scholarly journals Delayed diagnosis and treatment of pulmonary tuberculosis in high-burden countries: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029807 ◽  
Author(s):  
Alvin Kuo Jing Teo ◽  
Shweta R Singh ◽  
Kiesha Prem ◽  
Li Yang Hsu ◽  
Siyan Yi
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Delayed Diagnosis ◽  
Diagnosis And Treatment ◽  
Current Evidence ◽  
Future Research ◽  
Published Data ◽  
Chi Square ◽  
High Burden ◽  
Qualitative Thematic Analysis

IntroductionCountries identified to bear the highest tuberculosis (TB) incidence account for approximately 85% of the global TB burden. TB is curable, yet nearly 40% of TB cases remained undiagnosed hence delaying treatment and perpetuating transmission. This systematic review aimed to review current evidence on factors associated with delayed diagnosis and treatment of TB in the high TB-burden countries.Methods and analysisThis systematic review will incorporate qualitative and observational study designs published between 2008 and 2018. Articles will be retrieved from major databases including PubMed, EMBASE, CINAHL and PsycINFO. Reference lists of key articles, including relevant systematic reviews and meta-analysis, will be screened for additional studies. Two independent reviewers will screen and select studies, extract data and assess the quality and risk of bias of each study. Study-specific estimates will be pooled by meta-analysis, and effect sizes will be presented as OR and their 95% CI. Levels of heterogeneity will be evaluated using chi-square statistic Q and I2. Publication bias will be assessed using forest plots and Egger’s tests. Qualitative findings and sample quotes will be extracted. Textual references to the topics of interest will be retrieved and categorised using qualitative thematic analysis. We will triangulate quantitative and qualitative findings for a complete understanding of the reasons for delayed TB diagnosis and treatment. Results will be presented by geographical region.Ethics and disseminationThis study will be conducted based on published data. This systematic review may provide insights into the reasons for delayed TB diagnosis in high-burden countries. These findings will also inform future research and key stakeholders in developing interventions to reach these undiagnosed cases effectively. Findings from this review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018107237

scholarly journals Duration and determinants of delayed tuberculosis diagnosis and treatment in high-burden countries: a mixed-methods systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alvin Kuo Jing Teo ◽  
Shweta R. Singh ◽  
Kiesha Prem ◽  
Li Yang Hsu ◽  
Siyan Yi
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Median Duration ◽  
Meta Analysis ◽  
Delayed Diagnosis ◽  
Patient Delay ◽  
Diagnosis And Treatment ◽  
Middle Income ◽  
High Burden ◽  
Middle Income Countries

Abstract Background Thirty countries with the highest tuberculosis (TB) burden bear 87% of the world’s TB cases. Delayed diagnosis and treatment are detrimental to TB prognosis and sustain TB transmission in the community, making TB elimination a great challenge, especially in these countries. Our objective was to elucidate the duration and determinants of delayed diagnosis and treatment of pulmonary TB in high TB-burden countries. Methods We conducted a systematic review and meta-analysis of quantitative and qualitative studies by searching four databases for literature published between 2008 and 2018 following PRISMA guidelines. We performed a narrative synthesis of the covariates significantly associated with patient, health system, treatment, and total delays. The pooled median duration of delay and effect sizes of covariates were estimated using random-effects meta-analyses. We identified key qualitative themes using thematic analysis. Results This review included 124 articles from 14 low- and lower-middle-income countries (LIC and LMIC) and five upper-middle-income countries (UMIC). The pooled median duration of delays (in days) were—patient delay (LIC/LMIC: 28 (95% CI 20–30); UMIC: 10 (95% CI 10–20), health system delay (LIC/LMIC: 14 (95% CI 2–28); UMIC: 4 (95% CI 2–4), and treatment delay (LIC/LMIC: 14 (95% CI 3–84); UMIC: 0 (95% CI 0–1). There was consistent evidence that being female and rural residence was associated with longer patient delay. Patient delay was also associated with other individual, interpersonal, and community risk factors such as poor TB knowledge, long chains of care-seeking through private/multiple providers, perceived stigma, financial insecurities, and poor access to healthcare. Organizational and policy factors mediated health system and treatment delays. These factors included the lack of resources and complex administrative procedures and systems at the health facilities. We identified data gaps in 11 high-burden countries. Conclusions This review presented the duration of delays and detailed the determinants of delayed TB diagnosis and treatment in high-burden countries. The gaps identified could be addressed through tailored approaches, education, and at a higher level, through health system strengthening and provision of universal health coverage to reduce delays and improve access to TB diagnosis and care. PROSPERO registration: CRD42018107237.

