standard data extraction sheet. Studies will be assessed for quality and risk of bias. Heterogeneity of studies will be evaluated by the χ2test on Cochrane’s Q statistic. The prevalence of NAV and IF across studies and in relevant subgroups will be estimated by pooling the study-specific estimates using a random-effects meta-analysis. Visual analysis of funnel plot and Egger’s test will be used to detect publication bias. The report of this systematic review will be compliant with the Meta-analysis of Observational Studies in Epidemiology guidelines.Ethics and disseminationThe current study is based on published data; ethical approval is, therefore, not required. The final report of this systematic review will be published in a peer-reviewed journal. Furthermore, findings will be presented at conferences and submitted to relevant health authorities.Trial registration numberCRD42017079714.

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Clinical efficacy and security of glycyrrhizic acid preparation in the treatment of anti-SARS-CoV-2 drug-induced liver injury: a protocol of systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-051484 ◽

2021 ◽

Vol 11 (7) ◽

pp. e051484

Author(s):

Xia Tian ◽

Wenfan Gan ◽

Yisen Nie ◽

Rongtao Ying ◽

Yongji Tan ◽

...

Keyword(s):

Systematic Review ◽

Liver Injury ◽

Systematic Reviews ◽

Glycyrrhizic Acid ◽

Data Availability ◽

Final Report ◽

Supporting Evidence ◽

Drug Induced ◽

Drug Induced Liver Injury ◽

Subgroup Analyses

IntroductionCOVID-19 is a highly infectious acute pneumonia. Glycyrrhizic acid preparation (GAP) has been found to have hepatoprotective and antiviral effects, but there is no supporting evidence on its efficacy and security for patients with COVID-19.Methods and analysisThe systematic review methods will be defined by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This study will start on 1 July 2021 and end on 31 October 2021. A comprehensive electronic search will be conducted with the search of Web of Science, PubMed, Ovid web, China National Knowledge Infrastructure, Chinese Scientific and Journal Database, Wanfang Database and grey literature, and manual search will be conducted to search literature of randomised controlled trials, single-arm trials and retrospective studies about GAP in the treatment of anti-SARS-CoV-2 drug-induced liver injury from 1 December 2019 to 1 July 2021. There is no time limitations of publication and language will be restricted to Chinese and English. Retrieved studies will be independently screened by two researchers and relevant data will be extracted from studies. Interstudy heterogeneity will be assessed using the I2 statistic and explored through meta-regressions and subgroup analyses. Depending on data availability, we plan to conduct subgroup analyses by study population, geographical region and other selected clinical variables of interest. Quality assessment of the studies will be performed. Cochrane Handbook for Systematic Reviews of Interventions will be used to assess the risk of bias, and Grading of Recommendations Assessment, Development and Evaluation will be used to access the confidence in cumulative evidence.Ethics and disseminationEthical approval will not be required for no primary data of individual patients will be collected. The final report will be shared with the scientific community through publication in a peer-reviewed journal, as well as with key stakeholders, including patients, healthcare professionals and those working on COVID-19 research.PROSPERO registration numberCRD42021234647.

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Prevalence of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Ethiopia: A Systematic Review and Meta-Analysis

International Journal of Microbiology ◽

10.1155/2021/6669778 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Teklehaimanot Kiros ◽

Lema Workineh ◽

Tegenaw Tiruneh ◽

Tahir Eyayu ◽

Shewaneh Damtie ◽

...

Keyword(s):

