scholarly journals Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031844
Author(s):  
Gitau Mburu ◽  
Ewemade Igbinedion ◽  
Sin How Lim ◽  
Aung Zayar Paing ◽  
Siyan Yi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Private Sector ◽  
Clinical Outcomes ◽  
Low Income ◽  
Hiv Treatment ◽  
Future Research ◽  
Publication Date ◽  
Middle Income ◽  
Middle Income Countries ◽  
Secondary Outcomes

IntroductionPrivate sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC.Methods and analysisThis review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with <1000 copies/mL; (3) rate of all-cause mortality among ART recipients. Secondary outcomes will include: (1) proportion receivingPneumocystis jirovecipneumonia prophylaxis; (2) proportion with >90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results.Ethics and disseminationThe results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research.PROSPERO registration numberCRD42016040053.

scholarly journals Private sector delivery of quality care for maternal, newborn and child health in low-income and middle-income countries: a mixed-methods systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e033141
Author(s):  
Samantha R Lattof ◽  
Blerta Maliqi
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Child Health ◽  
Private Sector ◽  
Low Income ◽  
Quality Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Child Health

IntroductionTo accelerate progress to reach the sustainable development goals for ending preventable maternal, newborn and child deaths, it is critical that both the public and private health service delivery systems invest in increasing coverage of interventions to sustainably deliver quality care for mothers, newborns and children at scale. Although various approaches have been successful in high-income countries, little is known about how to effectively engage and sustain private sector involvement in delivering quality care in low-income and middle-income countries. Our systematic review will examine private sector implementation of quality care for maternal, newborn and child health (MNCH) and the impact of this care. This protocol details our intended methodological and analytical approaches, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline for protocols.Methods and analysisFollowing the PRISMA approach, this systematic review will include quantitative, qualitative and mixed-methods studies addressing the provision of quality MNCH care by private sector providers. Eight databases (Cumulative Index to Nursing and Allied Health, EconLit, Excerpta Medica Database, International Bibliography of the Social Sciences, Popline, PubMed, ScienceDirect, Web of Science) and two websites will be searched for relevant studies published between 1 January 1995 and 30 June 2019. For inclusion, studies in low-income and middle-income countries must examine at least one of the following critical outcomes: maternal morbidity or mortality, newborn morbidity or mortality, child morbidity or mortality, quality of care, experience of care and service utilisation. Depending on the data, analyses could include meta-analysis, descriptive quantitative statistics, narrative synthesis and thematic synthesis. Quality will be assessed using tools for qualitative and quantitative studies.Ethics and disseminationFormal ethical approval is not required for this research, as the secondary data are not identifiable. Findings from this review will be used to develop models for effective collaboration of the private and public sectors in implementing quality of care for MNCH. In addition to publishing our findings in a peer-reviewed journal, the findings will be shared through the Quality of Care Network, relevant mailing lists, webinars and social media.PROSPERO registration numberCRD42019143383

scholarly journals The Magnitude of Unsafe Child Feces Disposal Practices and Its Association With Reported Diarrhea in Low-income and Middle-income Countries: A Systematic Review and Meta-analysis Protocol

2020 ◽  
Author(s):  
Negasa Eshete Soboksa ◽  
Bekam Kebede Olkeba ◽  
Dinkinesh Begna Gudeta
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Current Evidence ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Future Research ◽  
Childhood Diarrhea ◽  
Middle Income ◽  
Middle Income Countries ◽  
Google Search

Abstract Introduction:The unsafe disposal of children’s feces may be an important contaminant in household environments, posing a high risk of exposure to infants. Several studies done on the magnitude of unsafe disposal of child feces and its association with reported childhood diarrheahave variedoutcomesand no tries have been made to systematically review this. Therefore, itis necessitating a systematic review to provide an exhaustive summary of current evidence. Thus, the objective ofthis study will be to pool out the available evidence on the magnitude of unsafe child feces disposalpractices and its association with reported childhood diarrhea in low-income and middle-income countries. Methods: PubMed, Science Direct, Cochrane Library database, and Ovid Medline will be searched to identify relevant literature for this review. Moreover, Google search engine, Google Scholar, and references of other studieswill be searched from January 2000 to December 2020. The primary outcome of interest will bethe magnitude of unsafe disposal of child feces and the secondary outcome will be its association with reported diarrhea. Observationalstudies (cross-sectional studies, case-control studies, and cohort studies) written in English will be included in this review. The selected studies will be critically appraised by two independent reviewers using an appropriate tool. The pooled magnitude of unsafe disposal of child feces and its association with reported childhood diarrhea will be analyzed using Stata version 16. Heterogeneity will be assessed using the chi-square test (Q-test) statistics and inverse variance index (I2). Forest plots will be used to present the combined estimate with 95% CI.A funnel plot and Egger’s test of small study bias will be used to assess publication bias.Discussion:This systematic review will identify the evidence available on themagnitude of unsafe child fecesdisposal practicesand its associationwith reported diarrhea. The findings from this study will bemade publicly available in a repository and published in a peer-reviewed journal. The findings from this study will also provide directions for future research and public health professionals with an understanding of the importance of safe child feces disposal practices to preventingchildhood diarrhea in the community.Systematic review registrationnumber: PROSPERO CRD42020189034

scholarly journals Implementation of clean cookstove interventions and its effects on blood pressure in low-income and middle-income countries: systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026517 ◽  
Author(s):  
Deborah Onakomaiya ◽  
Joyce Gyamfi ◽  
Juliet Iwelunmor ◽  
Jumoke Opeyemi ◽  
Mofetoluwa Oluwasanmi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Implementation Science ◽  
Low Income ◽  
Cochrane Library ◽  
Publication Date ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Implementation Outcomes