scholarly journals Determinants of delayed diagnosis and treatment of tuberculosis in high-burden countries: a mixed-methods systematic review and meta-analysis

2020 ◽  
Author(s):  
Alvin Kuo Jing Teo ◽  
Shweta R Singh ◽  
Kiesha Prem ◽  
Li Yang Hsu ◽  
Siyan Yi
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Meta Analysis ◽  
Delayed Diagnosis ◽  
Treatment Delay ◽  
Diagnosis And Treatment ◽  
Middle Income ◽  
High Burden ◽  
Middle Income Countries ◽  
Patient Health

Abstract Background: Globally, 30 countries with the highest tuberculosis (TB) burden bears 87% of the world’s TB cases. Delayed diagnosis and treatment are detrimental to TB prognosis and sustain TB transmission in the community, making TB elimination a great challenge, especially in these countries. Our objective was to elucidate the determinants and duration of delayed diagnosis and treatment of pulmonary TB in high TB burden countries. Methods: We conducted a systematic review and meta-analysis of quantitative and qualitative studies by searching four databases for literature published between 2008 and 2018 following PRISMA guidelines. For quantitative studies, we performed narrative synthesis of the covariates that were significantly associated with patient, health system, treatment, and total delays. The pooled median duration of delay and effect sizes of covariates were estimated using random-effects meta-analyses. We identified key qualitative themes using thematic analysis. Results: We included 124 articles from 14 low-and lower-middle-income countries (LIC and LMIC) and five upper-middle-income countries (UMIC) in this review. The pooled median duration of patient, health system, and treatment delay were 28 days (95%CI 20–30), 11.5 days (95%CI 3.9–24.7), and six days (95%CI 1–28.4), respectively. We found that the duration of delays was consistently shorter among UMIC compared to LIC and LMIC. There was consistent evidence that being female and rural residence was associated with longer patient delay. Furthermore, patient delay was also associated with other individual, interpersonal, and community risk factors such as poor TB knowledge, long chains of care-seeking through private/multiple providers, perceived stigma, financial insecurities, and poor access to healthcare. Health system and treatment delay were mediated by organizational and policy factors. These factors included the lack of resources and complex administrative procedures and systems at the health facilities. We identified data gaps in 11 high burden countries. Conclusions: This review detailed the determinants of delayed TB diagnosis and treatment in high burden countries. The gaps identified at different socio-ecological levels could be addressed through tailored approaches, education, and at a higher level, through health system strengthening and provision of universal health coverage to reduce delays and improve access to TB diagnosis and care.

scholarly journals 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 ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015444 ◽  
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.

scholarly journals A Systematic Review and Meta-Analysis of Buyang Huanwu Decoction in Animal Model of Focal Cerebral Ischemia

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Rui-li Wei ◽  
Hai-juan Teng ◽  
Bo Yin ◽  
Yang Xu ◽  
Yue Du ◽  
...  
Keyword(s):  
Systematic Review ◽  
Focal Cerebral Ischemia ◽  
Meta Analysis ◽  
Cell Types ◽  
Experimental Stroke ◽  
Current Evidence ◽  
Future Research ◽  
Neuroprotective Effects ◽  
Buyang Huanwu Decoction ◽  
Therapy Strategy

Buyang Huanwu Decoction (BHD) is a well-known Chinese herbal prescription for ischemic stroke. The objective of this systematic review and meta-analysis is to provide the current evidence for neuroprotective effects of BHD and its possible mechanisms in animal models of focal ischemia. A systematic literature search, through October 2012, was performed using six databases. The outcome measures assessed were infarct size and/or neurological score. Fifty-six studies with 1270 animals that met the inclusion criteria were identified. The median score for methodological quality was 3 with a range of 2 to 6. Compared with vehicle or no treatment controls, BHD gave a 37% improvement in outcome for all doses ranging from 1.0 g/kg to 60 g/kg at each time point that BHD was administered (P<0.01). Efficacy was higher in mouse models that utilized suture occlusion and temporary ischemia. The neuroprotective effects of BHD are involved in multiple mechanisms and act upon multiple cell types. In conclusion, BHD possesses substantial neuroprotective effects in experimental stroke probably as a result of the multitarget therapy strategy typically utilized in traditional Chinese medicine. Future research should examine the presence of possible experimental bias and an in-depth study of herbal compound preparations.