Systematic Review ◽

Outcome Measures ◽

Literature Search ◽

Meta Analysis ◽

Health Concern ◽

Cochrane Library ◽

Clinical Samples ◽

Published Data ◽

Extended Spectrum ◽

Pooled Prevalence

Background. Antimicrobial resistance especially caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) has become a global public health concern. Globally, these isolates have remained the most important causes of several infections and associated mortality. Their rapid spread in Ethiopia is associated with a lack of regular surveillance and antibiotic stewardship programs. Isolates of ESBL-PE from different regions of Ethiopia were searched exhaustively. However, published data regarding the pooled estimate of ESBL-PE are not conducted in Ethiopia. For this reason, we systematically reviewed laboratory-based studies to summarize the overall pooled prevalence of the isolates recovered from various human specimens. Methods. An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley Online Library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA follow diagram. Data extraction form was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at 95% confidence interval was performed using Der-Simonian-Laird’s random-effects model. Finally, results were presented via text, figures, and tables. Results. A comprehensive electronic database literature search has yielded a total of 86 articles. Among the total, 68 original articles were excluded after the review process. A total of 18 studies with 1191 bacterial isolates recovered from 7919 various clinical samples sizes were included for systematic review and meta-analysis. In this study, the pooled prevalence of ESBL-PE was 18% (95% CI: 9–26). Nine out of the total (50%) reviewed articles were studied using the combination disk test. Likewise, E. coli and K. pneumoniae (50% both) were the predominant isolates of ESBL-PE in addition to other isolates such as Salmonella spp. and Shigella spp. Conclusion. This meta-analysis has shown a low pooled estimate of ESBL-PE in Ethiopia.

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A systematic review and meta-analysis of the prevalence, trends and spatiotemporal distribution of HIV/AIDS infection in Northern African countries.

10.21203/rs.3.rs-67533/v1 ◽

2020 ◽

Author(s):

Mohamed A Daw ◽

Nadia E.M. Sifennasr ◽

Abdallah El-Bouzedi ◽

Mohamed O Ahmed

Keyword(s):

Systematic Review ◽

Hiv Infection ◽

Meta Analysis ◽

Vulnerable Groups ◽

Health Concern ◽

Published Data ◽

Human Immune Deficiency Virus ◽

African Countries ◽

Subtype B ◽

Hiv Aids

Abstract Background: Human immune deficiency virus (HIV) infection is a major global public health concern. Northern African countries carry a disproportionate burden of HIV, accounting for one of the highest prevalences in Africa. Here in, we sought to analyze the epidemiological characterization and spatial trends of HIV infection in the Northern African region.Methods: A systematic review was carried out on all the published data regarding HIV/AIDS in Northern African countries over a ten year period ( 2008-2017) following the PRISMA guidelines. We performed a comprehensive literature search using Medline PubMed, Embase, regional and international databases, and country-level reports were searched with no language restriction. The quality, quantity, and geographic coverage of the data were assessed at both the country and region levels. We used random-effects methods, spatial variables and stratified results by demographic factors. Only original data for the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.Results: A total of 721 records were identified by our data search , and only 41 that met our criteria were included in the meta-analysis during the study period. There was a considerable variability in the prevalence estimates of HIV within the countries of the region. The overall prevalence of HIV in northern African countries ranged from 0.9% (95% CI (0.8–1.27) to 3.8% (95% CI (1.17-6 .53)). The highest prevalence was associated with vulnerable groups, particularly drug abusers and sexual promiscuity. Dense HIV clustering was also reported during the study period, varying from one country to another. At least 13 HIV subtypes and recombinant forms were prevalent in the region. Subtype B was the most common variant , followed by CRF02_AG.Conclusion: This comprehensive review indicated that HIV infection in Northern African countries is an emerging threat. Effective strategies are needed both at national and regional levels to improve monitoring and controlling the transmission of HIV with a particular emphasis on geographic variability and HIV clustering.

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Contemporary occurrence and aetiology of chronic leg ulcers in Africa: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2018-026868 ◽

2019 ◽

Vol 9 (5) ◽

pp. e026868 ◽

Cited By ~ 1

Author(s):

Celestin Danwang ◽

Joel Noutakdie Tochie ◽

Temgoua Ngou Mazou ◽

Rolf Nyah Tuku Nzalie ◽

Jean Joel Bigna

Keyword(s):