ObjectiveA review of the implementation outcomes of clean cookstove use, and its effects on blood pressure (BP) in low-income and middle-income countries (LMICs).DesignSystematic review of studies that reported the effect of clean cookstove use on BP among women, and implementation science outcomes in LMICs.Data sourcesWe searched PubMed, Embase, INSPEC, Scielo, Cochrane Library, Global Health and Web of Science PLUS. We conducted searches in November 2017 with a repeat in May 2018. We did not restrict article publication date.Eligibility criteria for selecting studiesWe included only studies conducted in LMICs, published in English, regardless of publication year and studies that examined the use of improved or clean cookstove intervention on BP. Two authors independently screened journal article titles, abstracts and full-text articles to identify those that included the following search terms: high BP, hypertension and or household air pollution, LMICs, cookstove and implementation outcomes.ResultsOf the 461 non-duplicate articles identified, three randomised controlled trials (RCTs) (in Nigeria, Guatemala and Ghana) and two studies of pre–post design (in Bolivia and Nicaragua) met eligibility criteria. These articles evaluated the effect of cookstove use on BP in women. Two of the three RCTs reported a mean reduction in diastolic BP of −2.8 mm Hg (−5.0, –0.6; p=0.01) for the Nigerian study; −3.0 mm Hg; (−5.7, –0.4; p=0.02) for the Guatemalan study; while the study conducted in Ghana reported a non-significant change in BP. The pre–post studies reported a significant reduction in mean systolic BP of −5.5 mm Hg; (p=0.01) for the Bolivian study, and −5.9 mm Hg (−11.3, –0.4; p=0.05) for the Nicaraguan study. Implementation science outcomes were reported in all five studies (three reported feasibility, one reported adoption and one reported feasibility and adoption of cookstove interventions).ConclusionAlthough this review demonstrated that there is limited evidence on the implementation of clean cookstove use in LMICs, the effects of clean cookstove on BP were significant for both systolic and diastolic BP among women. Future studies should consider standardised reporting of implementation outcomes.

scholarly journals Economics of physical activity in low-income and middle- income countries: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e037784
Author(s):  
Priyanga Diloshini Ranasinghe ◽  
Subhash Pokhrel ◽  
Nana Kwame Anokye
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Economic Evaluation ◽  
Drug Treatment ◽  
Chronic Diseases ◽  
Low Income ◽  
Economic Burden ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries

BackgroundPromotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs).ObjectiveThe objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations.Data sourcesA systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature.Study eligibility criteriaCost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria.Study appraisal and synthesis of methodsScreening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed.ResultsThe majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost–utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil.LimitationsMeta-analysis was not performed due to heterogeneity of the studies.Conclusions and recommendationsEconomic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas.PROSPERO registration numberCRD42018099856.

scholarly journals Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis

2021 ◽  
pp. archdischild-2020-321385
Author(s):  
Omar Irfan ◽  
Fiona Muttalib ◽  
Kun Tang ◽  
Li Jiang ◽  
Zohra S Lassi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
World Bank ◽  
Low Income ◽  
Meta Analysis ◽  
Severe Disease ◽  
Income Level ◽  
Clinical Findings ◽  
Middle Income ◽  
Middle Income Countries

ObjectiveCompare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity.DesignSystematic review and meta-analysis.SettingBetween 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0–19 years old) COVID-19 were considered for inclusion.Main outcomes and measuresThe pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity.Results129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample.ConclusionPaediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally.

scholarly journals Health promotion at the workplace setting: a protocol for a systematic review of effectiveness and sustainability of current practice in low-income and middle-income countries

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027050
Author(s):  
Mary Njeri Wanjau ◽  
Belen Zapata-Diomedi ◽  
Lennert Veerman
Keyword(s):  
Systematic Review ◽  
Health Promotion ◽  
Systematic Reviews ◽  
Low Income ◽  
Workplace Health Promotion ◽  
The Body ◽  
Workplace Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Workplace Setting

IntroductionLow-income and middle-income countries (LMICs) are experiencing a growing disease burden due to non-communicable diseases (NCDs). Changing behavioural practices, such as diets high in saturated fat, salt and sugar and sedentary lifestyles, have been associated with the increase in NCDs. Health promotion at the workplace setting is considered effective in the fight against NCDs and has been reported to yield numerous benefits. However, there is a need to generate evidence on the effectiveness and sustainability of workplace health promotion practice specific to LMICs. We aim to synthesise the current literature on workplace health promotion in LMICs focusing on interventions effectiveness and sustainability.Methods and analysisWe will conduct a systematic review of published studies from LMICs up to 31 March 2019. We will search the following databases: EMBASE, MEDLINE, PubMed, Web of Science, Scopus, ProQuest and CINAHL. Two reviewers will independently screen potential articles for inclusion and disagreements will be resolved by consensus. We will appraise the quality and risk of bias of included studies using two tools from the Cochrane handbook for systematic reviews of interventions. We will present a narrative overview and assessment of the body of evidence derived from the comprehensive review of the studies. The reported outcomes will be summarised by study design, duration, intensity/frequency of intervention delivery and by the six-priority health promotion action areas set out in the Ottawa Charter. We will conduct a thematic analysis to identify the focus areas of current interventions. This systematic review protocol has been prepared according to the Preferred Reporting Items for Systematic reviews and Meta- analyses for Protocols 2015 statement.Ethics and disseminationThis study does not require ethics approval. We will disseminate the results of this review through peer-reviewed publications and conference presentations.Trial registration numberCRD42018110853.

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