scholarly journals Association of Plasma Thrombin-Antithrombin Complex and Ischemic Stroke: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Peipei Song ◽  
Jianqin Xie ◽  
Wei Li ◽  
Xinying Zhang ◽  
Zhipeng Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Meta Analysis ◽  
Cardioembolic Stroke ◽  
Current Evidence ◽  
Cochrane Library ◽  
Healthy Controls ◽  
Chi Square ◽  
Chi Square Test ◽  
The Relationship

Abstract Background and objectiveThrombin-antithrombin complex (TAT) is a prethrombotic marker, and its application in ischemic stroke is still uncertain. The purpose of this systematic review and meta-analysis is to evaluate the relationship between plasma TAT and ischemic stroke base on the current evidence.MethodsA systematic literature search was conducted for searching the relative studies that investigated the association of TAT and ischemic stroke in PubMed, EMBASE, and Cochrane library databases. Mean difference and 95% confidence interval as the effect sizes were synthesized by random effects model in Review Manager (RevMan) Version 5.4. Then, the heterogeneity was investigated using the Chi-square test and the possible sources of heterogeneity were explored by sensitivity analysis. The publication bias was estimated through Begg’s and Egger’s tests.ResultsA total of 12 eligible studies were included involving 1431 stroke cases and 532 healthy controls, of which six studies were eventually included in the meta-analysis. Plasma TAT in patients with ischemic stroke was significantly higher than that in healthy controls (MD 5.31, 95% CI =4.12-6.51, P<0.0001, I2=97.8 %). There is a difference of TAT level in the same period among cardioembolic, lacunar and atherothrombotic stroke (all P<0.0001), in which the cardioembolic stroke with the highest level. Meanwhile, it is significant of TAT levels among various phases of cardioembolic stroke and the acute phase are markedly elevated (MD 7.75, 95CI%, 6.07-9.43, P<0.001). However, no difference was found in the atherothrombotic (P=0.13) and lacunar stroke (P=0.34). Besides, the higher TAT level is closely related to the poor prognosis of patients with ischemic stroke, including higher recurrence, mortality, unfavorable recovery (modified Rankin scale >2), and poor revascularization.ConclusionsThis study suggested that plasma TAT levels are different in ischemic stroke subtypes, which are closely associated with the progression and might have an effect on the prognosis. PROSPERO CRD: 42021248787

Music Making Interventions with Adults in the Forensic Setting – A Systematic Review of the Literature – Part II: Case Studies and Good vibrations

2015 ◽  
Vol 7 (4) ◽  
pp. 50
Author(s):  
Biljana V. Coutinho ◽  
Anita L. Hansen ◽  
Leif Waage ◽  
Thomas K. Hillecke ◽  
Julian Koenig
Keyword(s):  
Systematic Review ◽  
Music Therapy ◽  
Case Studies ◽  
Meta Analysis ◽  
Current Evidence ◽  
Future Research ◽  
Music Making ◽  
Prisma Statement ◽  
Forensic Setting ◽  
Set Up

The purpose of this systematic review of international research is to summarize the available literature on active music making interventions with adult offenders in forensic settings (i.e. forensic psychiatry or correctional facilities at different security levels). A systematic search of 13 electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) statement was employed. 28 articles fitting the inclusion criteria were included in the review. The search revealed mainly qualitative and narrative reports including articles on group music therapy, educational music making, choir interventions, individual music therapy sessions and musical projects. The musical interventions are described in detail to provide therapists with ideas on how to set up session with clients who may be in this particular situation and to help them understand the possible impact of musical interventions in the forensic setting. Furthermore, implications from the current evidence and ideas for future research are discussed. Note: Due to the length of the review it is published in two subsequent issues. This is the second part of the review focusing on case studies and the Good Vibrations program. The first part of the review was published in the previous issue of Music and Medicine focusing on group interventions.