Systematic Review ◽

Global Economy ◽

Meta Analysis ◽

Grey Literature ◽

Case Series ◽

Published Data ◽

Leg Ulcers ◽

Cross Sectional ◽

Language Restriction ◽

Chronic Leg Ulcers

IntroductionChronic leg ulcers are known as a major and snowballing threat to public health and the global economy. In Africa, there is controversy on the dearth of studies reporting the epidemiology of chronic leg ulcers. The present systematic review and meta-analysis aim at synthesising the prevalence, incidence and aetiologies of this ailment in this continent from contemporary data.Methods and designWe will include cohort studies, case–control, cross-sectional studies and case series with more than 30 participants. Electronical databases including African Journals Online, MEDLINE, Excerpta Medica Database and Web of knowledge, and grey literature will be searched for relevant abstracts of studies published and unpublished between 1 January, 2000, and 28 February, 2019, without language restriction. The review will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Each study included in this review will be assessed for methodological quality. Clinically homogenous studies will be pooled using random-effects meta-analysis. Visual inspection of funnel-plots and the Egger’s test will be used to investigate publication bias. Meta-regression and subgroup analyses will be performed to investigate the possible sources of heterogeneity.Ethics and disseminationThe present study will be based on published data; therefore, ethical approval is not required. Result of the review will be presented at conferences, to relevant health authorities and will be published in a biomedical peer-reviewed journal.Protocol registration numberCRD42018108250.

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Do insomnia and/or sleep disturbances predict the onset, relapse or worsening of depression in community and clinical samples of children and youth? Protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034606 ◽

2020 ◽

Vol 10 (8) ◽

pp. e034606

Author(s):

Cecilia Marino ◽

Brendan Andrade ◽

Madison Aitken ◽

Sarah Bonato ◽

John D Haltigan ◽

...

Keyword(s):

Systematic Review ◽

Sleep Disturbances ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Random Effect ◽

Children And Youth ◽

Clinical Samples ◽

Forest Plot ◽

Published Data

IntroductionDisturbed sleep represents a potentially important modifiable risk factor for the development of depression in children and youth. This protocol for a systematic review proposes to investigate whether insomnia and/or sleep disturbances predict child and youth depression in community and clinical-based samples.Methods and analysisThe protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. English-written, longitudinal studies that quantitatively estimated the prediction of depression by insomnia and/or sleep disturbances in individuals 5–24 years of age will be included. EMBASE, MEDLINE, PsychINFO, Scopus and Web of Science and grey literature will be searched from 1980 to the present. For the selection of studies, two reviewers will be involved. Data extraction will be conducted by one author and checked independently by a second author. Risk of bias will be appraised using the Research Triangle Institute Item Bank tool. Heterogeneity will be measured using the I2 statistics. Meta-analysis will be carried out if ≥3 results are available and if outcome measures can be pooled. The choice between a random-effect or fixed-effect model will be based both on the I2 statistics and the participant and study characteristics of the combined studies. Results of the meta-analyses will be summarised by a forest plot. Analyses will be performed in subgroups stratified by key variables defined depending on the amount and type of information retrieved.A narrative synthesis will be conducted in place of the meta-analysis should the pooling of data not be possible. Quality of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation guidelines.As this is a protocol for systematic review and meta-analysis of published data, ethics review and approval are not required. The findings will be published in a peer-reviewed journal and disseminated at scientific conferences and in patient advocacy organisations.PROSPERO registration numberCRD42019136729.

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Risk of venous thromboembolism in patients undergoing gastric cancer surgery: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-033267 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033267

Author(s):

Dengfeng Wang ◽

Yang Yu ◽

Pengxian Tao ◽

Dan Wang ◽

Yajing Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Venous Thromboembolism ◽

Evaluation Method ◽

Clinical Decision Making ◽

Meta Analysis ◽

Cancer Surgery ◽

Published Data ◽

Gastric Cancer Surgery ◽

Positive Prevention

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication in patients with gastric cancer. Abnormal coagulation function and tumour-related treatment may contribute to the occurrence of VTE. Many guidelines considered that surgical treatment would put patients with cancer at high risk of VTE, so positive prevention is needed. However, there are no studies that have systematically reviewed the postoperative risk and distribution of VTE in patients with gastric cancer. We thus conduct this systematic review to determine the risk of VTE in patients with gastric cancer undergoing surgery and provide some evidence for clinical decision-making.Methods and analysisStudies reporting the incidence of VTE after gastric cancer surgery will be included. Primary studies of randomised controlled trials, cohort studies, population-based surveys and cross-sectional studies are eligible for this review and only studies published in Chinese and English will be included. We will search the Medline, Embase, Web of Science, CBM, CNKI and Wanfang data from their inception to November 2019. Two reviewers will independently select studies and extract data. The quality of each included study will be assessed with tools corresponding to their study design. Meta-analysis will be used to pool the incidence data from included studies. Heterogeneity of the estimates across studies will be assessed, if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus ethical approval is not required. The results of this review will be sought for publication.PROSPERO registration numberCRD42019144562

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