Music Making Interventions with Adults in the Forensic Setting – A Systematic Review of the Literature – Part I: Group Interventions

2015 ◽  
Vol 7 (3) ◽  
pp. 40
Author(s):  
Biljana Vrancic Coutinho ◽  
Anita Lill Hansen ◽  
Leif Waage ◽  
Thomas K. Hillecke ◽  
Julian Koenig
Keyword(s):  
Systematic Review ◽  
Music Therapy ◽  
Meta Analysis ◽  
Current Evidence ◽  
Future Research ◽  
Group Interventions ◽  
Subsequent Issue ◽  
Music Making ◽  
Forensic Setting ◽  
Set Up

The purpose of this systematic review of international research is to summarize the available literature on active music making interventions with adult offenders in forensic settings (i.e. forensic psychiatry or correctional facilities at different security levels). A systematic search of 13 electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) statement was employed. 28 articles fitting the inclusion criteria were included in the review. The search revealed mainly qualitative and narrative reports including articles on group music therapy, educational music making, choir interventions, individual music therapy sessions and musical projects. The musical interventions are described in detail to provide therapists with ideas on how to set up session with clients in this particular situation and to help understand the possible impact of musical interventions in the forensic setting. Furthermore, implications from the current evidence and ideas for future research are discussed. Note: Due to the length of the review it is published in two subsequent issues. This is the first part of the review focusing on group interventions. The second part of the review is published in the subsequent issue of Music and Medicine focusing on case studies and established music programs in the forensic setting.

scholarly journals O29 IDENTIFYING PREDICTORS OF VENTRAL HERNIA RECURRENCE: SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Samuel Parker ◽  
Sue Mallet ◽  
Laura Quinn ◽  
Christopher Wood ◽  
Richard Boulton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ventral Hernia ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Current Evidence ◽  
Future Research ◽  
Chronic Obstructive ◽  
Co Morbidity ◽  
Current Evidence Base

Abstract Aim Ventral hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence. Material and Methods PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool). Results Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III–IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence. Conclusions This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research.

scholarly journals Effectiveness of Web-based Cognitive Bias Intervention for Psychiatric Disorders: A Systematic Review Protocol (Preprint)

2018 ◽  
Author(s):  
Melvyn Zhang ◽  
Jiangbo Ying ◽  
Guo Song ◽  
Daniel SS Fung ◽  
Helen Smith
Keyword(s):  
Systematic Review ◽  
Psychiatric Disorders ◽  
Cognitive Bias ◽  
Cognitive Biases ◽  
Meta Analysis ◽  
Cognitive Bias Modification ◽  
Current Evidence ◽  
Future Research ◽  
Web Based ◽  
Bias Modification

UNSTRUCTURED Background: Traditional psychological therapies focus mainly on modification of individuals’ conscious decision-making process. Unconscious processes such as cognitive biases have been found to be accountable for various psychiatric psychopathologies. The advances in technologies have transformed how bias modification programs are being delivered. Objective: We seek to synthesize the current evidence of web-based cognitive bias modification for psychiatric disorders, by identifying the range of conditions targeted and their current efficacy. We wish to determine if web-based attention bias modification is as efficacious as compared to conventional methods. Methods and analysis: A systematic review will be conducted, and all studies types will be included. There will not be any restrictions on the participants included in the study. A search will be conducted on the respective databases up till 2017. Selection of studies will be by the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA-P) guidelines. Quality assessment of the included studies will be assessed using the Cochrane Risk of Bias tool (for randomized trials) and the Newcastle-Ottawa scale for other study designs. A narrative synthesises of the identified articles will be conducted. A meta-analysis will be considered, only if there are sufficient articles in a domain for statistical analysis. Ethical approval for the current protocol and the planned systematic review was not required. Results: Results synthesized would be disseminated using conference presentation or published works in peer-reviewed journals. Conclusions: This review is of importance given how technology transformed the delivery of conventional therapies. The findings from this review will provide guidance for future research involving technology and cognitive bias modification interventions. Registration details: International Prospective Register for Systematic Reviews (PROSPERO) number 2017 CRD42017074754

scholarly journals Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
S G Parker ◽  
S . Mallett ◽  
L Quinn ◽  
C P J Wood ◽  
R W Boulton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ventral Hernia ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Current Evidence ◽  
Future Research ◽  
Chronic Obstructive ◽  
Co Morbidity ◽  
Current Evidence Base

Abstract Background Ventra hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence. Methods PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool). Results Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III–IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence. Conclusion This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research.

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